When I sat down with the doctor at Prevén’s clinic at UPRM, I admittedly found myself a tad nervous even though I was not here for anything serious, just a casual conversation where I was going to dive headfirst into some of the questions people are too shy to ask. Midway through the conversation with the doctor, I realized there was no reason for this shyness to prevail; these women are as “chill” as can be, they’re here to help us and honestly, they’ve seen and heard it all.
The doctors at Prevén are general physicians but, needless to say, they are well-versed in matters of sexual health and contraception. Here’s what one doctor had to say:
When should one use condoms?
Every time, and everyone must use them; that also includes women who have sex with women.
You should also use condoms during oral sex; this is a habit people should have. People usually don’t do this, but it would be beneficial because it could prevent infections like genital and oral herpes. In oral sex, if the patient has a lesion, it can be transferred to the person receiving oral sex.
Is there any difference between a male and female condom? Which one is better?
In terms of their efficiency, there isn’t any difference. They are both for protection and are both efficient.
Say I had unprotected sex and my partner ejaculated inside me. I’m already on the pill. Should I take a Plan B?
You don’t have to use it, because you’re already covered. The Plan B pill is not something that should be used all the time; in fact, it should only be used up to twice a year. You would be wasting your opportunities to use the Plan B when you don’t really need it, because you already have the birth control method you would be using.
Does the Plan B lose its effect if I’m overweight?
If you’re overweight it wouldn’t lose any of its effect. However, being overweight is only thing, but being morbidly obese is another. If you have morbid obesity, the Plan B pill does lose its effect, because the hormone dosage of the pill wouldn’t be enough to have an effect on your system.
Can I get pregnant if I had unprotected sex during my period?
No, because when you’re menstruating you are expelling the endometrium, the inner layer of your uterus. There won’t be any way for the ovum to be implanted because all that internal uterine wall is coming off.
Say I’ve missed two menstrual cycles and I’m not sexually active/don’t have a male partner. Should I be worried?
It’s likely that you have an irregular period. In that case, you would have to visit a gynecologist to take some tests and figure out what’s going on. In some cases, birth control pills can be used to regulate your period.
Are IUDs (intrauterine devices) better than pills?
There are some benefits. IUDs are T-shaped devices that are inserted inside the uterus and can stay there up to five years, while with the pills, you simply take them daily and that’s that. The pills always have hormones; some IUDs don’t. There are IUDs made of copper, which are released to avoid ovulation. Over time, the endometrium gets thinner and the menstruation is always going to be moderate. Meanwhile, hormonal birth control pills have secondary effects in the first two weeks of taking them: headaches, breast tenderness, nausea, while some women gain weight, get acne or some get clearer skin.
If I had an abortion, could I get pregnant again if I wanted to?
Of course, why not? Sometimes abortion happens spontaneously. Sometimes the baby has genetic deformations and can’t get implanted correctly, so the female body expulses it. Afterwards, all that area recuperates and eventually you can get pregnant again; this applies to surgical abortions performed by a doctor or an induced abortion, which the women administers at home with prescribed pills. But if somebody introduced a strange object, that would be another story, because you could damage your insides. Otherwise, your fertility would not be affected. Abortion should always be performed by a registered medical doctor certified to perform abortions.
I’ve been using birth control pills for some time and I plan on using them even longer. Would this affect my fertility?
No, you can get pregnant again after the two-week period after you stopped using the pills. It doesn’t matter if you used them for a long period of time. There are women here that have used them for years and now have their families.
I usually get UTIs after sex. Am I doing something wrong?
Yes. UTIs are caused by the bacteria E.coli, which is found in the anal area, where it doesn’t do damage, though it can be opportunist. Let’s say that you had anal sex and right after, you had vaginal sex, what do you think could happen there? The vagina would be colonized by the microorganisms of the anal area, which can cause a UTI. There are also some women who don’t clean themselves correctly and do it from the back to the front instead of front to back. In some other cases where the partner performs cunnilingus could cause infections as well. The key is to stay clean before, during, and after sex. Emptying your bladder after sex helps too, as it naturally clears your urinary tract of many harmful bacteria.
How often should I get tested for STDs?
It depends of the patient’s sexual life. People should get tested each time they change partners, or every six months.
What is something you’d like all women to know about their sexual health?
That they shouldn’t have sex only to satisfy their partner or under pressure: there should always be consent. Every woman that has sex should do it because she wants to, not because she’s being obligated or coerced, because it is a very personal, important decision and an act that should only be shared if one wants. To the ladies of Colegio, I’d tell you to be very selective of the people you are intimate with.
Some things you’d like to add?
I think you should add that for every woman in their reproductive stage they should take 400 mg of folic acid, which is sold over-the-counter at any pharmacy. The baby needs this in its first 3 weeks to develop the neural tube.
Every woman who has sex must use a condom, because even if you think you know your partner, anything can happen. As a reminder, there are cures for gonorrhea, syphilis and chlamydia, but there is no cure for herpes or HIV, and there are a lot of other STDs, like vaginosis. Additionally, it’s always good to perform the breast exam for breast cancer one week after menstruating.
Finally, no woman should feel judged or ashamed if she chooses to get an abortion. At Prevén, this is not promoted but if a woman chooses to do it, she will be provided enough help to go through with her decision. However, there are many ways to avoid an unwanted pregnancy and thus, avoid an abortion.