Q&A: Emergency Contraception - Female Anatomy

General Information about Emergency Contraception can be found here:

Reproductive Health Page

Back to Topics Page

Emergency Contraception--birth control AFTER the fact...

On Cilest but...

I had an abortion on 2nd Sept and after two weeks I went for the Cilest method of contraception where the doctor advised me to take it for the first seven days before I had any unprotected sex. On the 8th day of taking the prescribed Cilest I had unprotected full sex. I have continued taking the Cilest as prescribed before. Do you think that there is a possibility that I might be pregnant again?

You followed your doctor's orders, so pregnancy is unlikely as long as you did not miss any pills.

Back to Topics Page

Changed pill time

I changed the time I take my pill in the middle of a pack. The first week I took them at 10 pm, the second, 10:30 pm, I know it's only a half an hour, but If I had sex at the end of the 2nd week, should I be thinking about EC?

Good question. Yes you are still protected. As long as you have been taking it every day around the same time, and have not missed any days, you are protected.

Back to Topics Page

TWO QUESTIONS- Very Similar:

Took EC, having discharge

My girlfriend took the morning after pill 6 days ago. Today she is producing a brown discharge which is odorless. It looks like it could be blood as I have heard the morning after pill can cause spotting. Is this the probable problem? What else could it be? Do you think it should be checked out?

...AND...

I had sex 2 1/2 weeks ago but he didn't come in me. I still took an emergency contraceptive just in case. A week later I had bleeding which I thought was my period, but it only lasted 2 days and it was 2 weeks early. Now I am having brown discharge, but I'm not supposed to start until next week. Could I be pregnant??

The brown spotting is old blood. Emergency contraceptive pills can cause spotting. It is difficult to say what this is without knowing more about your girlfriend's cycle and form of birth control. Please have her talk to her health care provider.

As for question 2, it is unlikely a pregnancy occurred, but the best way to know is to take a home pregnancy test or see your local family planning center for one. While you're there, talk to them about prescribing a reliable form of birth control. EC is not meant to be birth control - it's for emergencies. You should be using something every time you have sex if you do not wish to become pregnant. Take care of yourself.

Back to Topics Page

EC QUESTIONS

Took EC, had sex

My boyfriend and I already have a son, so we've been extremely faithful in our condom use ever since. But we slipped up once, very near the end of my cycle, used the withdrawal method, and the moring after I took emergency contraceptives. I took the first in the morning, the second 12 hours later, as instructed, but then an hour after I took the second pill, we had sex again and again used the withdrawal method.

Was the emergency contraceptive still in my system enough to prevent pregnancy, or should I worry?

Yes the emergency contraception you took will still be working for you. Good question!

Back to Topics Page

Plan B but period is late

I have a regular cycle every 30 days. I was prescribed Plan B for obvious reasons in January, after my January cycle. In February, I took a pregnancy test that came out negative. I also received my period on my regular date. Now that it is March, my period is either really late, or missed. I have not had sex since that day in January and I wasn't pregnant in February. So what could be going on?

If you have not had unprotected intercourse since your February period then pregnancy is very unlikely. Nevertheless, we would always repeat a pregnancy test and if negative wait to see if you get a period in April. You should keep in touch with your provider until things are back to normal. Take care.

Back to Topics Page

EC and delayed period

I took Emergency Contraception last week because the condom broke and I was on antibiotics. My period would have normally been on last Thursday, it came and went with no period. On Saturday I took a home pregnancy test and it was negative. But I still have not gotten my period-so I'm still concerned. Is this a normal occurrence after taking EC?

Yes, it is normal for a delayed period. Another pregnancy test is recommended if you do not get your period in the next week.

Back to Topics Page

ECs on the weekend

How do I get emergency contraceptives in New Jersey on the weekend?

Call 1-800-NOT TOO LATE from anywhere in the U.S.A. to get the Emergency Contraception provider closest to you .

Back to Topics Page

Missed a pill - do I need EC?

I am currently taking Cilest [Ortho Tri-Cyclen]. I take it every day at 6.00 pm. I forgot to take it the other day and I remembered to take it at 7.30 am next morning so I took it then. I then had unprotected sex. Can I take the morning after pill even though I am on the pill just to make sure I am not pregnant?

You missed taking your pill by just 12 hours. You are still protected by your method and EC is not necessary. Missing 2 or more pills would put you at risk.

Back to Topics Page

Can't get an appointment in time

I was having sex with my g/f and the condom broke... she wanted to go to the family planning center in our area but they don't have any appointments available soon enough to get the morning after pill. What should we do?

Perhaps when you called they did not understand what you needed - you do not need an appointment to get the morning after pill. Call the clinic back and tell them you need Emergency Contraception (EC) NOW. It needs to be taken within 72 hours of intercourse to be most effective. If you In you are in Maine you can call 1-800-887-4029 and talk to a nurse about how to get EC. If you are not in Maine, visit this website: www.not-2-late.com. There is some great information there, additionally they have a page where you can search for a provider in your area.

Back to top of page

Morning after pill

How much does it cost to get the morning after pill if you don't have any insurance?

If you get emergency contraception (morning after pill) from a family planning center, the charge is on a sliding fee scale based on your income. If you get the EC from a Pharmacy, with a prescription, it can cost around $30.00. Call your local family planning center for more details.

Back to top of page

Can I go to a clinic and get a pill to make sure I won't get pregnant after unprotected sex within 72 hours of it?

Yes, they are called Emergency Contraception Pills which are two pills that you take that will significantly lower your risk of an act of unprotected intercourse resulting in a pregnancy.They are commonly used for cases where birth control failed or the sex was unexpected. To be most effective, ECPs must be taken within 72 hours of intercourse. Please go to this link for more information about ECPs:

www.not-too-late.com

Then call your local family planning clinic to see where you can find them! Good luck!

Back to Topics Page

FEMALE ANATOMY

FAQ - Vaginal Discharge:
It is perfectly normal for all women to have some vaginal discharge; it's your vagina's way of taking care of itself. The time to worry is when it seems like there is a lot more than usual, and/or it's accompanied by a strong odor and/or it is accompanied by burning or itching or sex is painful and/or it is an unusual color (but not near your period). Writing to this column will not help - you need an examination! Please go to your local family planning clinic or health care provider.

Back to Topics Page

FEMALE ANATOMY QUESTIONS

Itching, burning continues

Five months ago I started to have a very intense itch and burning pain on urination and white chalky vaginal discharge. I went for a complete check-up at a local family planning center. It was confirmed that I had BV and received treatment. I looked up the possible causes of BV on the internet and tried to avoid it from happening again.

It's been 5 months, I have had no intercourse, avoided everything that could have endangered my situation and yet I still seem to have the itch every now and then and constant discharge plus burning pain on urination.

Two weeks ago I went for a second check-up to find out if I still had BV. The test showed nothing. Also my urine test is ok. I'm so fed up with the whole thing. The doctors don't know what else to do. They keep telling me they checked for infection and the results showed none and that I should drink lots of water. Do you think I could have some form of abnormalities or something that needs other types of examination (i.e. a smear test)?

You absolutely do need further follow-up for your symptoms. Frankly, the white discharge and the itching sound more like a yeast infection than BV (the discharge associated with BV is often described as thin and greyish or whitish and has a distinctive fishy smell), but it sounds as if your providers looked carefully for all kinds of vaginal and bladder infections at both visits. I’m assuming that they checked you for gonorrhea and chlamydia and trichomoniasis at your visits as well.

A small amount of vaginal discharge can be normal, and by itself would be nothing to worry about, but the burning pain with urination IS NOT NORMAL. There are some chronic problems NOT caused by infection that can cause constant burning with urination. If your providers have run out of ideas, then it’s time to ask them for a referral to a urologist, a doctor who specializes in bladder and kidney problems.

Back to Topics Page

Anal and vaginal sex

My boyfriend and I had intercourse, and in this intercourse, we had vaginal sex, anal sex, then back to vaginal sex...without washing. While having the oral sex, I experienced immense pain, and I also bled I am scared now, because I think it is quite possible that I have contracted an illness of some sort. What I would like to know is, what happens to the body when anal sex is perform then immediately followed by vaginal sex?

We're guessing that you mean "while having the anal sex" (penis in the anus or butt sex) you had pain and bleeding. We advise folks to make sure they are VERY gentle and use LOTS AND LOTS of lubrication during anal sex because the tissue of the anus is fragile and prone to bleeding and pain when sex is too fast or rough.

We also advise that everyone having anal sex use condoms because unprotected anal sex is a big risk factor for disease transmission. When having anal then vaginal sex, it's particularly important to change condoms when going from the anus to the vagina. The anus contains bacteria that are harmless in the anus, but that can cause a bacterial infection in the vagina. The bacteria have also been linked to urinary tract infections. (It's also important because using a fresh condom makes it less likely that a condom will break!)

If you were having sex without condoms (vaginal OR anal), and you are not your partner's first partner and/or he's not your first partner, then you are at risk for sexually transmitted infections (STIs). It's important that you be checked for STIs as a part of your annual exam or if you or your boyfriend develop any symptoms (itching, increased discharge, bad vaginal odor, discharge from his penis, bumps on your genitals, sores, abdominal pain, or irregular bleeding).

Back to Topics Page

Had BV, now itching

I am 25 and recently got married. I had no sex before marriage. A few weeks after losing my virginity to my husband I developed Bacterial Vaginosis (three months ago). This was confirmed after I received a sexual health screening at my local clinic. The doctor prescribed me some antibiotics (28 tabs for 2 weeks).

I'm fine as long as I don't have sex but as soon as I get a bit lubricated it itches and the following day I keep having itchings in and around my vagina. Last time I attempted to actually have sex was before my treatment where I felt a lot of pain and irritation inside my vagina. After that I did not dare to attempt again. All I know is that as soon as I get a bit lubricated it itches. I also recently noticed burning when I pass water. Ever since my teenagehood I had vaginal discharge. Am I ever gonna be able to have sex again? Is this BV gonna go away eventually? Should I see my GP again?

Yes, you should have a truly experienced medical person look at you. Sometimes after a woman takes antibiotics. she develops a yeast infection which can itch and burn. Consider seeing a medical provider who has lots of experience looking at cells under the microscope. And yes, you should be able to get this under control. Good luck

Back to Topics Page

Mass

A week ago I noticed a large mass, the shape and size of a tampon about two inches on the back side of my vagina. I have had an abortion within the last six months and the mass was not noted at that time. Is it possible that it could be a tampon and my vaginal wall has grow around it? When I try to feel it I get a reddish discharge.

The only way to answer your questions would be to see someone who can examine your vaginal canal and rectum as soon as possible. It does seem unlikely that you could have a tampon imbedded in your vaginal skin, however a tampon could be retained in your canal and is easily removed. Because the skin between your vaginal canal and rectum is thin, this could be a problem in your rectum that you can feel in your vagina. Either way it is important to check this right away.

Back to Topics Page

Bumps on vagina

For the past couple of weeks I have a problem with my vagina. I develop small bumps that hurt when I touch them. I popped one once, before and puss came out, and afterwards it started bleeding. After the puss is removed there is no longer a bump, just the imprint of the bump. Do you know what this problem is?

It is difficult to tell what the problem is without examining your skin. If you are shaving the area this could be a symptom of "folliculitis" an inflammation of hair follicles due to the irritation of shaving.

There is also a hereditary condition that is characterized by pustules that form, get red and tender, then rupture and heal with a residual purplish scar. Finally there are contagious conditions that may cause a raised rash. See someone for an exam when the bumps are present for a definitive answer.

Back to Topics Page

Am I still a virgin?

Am I a virgin still? I've decided to stay a virgin until I'm married, but one night my boyfriend and I became intimate one night and got carried away. Instead of sexual intercourse he fingered me. Does this mean I have broken the barriers of being a virgin?

A girl (or a boy!) who has never had penis-in-the-vagina sex is considered a virgin. The presence or absence of the hymen (the small ring of tissue just inside the vaginal opening, what you call the virginal barrier) is NOT an accurate indicator of whether or not a girl is a virgin.

The truth is that hymens are as individual as people. They can be thick and stiff and noticeable with first intercourse, or so thin and stretchy that they're completely undetectable. There can be one opening in the hymen or two or more. The hymen can be broken during vigorous exercise, during masturbation, or even with tampon use. Long and short: The lack of a hymen, or having a hymen that’s very thin and elastic, has nothing to do with whether or not a woman is a virgin.

Back to Topics Page

Discharge

I have been having a heavier discharge and painful intercourse for the past 3 months. Today, as I was wiping myself, I found that there was a little blood in my discharge. I don't have any itching or burning so I don't think it is a yeast infection. I have been on Ortho Evra for about 2 years. I did change my patch day from Wednesday to Friday. I have been feeling very fatigued all month long. What should I do?

Painful intercourse and discharge can be a symptoms and signs of infection. See your provider or go to family planning to have it evaluated.

Back to Topics Page

Vaginal Bump with discharge

I am a 16 yo female and my boyfriend is 21 and we have been together for a while now and have also been having sex very frequently like 1 to 2 times every day. Recently I discovered a largish lump right up inside my vagina to the left of it. The lump is smooth and hard but I can move it with my finger.

My discharge is also yellowish and lumpy. Please help me to find out what this lump is as it is really worrying the both of us and putting stress on our relationship and I am too scared to talk to someone about it. Thank you.

It is almost impossible to say what your "bump" is without examining you, so I would recommend you make an appointment right away to be evaluated.

Some possibilities are:

• a normal "cyst" of the vaginal wall - these are perfectly normal and require no treatment
• a swelling of the Bartholin's gland - these may be easily managed with hot baths an infection of the Bartholin's gland - requires testing and antibiotic therapy
• With your symptoms of discharge, I would favor an infection and that is why it is really important to get testing and treatment for you and your partner.

While you are reluctant to talk to anyone about this, it is a perfectly reasonable complaint to see a medical provider about and it is not uncommon. They will be able and willing to talk with you about this. Don't put it off - have it checked as soon as possible.

Back to Topics Page

Allergic to pads?

I have a sore vagina and even have redness all the way up to the top of my bottom and it is sometimes itchy.It seems to of started when I used Stayfree pads could I be allergic to them.

It does sound like the logical conclusion. Ask yourself: When you stopped using the Stayfree pads, did the symptoms subside? Does it happen with other brands? Sometimes excess moisture can cause these symptoms. Also, if you leave a pad on too long, this can happen.

Experiment with different brands, changing them more often. If the symptoms persist, see your provider ASAP.

Back to Topics Page

Shaving "down there"

Should a girl shave all of her pubic hairs? My boyfriend likes me to but it gets really itchy and starts to hurt, and when I don't shave it feels fine. I believe I read somewhere that you shouldn't, should I quit shaving all of it?

Shaving your genital, or pubic, area is a personal decision. Does your boyfriend shave around the base of his penis and scrotum?? We generally advise that it isn't a good idea, because the purpose of the hair that grows there is to protect you. And often, shaving that area can cause ingrown hairs or folliculitis, (irritated hair follicles) which look like red bumps, and shaving over those can cut the skin. These cuts make it easier to get an STD like herpes or genital wars if those viruses are present.

Not to mention the itchiness and pain that you mentioned as the hairs grow out!

I would strongly urge you stop shaving your genital area if it doesn't feel good to you, and tell your boyfriend that you are not willing to do something that so uncomfortable to you!

If you choose to continue shaving part or all of your pubic area, we suggest using an electric razor and changing the blade every time. That way you're less likely to get cuts. But you will probably still have the itchiness when the hair grows out.

Back to Topics Page

Ovulation

How can you tell when you're ovulating?

In general, women ovulate mid-cycle, so if you period is 28 days from the first day of bleeding to the first day of the next bleeding then you will ovulate at day 13/14 of that cycle. Day 14 is counted from first day of bleeding.

Now it gets complicated, as we know, most women do not have cycles that are exactly 28 or 30 or 35 days apart every month. So it is tricky to figure out from month to month when you ovulate. Two typical signs of ovulation that can be helpful are:

1) At the time of ovulation women produce a watery, clear, odorless discharge ; and

2) A woman's basal body temperature raises about 0.5 degrees at ovulation. This requires daily temperature readings in the morning before getting out of bed. Good luck, seek additional information from your health care provider.

Back to Topics Page

Does cervix block sperm?

I was wondering if the cervix allows sperm into the uterus even if there is already sperm in there? For example, if you have sex on Saturday, Sunday, and Thursday, after the sex on Saturday how much if any sperm will get into the uterus? Or does the cervix block incoming sperm?

The cervix does not block sperm regardless of the frequency of intercourse. Therefore, you must use protection EVERY SINGLE TIME you have sex if you do not wish to become pregnant.

Back to Topics Page

Wiping after urination

My cousin doesn't wipe herself after she urinates and I can smell urine from her. should I say something to her about wiping herself? She is 22 years old. I have seen people laugh at her because they say she smells.

Yes, you should definitely say something to her. Be as kind and gentle as possible. She needs to hear it from someone who cares about her before she hears it third-hand in an unkind way.

Wiping yourself after any kind of elimination is very important. It helps to keep the vaginal area from being too moist all the time, which helps ward off infections. Also, when wiping, a woman should always only wipe from front to back to avoid infections.

Back to Topics Page

Bleeding and spotting

I bled for the first time the other day after "normal" sex and I hurt for two days afterwards in my abdomen. I am definitely not pregnant or on my period. Now a week later I am spotting in my urine. Is this a sign of Cervical Cancer or I am just overreacting? And if yes, how accurate are Pap smears? I was tested last week and don't have an STD and I am on Cipro for a Sinus Infection. Thanks for any thoughts-I am stressed out!

The symptoms you describe are of concern. They need to be evaluated by a health care provider. Pap tests are very good at screening for cervical changes, but not for STDs or other infections. I cannot say more without examining you. Please see your family planning center or health care provider immediately.

Back to Topics Page

Excessive Lubrication

I have a weird problem because for most people it's the opposite, but I produce too much lubricant during sex, its really uncomfortable, and messy. I switched birth control almost a year ago and maybe that has something to do with it?

Without more information it is difficult to say whether your contraceptive method or something is contributing to the excess lubrication. Please consult your family planning center or health care provider. In the meantime, a similar question was posted here at www.sexualhealth.com.

Back to Topics Page

Pad makes me sore

When I am on my period, why does the pad rub on my vagina and make it sore?

You may be experiencing an allergic reaction to the pad. Make sure they are not the scented kind. Also, make sure the pad fits against you snugly, to avoid a lot of rubbing back and forth (make sure your underwear is snug and not too big). Try different brands, always avoiding the scented ones. If this continues, talk to a trusted older female (your mom would be the first choice, or an older sister, aunt, teacher, school nurse, or guidance counselor) or, if that's not possible, visit your provider or local family planning office. Good luck!

Back to Topics Page

Cervical Atypia

I am very concerned with a letter that I received in the mail today. It said that Cervical Atypia was detected in my pap smear, but it doesn't tell me what the heck it is! I called my family planning office, but everyone was busy. I am very disturbed by this. What is it, what can it lead to and how it is caused...please help.

There are five classifications in Pap test results. Class 1 is normal, and Class 2, "atypical," describes your result. This result could be caused by inflammation or infection and may resolve itself. Cervical Atypia is not a diagnosis, it simply describes some minor cell changes on the cervix. This can be caused by many different things and it could possibly be indicative of a potential problem, OR your next test could come back normal, as many do.

In general, when a Pap comes back with these changes your provider will recommend another Pap test in 3-6 months. Without knowing your history, I really cannot say more - you need to persist in calling your family planning center for a discussion. They can give you a more detailed answer because they know you and your health history.

Back to Topics Page

Fishy odor, yellow discharge

I am a 15 yr old female and am still a virgin and I do not ever masturbate. But for the past years I've been have a fishy odor and yellow discharge. I am not yet seeing a gynecologist and don't know if I have an infection and I would never mention it to my mother. I feel weird and embarrassed but I keep myself clean and I was wondering if instead of seeing someone about this I could help it myself like for example massengil or otherwise. Thanks for all your support.

Vaginal discharges and mild odors are not uncommon. It would be best to discuss this with your mother. However, if that is not possible, do you have a trusted adult woman you can go to? If not, please call your local family planning clinic and ask them if they can see you (even if you don't want birth control, they still provide exams and answer questions, so you do NOT have to be sexually active to go to family planning).

If this odor and discharge is strong enough to bother you, then you should be examined. Your local family planning clinic nurses and counselors can help you and will answer all your questions. Your visit will be confidential and you only pay what you can afford. Please look into it for your own peace of mind. Take care.

Back to Topics Page

Vagina smell

Why does my vagina smell like urine and like fish? I wash it and make sure it's clean but I still smell these odors. I have had it checked out and they say I have no infections at all.

The vagina should not have a fishy smell. Please see your health provider again for a check up. You may want to consider a second opinion - going to a different health provider, such as your local family planning clinic. The women that work at these centers are well educated in all matters concerning the vagina! Please see the top of this page for how to find your clinic.

Back to Topics Page

Discharge

Ever since my early teens I have been getting this yellowish discharge in my knickers and it is really embarrassing. Sometimes it's just yellow other times it is yellow with a smell and really thick. I'm too embarrassed to go to my doctor but really want it sorted out; is there any medication I can get? Please help. Thanks a lot!!!

Some discharge is natural -- all women have a certain amount of vaginal discharge. It should be clear to white, and odorless. It is difficult to determine what you are experiencing without an exam where a sample of the discharge can be taken. It's a bit like trying to set a broken bone without having it in front of you! Your discharge needs to be examined by a professional.

My advice is to seek medical attention. Although you are embarrassed to take this step, please remember that doctors and family planning clinicians see this sort of thing every day. If you are too embarrassed to go to your family doctor, please call your local family planning clinic -- they will alleviate any embarrassment you have as well as give you a much-needed (I suspect) exam.

It is very important that you take care of your reproductive health - as a woman it is a major part of your overall health! Please don't let this slide any longer - vaginal discharge can be nothing, or it can be a symptom of something -- call your local FP clinic today.

Back to Topics Page

Discharge before menstruation

I have been having blood discharge few days before menstruation. Usually, it occurs 1 or 2 days or more before menstruation before the actual bleeding occurs. Is this normal or should I go for a check up?

Bloody discharge 1 to 2 days before your period starts can be normal, but you should have a check up if you are having any unusual pain or vaginal itching or burning.

Back to Topics Page

Are there three holes in the vagina? What is below the vagina?

A very good question! There are 3 orifices in the genital area. The top one, from front to back, is the urethra, which is where urine comes out. The next is the vaginal opening, and the third is the rectum which is where bowel movements come from. At your local library, you can find books on anatomy that will clearly show how the female reproductive system is laid out.

Back to Topics Page