Love and Sex Prescription

by Dipika Dandade

QUESTION

I am 28 and trying to meet someone to marry. I have friends my age who are also single. We feel it is so hard to meet people. How come guys my age aren't serious about marriage at the age of 28?

ANSWER

You are right that it becomes more difficult to meet people as we get older. In our early 20s, in college or graduate school, we are exposed to so many young and single people. But upon entering the work force, it is not as easy to meet date-worthy men. Interesting guys might already be married or involved in a relationship. Or on the flip side, the men may still be exploring options (i.e. playing the field). In American society, as we concentrate on building our careers, we seem to be marrying later in life. The guys your age likely are too busy to commit or trying to enjoy a carefree lifestyle. But you might find that men three or four years older than you are more mature and willing to become involved in a serious relationship. Truth be told, when you find the right person, no matter the age, you and he will know that it is time to settle down.

QUESTION

I have been on birth control for the last four years. When I went to India, a doctor told me that it was not healthy to be on birth control continuously. The doctor said that in India, women are on birth control for nine months and then have natural ovulations for three months. When I returned to the U.S., I consulted with my doctor here. The doctor seemed offended and said it was inappropriate for the Indian doctor to make those comments. The doctor further said that it was really a personal decision that I had to make regarding birth control. I am so confused. Can you shed some light?

ANSWER

Regardless of the kind of birth control you are using, there is nothing to suggest that it is unhealthy to be on monthly birth control. The literature does not support the idea that a woman needs “natural ovulations” interspersed with monthly contraceptive use.

Actually, there are many health benefits associated with using combined contraceptives, which are a kind of birth control added with estrogen and progesterone components. These contraceptives can come in pill, patch or ring form. The health benefits include a decreased incidence of ovarian cysts, ovarian cancer and endometrial cancer. Another advantage is that you know when your period is going to come. Many women are using combined contraceptives to decrease the amount of bleeding that occurs with their menses, which would prevent anemia. And no need to worry about subsequent fertility after prolonged use of these contraceptives. Luckily, the contraceptives are designed to allow ovulation to return to normal the very next month after discontinuation.

Now, if you are using the injectable hormone known as DepoProvera, then you should be aware of a recent black-label warning regarding its use. The manufacturers are suggesting that its use be limited to two years due to concerns of possible bone loss with prolonged use of the drug. If you have been using DepoProvera for more than about two years, you might want to review other birth control options with your physician. The doctor might suggest getting a bone density scan before switching medications. One last point regarding this injectable drug – it can potentially take one year to resume normal ovulation. This is an important point for women who are eager to become pregnant soon after discontinuing use of this drug.

Keep in mind that your physician in India must be able to provide viable alternatives to your birth control during those few months that you are “going natural.” If you are avoiding hormonal options during that time, well, that leaves you with condoms or nothing. If you are in a relationship where you and your partner have become used to your usual birth control method, it is possible that using a condom may not sound too appealing. The effectiveness of condoms in actual use (meaning forgetting to use it every now and then) will lead to a 13% pregnancy rate. Now, compare that with a much lower 5% pregnancy rate with actual use (forgetting to take a pill here or there) of the birth control pill. The birth control pill has a 99% effectiveness with perfect use. There are just too many risks associated with that three months of pill free existence – and too many benefits to justify discontinuance.