| The other option is to
use your parents’ insurance. Be honest (or at least partially)
with your mother and tell her you have been having some pelvic pain.
And, don’t worry–it does not necessarily have to be caused
by sex! There are multiple causes for pelvic pain including ovarian
cysts, endometriosis, gastrointestinal problems and infections. Your
doctor will take a very thorough history including how long you’ve
had the pain, its location, and what makes it better or worse. A physical
exam will include an abdominal and pelvic exam. Further tests will
likely include STD testing and possibly, a pelvic ultrasound.
If your mother accompanies you into the exam room, the physician
you are seeing should ask her to step out for part of the initial
interviewing and for the physical exam. Her presence can breech doctor/patient
confidentiality. That time should allow you to be upfront and honest
with your doctor. Again, anything you tell your doctor is not supposed
to be disclosed to your mother. That, however, would not necessarily
be the case if you were underage and the victim of rape or molestation.
Despite your being on your parents’ insurance, they do not
have to be present at your visits. You could go to the doctor on your
own. Your parents will get a bill from the insurance, though. If they
happen to ask about it, just tell them you weren’t feeling well
and didn’t want to bother them about it. You are an adult. Now
is the time to take your healthcare into your own hands. The other
option is to see a physician that is not covered by your insurance.
You would have to pay out of pocket, but your parents would never
have to know. Whatever you decide, you need to be seen by a healthcare
professional … sooner rather than later.
QUESTION
My boyfriend and I started having sex a few months
ago, and we used condoms to prevent pregnancy. We recently decided
to have intercourse without condoms, but since it could take a while
for birth control pills to take effect we decided to look for alternatives
instead. I’ve heard of the “morning after pill,”
but don’t know much about it. Where can I get it and how long
does the effect last? I mean, can I take it the morning after we have
had intercourse, and have sex again that day without having to worry?
Also, are there any harmful side effects to be wary of?
ANSWER
To start off with, just a reminder that continued
condom use will help prevent the transmission of sexually transmitted
diseases.
If you have just started using the oral birth control pill (OCP),
then you will need an alternative form of birth control for at least
2 weeks. Most often, patients will be abstinent or use condoms.
The “morning after pill,” or emergency contraception
(EC), is not meant to be a form of alternative birth control. EC is
not as effective at preventing pregnancy as an ongoing reliable type
of birth control.
There are two forms of EC. One method involves taking pills. A combined
estrogen-progestin pill (marketed as Preven) or a progestin-only pill
(Plan B) is given within 72 hours of unprotected intercourse, followed
by a second dose in 12 hours. The sooner you take the medication after
intercourse, the more effective it is. Preven results in a 75% reduction
in the number of pregnancies that would have occurred had EC not been
used (instead of 8 women out of 100 becoming pregnant, only 2 will
become pregnant). Plan B decreases the chance you will get pregnant
by 89% (1 of 8 women will get pregnant). The other method involves
placement of an Intrauterine device (IUD) in the uterus. The IUD can
then be removed after the next period or can be left in place as a
form of contraception. It is over 99% effective at preventing pregnancy.
In some states, you can obtain Preven or Plan B without a prescription.
Other states require a prescription. You may want to obtain a prescription
from your doctor “just in case.” It may be worth filling
the prescription, as well, so that you have the medication on hand.
EC has not been shown to have serious complications.
However, women who are unable to take hormonal contraceptives (for
example women who have a history of blood clots in their legs) should
not take EC.
Side effects with emergency contraception pills are similar to those
of hormonal contraceptives including nausea, breast tenderness, bloating,
and headache. If you vomit within an hour or two of taking the medication,
let your doctor know. You may need another dose. You may also experience
some irregular bleeding. If your normal period is delayed by more
than a week, you should take a pregnancy test. Do not take the medication
if you are already pregnant.
Dipika Dandade, 31, is an obstetrician/gynecologist practicing in
the Los Angeles area.
ABCDlady does not provide medical advice, diagnosis or treatment. See
additional information.
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