Ask Naughty Nurse Kimpy: Birth Control 101 2-23-12

Ask Naughty Nurse Kimpy is an advice column that addresses reader’s most burning questions on sexual health/relationships. STIs, birth control, is it real or is it fic, sexual positions--you name it. There are no stupid questions, only ones that are too embarrassing to asks someone you know. If Naughty Nurse Kimpy doesn’t know the answer, she’ll find an expert who does!

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DISCLAIMER: The information and advice from Ask Naughty Nurse Kimpy is for entertainment/educational purposes only and is not intended to be used as expert medical advice. It is not meant to replace the advice of your physician. All medical advice and information should be considered to be incomplete without a physical exam, which is not possible without a visit to your doctor.

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If you haven’t been living under a rock lately, you’re aware that the subject of birth control pills and insurance coverage has come up a great deal in the media. So much of the national debate/discussion has spiraled out of control; it’s almost like a referendum is taking place over whether women should be able to determine how many children they choose to have, and when to have them.

Because of all the angst that has been stirred up, this week’s Ask Naughty Nurse Kimpy is devoted to reader questions about birth control. It’s easy to lose sight of what an important role it can play in a woman’s life, and Nurse Kimpy simply wants to refocus on this topic so that her readers can make more informed decisions.

Before we answer any questions, however, let’s make it clear just how effective some forms of birth control are when compared with others. The Birth Control Chart is a great resource that clearly outlines the various methods and their level of effectiveness.

There is a great tool available on the web that helps you choose the right method of birth control for you. My Method asks you a series of questions, and then makes personal recommendations for you based on what methods seem to fit your lifestyle. Nurse Kimpy encourages anyone who is uncertain about what to use to give My Method a try.

I've heard that birth control pills don't prevent conception but actually abort it. Is that true?

*Nurse Kimpy stomps her tiny foot in indignation* No matter what your stance on abortion may be, it’s wholly unfair to make the assertion that birth control pills are essentially a way to abort a fetus. NO. An emphatic, shouted, no-holds-barred N. O. Birth control pills are effective because they use hormones to trick your body into thinking it’s pregnant. It doesn’t release any eggs because--duh!--it’s “pregnant.” The pill prevents conception by suppressing ovulation. If there is no egg present, then there’s no way an egg can be fertilized, and thus, no way a fetus can be created. If there’s no fetus, there’s no abortion, plain and simple.

Dear naughty nurse, I just started the birth control a few months ago, and my period has gone off for over 3 weeks because I was advised by my doctor to skip the first two months of sugar pills. That’s not my real problem though, recently I have developed red lumps in between my legs near my vagina and I found a cyst next to my clitoris. I have never been sexually active and I wonder if it could be relevant to my wearing pads for 3 weeks or if it could be a staph infection, or maybe something worse, what do you think it could be?

Nurse Kimpy wants to address both the issues raised in your question, because other readers might be experiencing both problems and thus can benefit from the answers.

First of all, there’s the issue of having your period for three full weeks because you skipped the first two months of sugar pills. While Nurse Kimpy isn’t going to say that your doctor is wrong to have given you these particular instructions for taking the pill, it *is* unusual to skip the first two months of sugar pills and to subsequently have your period for three continuous weeks. She encourages you to follow up with your doctor to make sure that this is a typical response to starting the pill. It’s also not unusual to have irregular bleeding when you first start taking the pill. These irregularities kind of work themselves out as your body gets used to the pill. Nurse Kimpy just wants to make sure that your physician is aware that you’ve been bleeding that long.

Usually, you can start the pill at any time during your cycle. If you start taking it within five days of getting your period, you’re considered fully protected and can start having sex right away. If you start it at any other time of the month, however, it takes seven consecutive days of taking the pill before you are fully protected. During those first seven days, you need to use a back up method of birth control, like a condom.

As for your issue with the red lumps and/or cysts you’ve encountered, Nurse Kimpy’s very first suspicion is that they stem from wearing a pad continuously for three weeks. Your lady bits need air in order to stay healthy; any prolonged exposure to moisture can create an environment that easily breeds an infection. When you use pads, you’re kind of faced with a good old one-two punch. They not only retain moisture next to your bits 24/7, but they’re also manufactured with a number of materials that can irritate the sensitive lady bits skin.

*Naughty Nurse Kimpy uses this moment as a PSA for Diva Cups* It’s no secret that Nurse Kimpy is a strong proponent of Diva Cups, or menstrual cups of any variety (and no, Nurse Kimpy does not receive financial incentives from plugging the Diva Cups--she just happens to love them. In fact, she doesn’t receive financial incentives of ANY kind for her blog, just so we’re all clear on that). Diva cups help to keep your vulva happy by keeping the moisture inside the vagina, rather than making you sit on it 24/7. She urges you to give them a try. *PSA over*

Recently (November 23rd) I switched from taking the actual pill to the shot, because I forget the pill regularly and that's too risky when being sexually active (and not wanting a pregnancy). The problem here is that I started bleeding, almost as if on a period, December 15th. And it hasn't stopped. It's not as heavy as an actual period for me, but I'm still losing blood and it's becoming frustrating. How come I'm bleeding for this long, and what can be done about it? Also, can I get pregnant?

The birth control shot, called Depo-Provera, is different than the combination pill, the ring, and the patch, because it contains progestin only--the other methods rely upon a combination of estrogen and progesterone.

One of the most common side effects of Depo-Provera is irregular bleeding. This is especially true during the first six to twelve months you use this method. The good news is that for about half the people who use Depo-Provera, their periods stop altogether once they’ve been using the shots for a year or more. However, for some users, their periods can become longer and heavier, and some women experience an increase in spotting and breakthrough bleeding.

That being said, Nurse Kimpy encourages you to have another shot or two before you give up on it--you never know, you might be one of those women whose period stops. If not, you can always switch to the ring or the patch, to see if they work a little bit better. You don’t need to remember to take those every day, either.

Can you get pregnant now, while you’re bleeding? Each shot provides protection for three months. Given that you had the shot on November 23rd, you will be protected until February 23rd. So up until now, no, you shouldn’t have gotten pregnant. You’re due for another shot though, so if you haven’t gotten one, Nurse Kimpy encourages you to go get another one now. For some of the women who’s periods stop occurring, they worry that they’re pregnant, but as long as you get your shots religiously every three months, you’ll be protected against pregnancy.

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