Thursday, March 1, 2012

Ask Naughty Nurse Kimpy - Birth Control Part 2 - 03/1/2012


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!


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

Part 2:

Before we answer any questions today, 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 had sex with my boyfriend the day after my last period and we did use a condom, but it came off inside of me (at that point he hadn't ejaculated yet). My period is now a week and a half late. I've taken two HPTs (once at night, and another first thing in the morning) and both are negative. I've never been this late before (even when I'm really stressed). Should I be concerned?

Before we get down to the business of answering your concerns, Nurse Kimpy wants to applaud you and your boyfriend for being responsible enough to use protection. It can be devastating to face an unplanned pregnancy when you’re trying to be careful and safe. That being said, should you be concerned about pregnancy in the face of condom failure? The short answer is yes, simply because it’s always going to be statistically possible for you to be pregnant in that scenario, even if your boyfriend hadn’t ejaculated yet. Remember, for every 100 people using condoms for birth control, 15-24 will get pregnant.

In your situation, however, the important thing to remember here is how likely it is that you’re pregnant; you have several factors in your favor. First, you had sex the day after your last period. The likelihood that you were ovulating at that time is slim--not impossible, but slim. Second, you stopped having sex once the condom failed, limiting your exposure to sperm. Lastly, your boyfriend hadn’t yet ejaculated. Each of these things will reduce the likelihood that you got pregnant, which is good.

You should know that home pregnancy tests are very accurate--99 to 100% if used after your period is late. They are less effective if you take them too early (like right after the slipped condom incident occurred) or if the kit is expired. Rather than taking a test at night, and then again the following morning, it is probably best to wait a few days in between. They are most effective if you wait until your period is already late, as you did in your case. Since you had two negative tests, and you were 1½ weeks late, it looks like you’re not pregnant.

Nurse Kimpy suspects that your period was late because you were very stressed out about it. To avoid such stress in the future, she recommends that you either use a backup method of birth control (like condoms combined with a spermicidal gel, for example), or switch to a more effective method of birth control, like the pill (2-9 pregnancies for every 100 people who use it). You should also acquaint yourself with the Plan B pill (emergency contraception. It can be taken up to five days after having unprotected sex.

Dear ANNK, I'm hearing that if I'm on the pill for a long time it can damage my hormones or cause breast cancer. Is this bullshit or a real risk/side effect?

While there are certainly risks and side effects with any medication, birth control pills have been dragged, unfairly, through the mud lately. Naughty Nurse Kimpy would like to take this moment to redeem the birth control pill, and any other hormone-related birth control, for that matter.

There is a misconception in the media that long-term use of birth control pills can result in a permanent inability to conceive. Since the birth control pill was first available in the 1960s, there has been a ton of research conducted. What we’ve learned is that the notion of conception being affected by long term pill use is completely unwarranted.

As long as you’re in overall good health and are a non-smoker, you can take the pill as long as you need to, until you reach menopause. This is true for women taking a combination pill (containing both synthetic estrogen and progesterone) or a progestin-only pill.

There are certain groups of women for whom taking the pill might be dangerous:
  • Women over age 35
  • Women who smoke
  • Women who have uncontrolled high blood pressure
  • Women with blood-clotting issues

If you are breastfeeding, you can still take the pill, but need to consult with your doctor about which method is the most appropriate choice for you.

As far as the link between the pill and cancer, there is research that suggests the pill could increase your risk of cervical cancer and liver cancer. However, taking the pill can also reduce the risk of getting other types of cancer, such as ovarian or endometrial cancers.

The jury is still out on when it comes to the pill and a subsequent risk for breast cancer. There is some research that has shown the pill causes a slight increase in the risk of breast cancer, but after ten years of stopping the pill, the risk returns to the same level as women who have never been on the pill. There have been other studies that have shown that there is no link between birth control pulls and breast cancer rates.

Nurse Kimpy encourages anyone who is on the pill or wants to be on the pill to consult their gynecologist about the individual risks and benefits. They can help you make an informed choice about what’s best for you.

I have some questions about birth control! I'm 19 (not sexually active), and I've been on the pill since 13 for PMS and ridiculous flow. Anyway, I'm starting to be concerned about the side effects of long term use. I'd really like to get off it, but when I try going off for a month I turn into a banshee and get demon cramps. Any suggestions for getting off the pill? I feel like I'm not taking care of my body when I subject it to all these fake hormones. Thanks Kimp! You're just awesome. :)

P.S. Is it true that the internal clit is larger than a penis?

While Nurse Kimpy truly understands your concern about the long-term use of birth control pills, she is sad that you feel like you’re not taking good care of yourself by using the pill to control some very serious side effects of menstruation. For her, your comfort and well-being are paramount; it doesn’t appear that your personal cost/benefit analysis warrants going off the pill merely to diminish your exposure to “fake hormones.”

So, honestly? Any suggestions for going off the pill? Well, since your past experiences with going off of the pill have turned you into a banshee with demon cramps, my answer would be “No.” That isn’t a cop out--it’s just that you’re either on, or off, the pill. There isn’t any semi-pill that gets you half-way there, so that your periods are only semi-traumatic and heavy. About the only thing Naughty Nurse Kimpy can think of is to talk to your gynecologist about the possibility of what might be the underlying cause of your periods from hell, like endometriosis. As long as you are otherwise healthy and have none of the risk factors mentioned in the previous question, staying on the pill is most likely your best salvation. And trust, there’s nothing wrong with that. It’s okay to save yourself from the literal pain and ache of periods.

P.S.--As far as the internal clit being larger than a penis? As you can see in the image, clitoral tissue is very deep, and, in some instances, could be larger than a penis. So, that cute little button that is located outside? It’s the “on” switch for some pretty powerful nerve endings. But then again, I think we all know that already. *wink*

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