Thu | Dec 8, 2016

DOCTOR'S ADVICE - How does the Pill work?

Published:Saturday | October 11, 2014 | 12:00 AM

Q. Doc, I am extremely bewildered about the Pill. I am a virgin, age 19. My boyfriend is desperate to have sex with me, so I am going to see my doctor shortly to ask her to prescribe the Pill. But what I don't understand is this, if I give my boyfriend my virginity on the day before I start the Pill, would I be protected against pregnancy? Also, I have been told that taking the Pill involves a week's break each month. Surely, I could get pregnant during that week, couldn't I? Finally, does the Pill give a girl any protection against sexually transmitted infections (STIs)?

A: These are three good questions, which puzzle a lot of young women.

First, I beg you not to 'give in' to your boyfriend on the night before you start the Pill! You might well get pregnant. These days, doctors generally advise women to start taking the first pack of pills on the first day of the menses. If you do that, you will be protected immediately. But you cannot expect to be protected before you have started taking the little tablets!

Second, you are quite right in saying that with most brands of the Pill, the woman must take a week's break between packs. But if she has swallowed each pill on the correct day, then she will be protected during the seven-day break.

Third, the Pill offers absolutely no protection against STIs. Indeed, the only form of contraception which gives any protection against STIs is the condom - male or female type.

It does occur to me to wonder why you are concerned about the possibility of getting an STI. Has your boyfriend perhaps been 'playing around'? If so, then you should insist that he has tests for STIs before you let him take your virginity.

Q. Good day. My wife had an ectopic pregnancy two years ago. So her right tube was removed. Now she is pregnant in the normal way. In fact, she is five months into the pregnancy. So can we have sex now? She's sometimes calling for sex, but I am scared about the child's safety. Some say that sexual intercourse during pregnancy leads to good health in the baby, and can help to cause a normal delivery. But I remember that when she was in very early pregnancy (two months), my doctor said not to have sex.

A: OK, let me explain exactly what an ectopic pregnancy is. It's a pregnancy that happens in the wrong place - usually in one of the Fallopian tubes. When that occurs, there is usually no way that the baby can survive. Generally, the tube has to be removed surgically. And that is what the surgeons did in your wife's case.

Fortunately, women have two Fallopian tubes. And your wife's other tube must have been healthy and in good working order, because she has successfully conceived, and indeed is now five months into this pregnancy.

I think it was perfectly reasonable for your doctor to say 'No sex' when the pregnancy was in its very early stages. But things are much farther on now. So it is probable that it would be safe to have intercourse.

I appreciate that your wife is asking you for sex. But I feel that your best course would be just to check with the doctor or midwife that it is now OK to go ahead - and then carry on. If by any chance the health professionals feel that your spouse should not have actual intercourse, then there is no reason you should not relieve the lady's frustrations by various forms of petting. Finally, there is no truth in the widespread myth that sex during pregnancy causes 'good health' in the baby, and can ensure a normal delivery.

Q. I am a guy of 17, and I am frightened about having sex with my girlfriend while she has her menses. I did this last week, and now I feel terrible. Is there any way this could have harmed my health, Doc?

A: No, there is no way that sex during the menses can damage a guy's health. It is certainly not everybody's 'cup of tea', but healthwise it is harmless.

Q. My fiancé has been away in England, working. He has been there for six months, and is coming home soon, so we can get married. Doc, the awful thing is that while he has been abroad, I have gone with another guy - three times. Will my fiancé be able to tell?

A: No, there is no way that anyone (even a gyno) could tell that you have cheated. Presumably, you didn't get pregnant. And I hope you didn't catch any infection! But what is making me concerned is this. You are intending to marry this young man soon and already you have been unfaithful to him - three times!  This does not suggest to me that your relationship has a great future. So I feel that you should seriously reconsider your wedding plans.

Q. I am a teenager (male), with a relatively small organ. Doctor, I am not worried about this. But my problem is that the condoms I buy are too long for me. They are probably around two inches too long. So they end up in 'rolls' around the base of my penis. This is most uncomfortable. Therefore, Doc, in your medical opinion, could I just cut the bottom two inches off each condom?

A: Please don't do this! Cutting condoms will damage them - and may well lead to pregnancy. You are very far from alone in having this problem. Quite a lot of young guys have penises which are still quite short. So the average-sized condom is far too long for them. Happily, it is now possible to buy shorter condoms which are suitable for young men. Just Google the words 'short size condom' and you will find various American and English firms that are eager to sell them to you.

Email questions to Doc at saturdaylife@gleanerjm.com and read more in the Outlook Magazine tomorrow.