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Doctor's Advice: The Pill makes me sick

Published:Sunday | June 21, 2015 | 12:00 AM
Birth control pills

Q. I started a new brand of the Pill last week, and since then, I have been rather nauseous and have actually thrown up a few times.

Why is this? Is it serious, Doc?

A. I hope you have not 'lost' any of the pills as a result of throwing up. If that happens, follow the instructions which are contained in the leaflet inside the pack. This type of nausea is very common when starting on a new brand of Pill. It is because of taking a different kind of hormone – probably the oestrogen in the Pill. Generally, the feeling of sickness goes away after a few weeks.

But if it doesn't, then you should ask your doctor about changing to another Pill – preferably one with a different oestrogen. I do not know why you came off your old Pill, but maybe there would be a case for going back to it, if your doctor agrees. Finally, an alternative would be to go on the Mini-Pill. This contains no oestrogen, so it doesn't often cause sickness.


Sex before a Pap smear

Q. Doc, I am a woman with an active sex life and I would like your advice about Pap smear tests. First, is it OK to have sex immediately before you do the test? To be frank, I do have sex most days of the week in the afternoon. And in the area where I live, I can only get the test done in the early evening. Second, what is the test for? And what actually happens during it? I have never had one before.

A. Sounds like you have a slightly unusual sex life. But I can assure you that you should most definitely have Pap (cervical screening) tests. And that applies to every woman who has ever had sex. Why? Well, sex very often transmits a virus called 'HPV'. Some strains of this virus cause cancer of the cervix.

The cervix is the lowest part of the womb. It is located at the farthest part of the vagina, and you can just feel it with your fingertip. It feels soft – like the tip of someone's nose. Cervical cancer is very common, and there is no way of defeating it! Thanks to the pioneering work of Greek doctor Dr Papanikolau, women can be almost totally protected against this cancer (obviously, the 'Pap' test is named after him).

Dr Papanikolau discovered that if some cells were removed from the cervix and then examined under a microscope, it was possible to detect whether there were any 'pre-malignant' cells there. Pre-malignant cells can sometimes go on to be cancerous, but often they don't. And if they do look as if they are 'turning nasty,' then they can be treated successfully.

It's important to realise that a Pap smear will detect this problem long before it causes any symptoms. Summing up, every woman (unless she is a virgin) needs regular Pap smears throughout her adult life. What happens during the test? You lay down on a bed in the doctor's office and she inserts an instrument called a 'speculum' into the vagina. The speculum is a 'viewing device.' With that, she can see your cervix clearly.

She can then remove some cells from the cervix. She puts them into a special bottle, and sends that off to the lab for microscopic inspection. That's it! The whole procedure only takes around five minutes. Some time later, you will be informed of the results – if you are OK or whether any treatment is necessary. As it relates to sex before a screening, surprisingly some women do this. On quite a few occasions, I have seen lab reports in which the technician says that she saw sperms among the cells from the cervix.

However, I feel that it is a good principle to avoid doing anything which might confuse the results of the test. So I advise you not to have sex 24 hours before you have a cervical screening. Also, do not douche before! Doing that will wash away quite a lot of the cells on the cervix and may possibly make the test difficult to interpret.


Scared of upcoming circumcision

Q. Doc, I am a 31-year-old male and I have to take a circumcision operation. I am terrified that, in the weeks after the operation when I have stitches in my penis, any erection will be agonising for me! Can you please advise? Is there a drug that would help?

A. After taking a circumcision operation, most men do not feel much like having an erection – at least, not for some days. However, for a man of your age, it is possible that some spontaneous erections are bound to occur, particularly at night. But the pain will not be terrible, and it should go away as soon as you lose the erection. Obviously, during the first week or so after sex, it is a good idea to avoid thinking about sex. And you must definitely not have intercourse until your surgeon tells you it is OK to do so. Finally, there used to be a drug called 'bromide' which was given to men who had just been circumcised, in order to try and dampen their sexual urges. But it didn't work very well, and so it isn't often used now.


Girlfriend wants to use sex aids on me

Q. Doc, I have a new American girlfriend and, although she is a lot older than I am, she is a very sexy woman. I think I love her. But I don't understand one thing about her – she actually wants to use 'sex aids' on me! Isn't this rather strange, Doctor? I thought that sex aids were for women – not men.

A. Well, as you say, the vast majority of sex aids, such as vibrators, are used in order to increase the pleasure of women, and to help them 'discharge'. But in some countries – particularly the United States, there is an increasing use of sex aids aimed at men.

Sometimes they are employed successfully on men who have 'lost their nature'. The very fast vibration of these things can often produce an erection.

Also, I have heard that older women sometimes like to use vibrating sex aids in order to stimulate their partners.

But in recent times, some couples have just been using them for fun. So I see no reason why you shouldn't let your American girlfriend try this.


Would my boyfriend feel my diaphragm?

Q. I am a reader of your column and I live in England and my doctor wants me to use a 'diaphragm' to protect me from pregnancy.

But would my boyfriend be able to feel it when he enters me?

A. No, if a diaphragm has been properly fitted, the woman's partner should not be able to feel it during intercourse. The tip of his organ does 'poke' against it, but, generally, he would be unaware of its presence.