Sex & Relationships

Birth Control aka Contraception

What is Birth Control? What is Contraception?

What’s the difference? What are my options?

When it comes to birth control and contraception, sometimes information can be confusing and misleading. There are lots of unanswered questions and misconceptions. That’s why women’s Health Base will provide you with a comprehensive guide to clarify everything you ever wanted to know about birth control.

Birth control, also known as contraception, is designed to prevent pregnancy. Birth control methods may work in a number of different ways. There are several general methods of birth control, including (but not limited to):

Barrier methods

• There are various barrier birth control methods that prevent sperm from entering into the uterus and getting to the eggs. The forms of contraception that work this way include:
  • Condoms
  • Diaphragms
  • Intrauterine devices (IUDs)
  • Cervical cap

Intrauterine device (IUD)

• An IUD is a small device inserted into the uterus by your doctor or health care provider. The IUD is more than 99 percent effective at preventing pregnancy.
  • An IUD can stay in the uterus for up to 10 years until it is removed by your doctor or health care provider.

Hormonal birth control

• Keeping the woman’s ovaries from releasing eggs that could be fertilized. The forms of contraception that work by releasing hormones into a woman’s body that interfere with fertility by preventing ovulation. The forms of contraception that work this way include:
  • Birth control pills
  • Injections
  • Skin Patches
  • Vaginal Rings
  • Implants

Sterilization

• A method that permanently prevents a woman from getting pregnant or a man from being able to get a woman pregnant.
  • Sterilization involves surgical procedures that must be done by your doctor or health care provider.
  • The sterilization procedure usually cannot be reversed.

Your choice of birth control should depend on several factors. These include your health, frequency of sexual activity, number of sexual partners and desire to have children in the future. Your health care provider can help you select the best form of birth control for you.

Sexually Transmitted Diseases (STDs)

What are Sexually Transmitted Diseases (STDs)?

STDs, also called sexually transmitted infections or STIs, are diseases that you get by having intimate sexual contact, that is having sex (vaginal, oral, or anal intercourse), with someone who already has the disease. Every year, STDs affect more than 13 million people.

What are the different types of STDs?

20 different kinds of STDs have been identified. All STDs fall into two main groups:

• STDs caused by bacteria – These diseases can be treated and often cured with antibiotics. Some bacterial STDs include: chlamydia, gonorrhea, trichomoniasis, and syphilis.
• STDs caused by viruses - These diseases can be controlled, but not cured. If you get a viral STD, you will always have it. Some viral STDs include: HIV/AIDS, genital herpes, genital warts, human papilloma virus (HPV), hepatitis B virus, and cytomegalovirus.

What are the symptoms of STDs?

The symptoms vary among the different types of STDs. Some examples of common symptoms include:

• Unusual discharge from the penis or vagina
• Sores or warts on the genital area
• Burning while urinating
• Itching and redness in the genital area
• Anal itching, soreness, or bleeding

If you are having any of these symptoms or think you might have an STD, talk to your health care provider.

How can STDs be prevented?

The only way to ensure that you won’t get infected is to not have sex. This means avoiding all types of intimate sexual contact.

If you are sexually active, you can reduce your risk of getting STDs by practicing “safe sex.” This means:

• Using a condom for vaginal, oral, and anal intercourse-every time
• Knowing your partner and his/her STD status and health
• Having regular medical check-ups, especially if you have more than one sexual partner

AIDS/HIV

What are AIDS and HIV?

AIDS stands for acquired immunodeficiency syndrome, a condition first reported in the United States in 1981, that has since become a major worldwide epidemic.

AIDS is caused by HIV (human immunodeficiency virus). By killing or damaging cells of the body’s immune system, HIV progressively destroys the body’s ability to fight infections and certain cancers. The term AIDS applies to the most advanced stages of HIV infection.

How is HIV spread?

There are several common ways that HIV can be passed from person to person, including:

• Having unprotected sex with someone who is infected
• Using needles or syringes that have been used by people who are infected
• Receiving infected blood products or transplanted organs (Since 1985, the United States actively tests all donated blood for HIV; therefore, the risk of getting HIV in this way in the United States is now extremely low.)
• Transmission from mother to child – An infected mother may pass the virus to her developing fetus during pregnancy, during birth, or through breastfeeding.

If you have a sexually transmitted disease, you may be at higher risk for getting infected with HIV during sex with an HIV-infected partner.
There is no evidence that HIV is spread by contact with saliva or through casual contact, such as shaking hands or hugging, or the sharing of food utensils, towels and bedding, swimming pools, telephones, or toilet seats. HIV is not spread by biting insects such as mosquitoes or bedbugs.

What is the treatment for HIV/AIDS?

Although when AIDS first appeared there were few treatments, researchers have now developed drugs that can help fight both HIV and the related infections and cancers that come with it. Treatment advances have improved the survival rates and decreased progression of HIV disease in developed countries like the United States, where antiretroviral drugs are available.

How does HIV/AIDS affect women?

According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), 19.2 million women are living with HIV/AIDS throughout the world. In many countries, the rate of HIV infection in women is rising faster than in any other group.

Worldwide, more than 80 percent of HIV infections are spread by heterosexual sex (vaginal intercourse); women are particularly at risk of contracting HIV through this type of contact. HIV is increasing most dramatically among African American and Hispanic women.

Although most of the signs and symptoms of HIV infection are similar in men and women, some are more specific to females. For example:

• Vaginal yeast infections may be chronic, more severe, and difficult to treat in women with HIV infection than in women who are uninfected.
• Pelvic inflammatory disease, an infection of the female reproductive organs, may also be more frequent and severe in women with HIV infection.
• Human papillomavirus (HPV) infections, which cause genital warts, may occur more frequently in HIV-infected women, and can lead to pre-cancerous lesions of the cervix or cancer of the cervix.

The NICHD, along with other Institutes, supports studies to determine what aspects of HIV are specific to women and the best treatments for these symptoms.

How does HIV affect pregnant women and infants?

Women can give HIV to their babies during pregnancy, while giving birth, or through breastfeeding.

But, there are effective ways to prevent the spread of mother-to-infant transmission of HIV:

• Taking anti-HIV drugs during pregnancy-either a drug called zidovudine or AZT alone or in combination with other drugs called highly active antiretroviral therapy (HAART)-a mother can significantly reduce the chances that her baby will get infected with HIV.
• Delivering the baby by cesarean section, and doing so before the mother’s uterine membranes rupture naturally, reduces transmission that may occur during the birth process. Use of anti-HIV drugs during pregnancy and delivery, combined with a cesarean section in women with certain levels of HIV in their blood, can reduce the chance that the baby will be infected to less than 2 percent.
• Avoidance of breastfeeding by an HIV-infected mother. HIV can be spread to babies through the breast milk of mothers infected with the virus. The American Academy of Pediatrics recommends that, in countries such as the United States, where infant formula is safe and is often available and affordable, HIV-infected women feed their infants commercially available formula instead of breastfeeding.

Approximately one-fourth to one-half of all untreated pregnant women infected with HIV will pass the infection to their babies. HIV infection of newborns is very rare in the United States because women are tested for HIV during pregnancy, and women with HIV infection receive anti-HIV drugs during pregnancy, cesarean delivery if their HIV blood levels are high, and are advised not to breastfeed their infants.

How does HIV affect children and adolescents?

It is estimated that approximately 10,000 children are living with HIV infection in the United States. In the United States, the number of infants born with HIV infection has dramatically decreased from about 2,000 a year to fewer than 200 a year due to identification of HIV infection in pregnant women and use of anti-HIV drugs during pregnancy, cesarean delivery, and avoidance of breastfeeding.

In contrast to the United States, mother-to-child transmission in developing countries remains a major problem; about 700,000 infants are newly infected with HIV each year because most women are not screened for HIV during pregnancy, anti-HIV drugs are not available, and safe alternatives to breastfeeding are not available.

Prior to 1985, when screening of the nation’s blood supply for HIV began, some children as well as adults were infected through transfusions with blood or blood products contaminated with HIV, but this is now rare in the United States.

In contrast to the dramatic decrease in mother-to-child transmission of HIV infection, the number of cases of HIV infection in adolescents and young adults continues to increase in the United States.   About one-third to one-half of new HIV infections in the United States are among adolescents and young adults.

Most HIV-infected adolescents and young adults are exposed to the virus through unprotected sex; some teens and young adults are also infected through injection drug use. In addition, an increasing number of children who were infected as infants are now surviving to adolescence.

Menstruation and the Menstrual Cycle

What is the menstrual cycle?

The menstrual cycle is the process by which a woman’s body gets ready for the chance of a pregnancy each month. The average menstrual cycle is 28 days from the start of one to the start of the next, but it can range from 21 days to 35 days.

In the beginning of the menstrual cycle, levels of estrogen rise, causing the lining of the uterus to grow and get thicker. An egg starts to mature in one of the ovaries. Around the middle of the cycle, the egg leaves the ovary, a process called ovulation.

The egg begins to travel down the fallopian tubes to the uterus. If the egg becomes fertilized by a sperm cell and attaches to the uterus, the woman becomes pregnant. If not, the uterus does not need the extra thick lining and it begins to shed.

This shedding of the uterine lining through the vagina is menstruation.

What is menstruation?

Menstruation is the part of a woman’s monthly menstrual cycle in which blood and tissue are discharged from the vagina. It is also commonly called a period or menstrual period.

Most menstrual periods last from three to five days. In the United States, most girls start menstruating at age 12, but girls can start menstruating between the ages of 8 and 16.

What are the signs of menstruation?

Bleeding from the vagina is the primary sign of menstruation.

Some women have other symptoms around the time of menstruation, including:

• Cramping, bloating, and sore breasts
• Food cravings
• Mood swings and irritability
• Headache and fatigue

If these symptoms are severe, it might be a sign of premenstrual syndrome (PMS). PMS usually occurs one or two weeks before menstruation. PMS may affect a woman of any age who has menstrual periods. If the symptoms disrupt your lifestyle, you may want to seek medical care.

Menstrual Irregularities

What if I have a problem with my menstrual periods?

A stop in menstrual periods (called amenorrhea), or other menstrual irregularities could be a sign that something is wrong. Menstrual irregularities can mean bleeding between your periods, skipping a period, or having very heavy menstrual periods. It is important to tell your health care provider about these symptoms.

Are there treatments for painful menstruation?

Placing a heating pad on the abdomen and over-the-counter pain relievers may help lessen the symptoms. It is important to tell your health care provider if you have severe cramping and pain or other symptoms, during menstruation.

What are menstrual irregularities?

Sometimes women have problems in their menstrual cycle-called menstrual irregularities or menstrual problems. They may not get periods, get periods too frequently, have unpredictable menstrual bleeding, or they may have painful periods.

When not caused by pregnancy, menstrual irregularities are usually a sign of a larger condition or problem.  There are many conditions that can cause menstrual irregularities.

• Amenorrhea – Amenorrhea occurs when a woman does not get her period by age 16, or when she stops getting her period for at least three months and is not pregnant.

  Amenorrhea is not a disease. Instead, it is a symptom of another condition. Possible causes can include moderate or excessive exercising, eating disorders (such as anorexia nervosa), physical or psychological stress, tumors, and hormonal problems. Women with polycystic ovary syndrome (PCOS) may also experience amenorrhea.

  It is important for you to see your health care provider to determine the cause of amenorrhea. Treatment for amenorrhea depends on the underlying cause. Sometimes lifestyle changes can help if weight, stress, or extreme physical activity is causing the amenorrhea. Other times, medications and oral contraceptives can help the problem.

• Oligomenorrhea - (pronounced oh-ligg-oh-men-or-ee-uh) This term refers to infrequent menstrual periods, or having a period only now and then. Like amenorrhea, oligomenorrhea is not a disease itself, but is a symptom of a larger condition. For example, many women with polycystic ovary syndrome (PCOS) have oligomenorrhea.

• Premature Ovarian Failure (POF) – POF describes a stop in the normal functioning of the ovaries in a woman younger than age 40. Women with POF may not have periods or may get them irregularly. Although getting pregnant is difficult for women with POF, it may still be possible.

  There is no proven treatment to make a woman’s ovaries work normally again. However, estrogen replacement therapy (ERT) gives women the estrogen and other hormones their bodies are not making and can help women have regular periods and lower their risk for osteoporosis.

• Uterine Fibroids – Uterine fibroids are the most common, non-cancerous tumors in women of childbearing age. Most women with fibroids do not have problems with fertility and can get pregnant. But some women with fibroids may not be able to get pregnant naturally.

  Women who have uterine fibroids but show no symptoms may not need any treatment. Some women with fibroids have heavy menstrual periods, and some may bleed in between periods. Medications can often offer relief from many of the symptoms of fibroids, such as pain, and can even slow or stop their growth. There are also several types of surgery that can remove the fibroids.

• Endometriosis – Endometriosis occurs when tissues that usually grow inside a woman’s uterus grow on the outside instead. Endometriosis may cause pain before and during the first few days of the menstrual period. About 30 percent to 50 percent of women with endometriosis are infertile, making it one of the top three causes for female infertility. Women with endometriosis may also have very heavy periods.

  There are several ways to treat pain, including pain medication, hormone therapy, and surgery.

  There are also some treatments for infertility associated with endometriosis. In vitro fertilization often works to improve fertility in women with the condition. Hormone treatments and surgery offer other infertility treatment options.

• Dysmenorrhea – Dysmenorrhea refers to painful periods, including severe menstrual cramps. The condition is usually not serious, although it can sometimes be caused by infection, endometriosis, or ovarian cysts.

  Painful periods can sometimes be eased by using heating pads or taking a warm bath. Over-the-counter (OTC) pain relievers can also help with the pain. Your health care provider might recommend birth control pills or a birth control shot to make periods less painful.

Vaginitis

What is vaginitis?

Vaginitis is a term for any infection or inflammation of the vagina.

What are the symptoms of vaginitis?

In general, vaginitis may cause itching, irritation, or abnormal vaginal discharge.

There are a several different kinds of vaginitis, each with their own causes and symptoms:

• Candida or “yeast” infections – Yeast infections of the vagina are probably the most familiar form of vaginitis. They occur when too much of the fungus Candida grows in the vagina.

Yeast infections produce a thick, white discharge from the vagina that can look like cottage cheese. The discharge can be watery and often has no smell. Yeast infections usually cause the vagina and vulva (the area outside the vagina) to become itchy and red.

• Bacterial vaginosis – Bacterial vaginosis is the most common vaginal infection in women of reproductive age. It is caused by an overgrowth of bacteria that are usually present in the vagina.

Bacterial vaginosis will often cause a thin, milky discharge from the vagina that may have a “fishy” odor. Many women with bacterial vaginosis have no symptoms and only discover they have it during a routine gynecologic exam.

• Trichomoniasis – Trichomoniasis is a sexually transmitted disease that is caused by a single-cell parasite. It can cause vaginal itching, burning, and soreness of the vagina and vulva, as well as burning during urination. Many women with trichomoniasis do not develop any symptoms.

• Non-infectious vaginitis – This form of vaginitis is usually caused by an allergic reaction or irritation from vaginal sprays, douches, spermicidal products, soaps, detergents, or fabric softeners. It can cause burning, itching, or vaginal discharge even if there is no infection.

What are the treatments for vaginitis?

The key to treating vaginitis is knowing which kind you have. The treatment must be specific to the type of vaginitis present.

• Yeast infections are usually treated with an anti-yeast cream or suppository placed inside the vagina. A health care provider can write a prescription for most yeast infection treatments.

  Although you can also buy medicine to treat yeast infections over-the-counter, it is a good idea to see a health care provider the first time you have symptoms of a yeast infection. Because this medicine will not cure other types of vaginitis, it is important to be sure you actually have a yeast infection before using these treatments.

• Bacterial vaginosis is treated with an antibiotic that gets rid of the “bad” bacteria and leaves the “good” bacteria. There is no over-the-counter treatment for bacterial vaginosis, so it is important to see your health care provider for a prescription.

• Sexually transmitted forms of vaginitis need to be treated by a health care provider right away. It is important to avoid sexual contact until you have been treated to prevent spreading the infection. A woman’s sexual partner(s) will need treatment as well.

Trichomoniasis and Chlamydia are both treated by antibiotics. Neither genital herpes nor HPV can be cured, but both can be controlled with the help of your health care provider and medications.

• Non-infectious vaginitis can be treated by stopping the use of the product that caused the allergic reaction or irritation. Your health care provider may also be able to provide medicated cream to help reduce the symptoms until the reaction goes away.

It is important to remember that each type of vaginitis has a different treatment. Therefore it is very important to see a health care provider to be sure you are using the right treatment for your condition.  Also, some kinds of vaginitis have no symptoms so it is important to have regular gynecologic exams.

Can I prevent vaginitis?

There are some things you can do to lower your chances of getting vaginitis.

• If you often get yeast infections, you may want to avoid clothes that hold in heat and moisture, such as panty hose without a cotton lining, nylon panties, or tight jeans.

• Avoid douching and vaginal sprays because they can kill “good” bacteria or cause irritation.

• Practicing safe sex can help protect against sexually transmitted forms of vaginitis.

Bacterial Vaginosis

What is bacterial vaginosis?

Bacterial vaginosis is an infection of the vagina. It occurs when there are too many bacteria that are normally present in the vagina.  It is the most common vaginal infection in women of reproductive age.

What are the symptoms of bacterial vaginosis?

Bacterial vaginosis often causes a thin, milky discharge from the vagina that is described as having a “fishy” odor. This odor may be more noticeable after sexual intercourse. Redness or itching of the vagina is not common. In fact, some women with bacterial vaginosis have no symptoms at all.

In addition, having bacterial vaginosis increases the risk of getting other sexually transmitted diseases.  The condition has also been associated with pelvic inflammatory disease.

Bacterial vaginosis is thought to be associated with preterm labor and preterm birth.

What are the treatments for bacterial vaginosis?

A health care provider can prescribe an antibiotic to treat bacterial vaginosis. The medication will bring the level of bacteria in the vagina back into a healthy range. There are no over-the-counter treatments for bacterial vaginosis.

Content Created/Medically Reviewed by our Expert Doctors