1. I have missed two pills in my birth control pill pack and I am concerned about my risk of getting pregnant. What should I do?

If you have missed more than two pills in your birth control pill pack your risk of pregnancy is increased. You should use a backup method of birth control such as condoms to prevent pregnancy during this cycle. To prevent future missed pills it may be useful to set a reminder on your cell phone.

2. I recently had unprotected sex. How do I get Plan B? What is the time frame for taking this pill?

Plan B is available over the counter at most drugstores and can be obtained without a prescription. It is ideal to take this medication within the first 72 hours after unprotected sex for the best results. This medication can be taken up to 120 hours after intercourse (5 days) but the effectiveness may be diminished.

3. I recently started taking a new birth control pill and I am experiencing spotting. What should I do?

When starting a new birth control method there is a risk of vaginal spotting within the first three months of the new method. It is important to continue the pill as prescribed and the symptoms of vaginal spotting will generally resolve after the third pill pack. If it has been longer than 3 months and you are still experiencing spotting, consult your gynecologist.

4. I am currently having vaginal itching and discharge and it also burns when I urinate. How do I know if it is a urinary tract infection or a vaginal infection?

This situation is relatively common and is best addressed with a visit to your gynecologist. If you are experiencing discharge the source is often vaginal. The burning during urination is associated with irritation of the surrounding area.

5. I was recently told that I have uterine fibroids. What do I do about this? Is this cancerous?

Uterine fibroids are a common complaint in many women. Depending on the size, your fibroids can be managed by annual ultrasound. Fibroids are not cancerous, but if they are growing rapidly urgent attention is recommended. If you are experiencing severe pain with your periods, heavy vaginal bleeding, frequent urination or difficulty with intercourse, these fibroids may require treatment. Surgery is the traditional method of fibroid removal either via an open incision or laparoscopy (minimally invasive approach). This can be used to remove only the fibroids or the entire uterus depending on your condition. Uterine artery embolization is a non-invasive technique to shrink uterine fibroids. It is important to obtain information about all of your options prior to deciding on a treatment option.

6. I suffer from frequent urinary tract infections. I need treatment at least twice per month. Is there any way I can prevent these infections from recurring?

Urinary tract infections are a common complaint. Things that increase your risk for a UTI are age, female gender, bladder catheter, prior antibiotic use, diabetes, pregnancy, kidney stones and the short distance between the anus and the urethra. Some ways to prevent this would be with the use of cranberry in juice or pill form. Cranberry acidifies the urine making it hostile to bacteria. Topical estrogen use is reasonable in post-menopausal women with recurrent UTIs. It works to balance the vaginal flora. Above all, it is important to notify your gynecologist if you are having a burning, frequency or urgency of urination so that you can be treated expeditiously to prevent damage to your kidney.

7. I am extremely moody and tearful one week before my period. It interferes with my work and my boyfriend notices it as well. Is this premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD)?

PMS presents with mood irritability up to two weeks before the start of the menstrual cycle. Symptoms can be perceived as mild or severe but terminate when the menstrual period starts. In contrast, PMDD is experienced as a more debilitating mood disorder that begins two weeks before the menstrual cycle but persists throughout the time you are on your period. These patients generally have only one good week per month. If PMS is your problem it can be improved with oral contraceptive pill. If more support is needed a low dose anti-depressant can be used during the time of moodiness. For patients suffering from PMDD the anti-depressant is usually required on a daily basis.

8. Is it risky to get pregnant over the age of 35?

We know that as a woman ages, the risk of genetic problems also increases. In response to that risk we take every effort to screen for these high risk abnormalities, i.e. Down's Syndrome. We can screen for these abnormalities early in pregnancy. If a woman is otherwise healthy, she should be able to carry a pregnancy with little difficulty.

9. I have high blood pressure and I'm pregnant. Is it safe to take blood pressure medication?

Optimal blood pressure control is necessary for proper growth and development of your baby. There are some medications that cannot be used during pregnancy and you should consult your obstetrician before continuing your current hypertensive regimen. Blood pressure control is also important to prevent later complications in the pregnancy.

10. I would like to prevent pregnancy but I cannot tolerate birth control pills. Are there any non-hormonal methods of contraception other than condoms?

Although birth control pill is the most widely used form of contraception, there are women who cannot tolerate them. For those women, we offer non-hormonal methods such as a condom, which prevents against sexually transmitted infection and non-hormonal IUD. The IUD is placed inside the uterus and is effective for 10 years. If this is of interest a consultation is recommended.