Frequently Asked Questions About Reproductive Health
From the National Women's Health Information Center
What causes vaginal yeast infections?
Many things can raise your risk of a vaginal yeast infection, such as:
How can I prevent yeast infections?
- Taking certain medicines, including birth control pills, antibiotics and steroids
- Diseases like poorly-controlled diabetes and HIV/AIDS
- Poor eating habits, including eating extreme amounts of sugary foods
- Lack of sleep
- Having your period
- Hormonal changes during your periods
- Avoid douches.
- Avoid scented hygiene products like bubble bath, sprays, pads and tampons.
- Wear cotton underpants and pantyhose with a cotton crotch.
- Change tampons and pads often during your period.
- Change out of wet swimsuits and exercise clothes as soon as possible.
- Avoid hot tubs and very hot baths.
If you keep getting yeast infections, be sure to talk with your doctor.
How do I know if I have pelvic inflammatory disease (PID)?
Many women don't know they have PID because they don't have any symptoms. For women who have them, symptoms can range from mild to severe. The most common symptom of PID is pain in your lower abdomen (stomach area). Other symptoms include:
- Fever (100.4¢ªF or higher)
- Vaginal discharge that may smell foul
- Painful sex
- Irregular periods (monthly bleeding)
- Pain in the upper right abdomen
- Painful urination
PID can come on fast with extreme pain and fever, especially if it's caused by gonorrhea.
How can I keep myself from getting PID?
PID is most often caused by an STI that hasn't been treated. You can keep from getting PID by not getting an STI.
What is emergency contraception (or emergency birth control)?
- The best way to prevent an STI is to not have sex of any kind.
- Have sex with 1 partner who doesn't have any STIs.
- Use condoms every time you have vaginal, anal, or oral sex. Read and follow the directions on the package. Condoms, when used the right way, can lower your chances of getting an STI.
- Don't douche. Douching removes some of the normal bacteria in the vagina that protect you from infection. This makes it easier for you to get an STI.
- If you're having sex, ask your doctor to test you for STIs. STIs are easier to treat if they are found early.
- Learn the common symptoms of STIs. If you think you might have an STI, see your doctor right away.
Emergency contraception, or emergency birth control, is used to help keep a woman from getting pregnant after she has had unprotected sex (sex without using birth control).
Use emergency contraception if:
- You didn't use birth control.
- You were forced to have sex.
- The condom broke or came off.
- Your diaphragm slips out of place.
- Your partner didn't pull out in time.
- You missed at least two or three birth control pills in a row (depending on which pill brand you use).
- You were late getting your shot.
- You have reason to think your regular birth control might have failed.
Emergency contraception should not be used as regular birth control. Other birth control methods are much better at preventing pregnancy. Talk with your doctor to decide which one is right for you.
What are the types of emergency contraception and how do they work?
There are two types:
Emergency contraceptive pills (ECPs)
With ECPs, higher doses of the same hormones found in regular birth control pills prevent pregnancy by keeping the egg from leaving the ovary or keeping the sperm from joining the egg. While it is possible that ECPs might work by keeping a fertilized egg from attaching to the uterus, the most up-to-date research suggests that ECPs do not work in this way. In the United States, there is only one FDA-approved pill that is specially made to be used as an ECP. It is called Plan B. However, when used in a certain way, some regular birth control pills also can be used as ECPs.
- Plan B – Plan B is a progestin-only ECP. It is made for use as emergency contraception. Plan B is like progestin-only birth control pills, but contains higher levels of the hormone. The instructions for Plan B say to take the two pills 12 hours apart. But research has shown that taking both pills at the same time works just as well and does not increase side effects.
- Higher dose of regular birth control pills – The number of pills in a dose is different for each pill brand, and not all brands can be used for emergency contraception. For more information on birth control pills that can be used for emergency contraception, visit the Emergency Contraception Website (not-2-late.com). The pills are taken in 2 doses (1 dose right away, and the next dose 12 hours later). Always use the same brand for both doses, and be sure to use the active pills, not the reminder pills.
You should always take ECPs as soon as you can after having unprotected sex, but they can work up to 5 days later. Women who are breastfeeding or cannot take estrogen should use progestin-only ECPs (like Plan B). Some women feel sick and throw up after taking ECPs. If you throw up after taking ECPs, call your doctor or pharmacist.
Intrauterine device (IUD)
The IUD is a small, T-shaped device placed into the uterus by a doctor within 5 days after having unprotected sex. The IUD works by keeping the sperm from joining the egg or keeping a fertilized egg from attaching to the uterus. Your doctor can remove the IUD after your next period. Or, it can be left in place for up to 10 years to use as your regular birth control method.
How often do I need a Pap test?
It depends on your age and health history. Talk with your doctor about what is best for you. Most women can follow these guidelines:
- Starting at age 21, have a Pap test every 2 years.
If you are age 30 or older and have had three normal Pap tests for three years in a row, talk to your doctor about spacing out Pap tests to every two to three years.
If you are over age 65, ask your doctor if you can stop having Pap tests.
Ask your doctor about more frequent testing if:
- You have a weakened immune system because of organ transplant, chemotherapy or steroid use
- Your mother was exposed to diethylstilbestrol (DES) while pregnant
- You are HIV-positive
Women who are living with HIV, the virus that causes AIDS, are at a higher risk of cervical cancer and other cervical diseases. The U.S. Centers for Disease Control and Prevention recommends that all HIV positive women get an initial Pap test, and get re-tested 6 months later. If both Pap tests are normal, then these women can get yearly Pap tests in the future.
The only women who do not need regular Pap tests are:
What is human papillomavirus (HPV)?
- Women over age 65 who have had 3 normal Pap tests and in a row and no abnormal test results in the last 10 years, and have been told by their doctors that they don't need to be tested anymore.
- Women who do not have a cervix and are at low risk for cervical cancer. These women should speak to their doctor before stopping regular Pap tests.
Human papillomavirus (pap-uh-LOH-muh-veye-ruhss), or HPV, is the name for a group of viruses that includes more than 100 types. More than 40 types of HPV can be passed through sexual contact.
The types of HPV that infect the genital area are called genital HPV. Over half of sexually active people will have HPV at some point in their lives. But most people never know it. This is because HPV most often has no symptoms and goes away on its own.
Some types of HPV can cause cervical cancer. These types of HPV are called high-risk. Having high-risk HPV is not the same as having cervical cancer. But high-risk HPV can lead to cancer. Most often, high-risk HPV causes no health problems and goes away on its own. High-risk HPV cases that don’t go away are the biggest risk factor for cervical cancer. If you have high-risk HPV, your doctor can look for changes on your cervix during Pap tests. Changes can be treated to try to prevent cervical cancer. Be sure to have regular Pap tests so changes can be found early.
Low-risk HPV can cause genital warts. Warts can form weeks, months, or years after sexual contact with an infected person. In women genital warts can grow:
- Inside and around the outside of the vagina
- On the vulva ("lips" or opening to the vagina), cervix, or groin
- In or around the anus
In men, genital warts can grow:
- On the penis
- On the scrotum, thigh, or groin
- In or around the anus
Rarely, genital warts grow in the mouth or throat of a person who had oral sex with an infected person.
The size of genital warts varies. Some are so small you can't see them. They can be flat and flesh-colored or look bumpy like cauliflower. They often form in clusters or groups. They may itch, burn, or cause discomfort.
Low-risk HPV doesn’t always cause warts. In fact, most people with low-risk HPV never know they are infected. This is because they don't get warts or any other symptoms.
How do I know if I have an HPV infection?
Most women who have HPV infections never know it. This is one reason why you need regular Pap tests. A Pap test is when a cell sample is taken from your cervix and looked at with a microscope.
A Pap test can find changes on the cervix caused by HPV. To do a Pap test, your doctor will use a small brush to take cells from your cervix. It’s simple, fast, and the best way to find out if your cervix is healthy.
If you are age 30 or older, your doctor may also do an HPV test with your Pap test. This is a DNA test that detects most of the high-risk types of HPV. It helps with cervical cancer screening. If you’re younger than 30 years old and have had an abnormal Pap test result, your doctor may give you an HPV test. This test will show if HPV caused the abnormal cells on your cervix.
Another way to tell if you have an HPV infection is if you have genital warts. Genital warts can grow inside and around the outside of the vagina, on the vulva ("lips" or opening to the vagina) and cervix, groin and in or around the anus. In men, genital warts can grow on the penis, scrotum, thigh, groin, or in or around the anus. Most of the time, people who have HPV infections never know they have it.
Should I get the HPV vaccine?
It depends on your age and whether or not you already have had sex.
Two vaccines (Cervarix and Gardasil) can protect girls and young women against the types of HPV that cause most cervical cancers. The vaccines work best when given before a person's first sexual contact, when she could be exposed to HPV. Both vaccines are recommended for 11 and 12 year-old girls. But the vaccines also can be used in girls as young as 9 and in women through age 26 who did not get any or all of the shots when they were younger. These vaccines are given in a series of 3 shots. It is best to use the same vaccine brand for all 3 doses. Ask your doctor which brand vaccine is best for you. The vaccine does not replace the need to wear condoms to lower your risk of getting other types of HPV and other sexually transmitted infections. Women who have had the HPV vaccine still need to have regular Pap tests.
Studies are also being done on HPV vaccines for males.