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Frequently Asked Questions About Reproductive Health
From the National Women's Health Information Center
What causes vaginal yeast infections?
Many things can change the acidity of the vagina and boost your chances of a vaginal yeast infection. These include:
- Pregnancy
- Taking birth control pills
- Diseases like poorly-controlled diabetes and HIV infection
- Poor diet, or extreme intake of sugary foods
- Taking steroid medication or antibiotics
- Stress
- Lack of sleep
- Having your period
How can I prevent yeast infections?
Avoid scented hygiene products like bubble bath, sprays, pads and tampons. Don't use douches. Wear cotton underpants and pantyhose with a cotton crotch to help keep the genital area ventilated. Change tampons and pads often during your period. Change out of wet swimsuits and exercise clothes as soon as possible. If you have a problem with recurring yeast infections, ask your health care provider about ways to prevent them.
What are the symptoms of fibroids?
Most fibroids do not cause any symptoms, but some women with fibroids can have:
- Heavy bleeding or painful periods
- Bleeding between periods
- Feeling of fullness in the pelvic area (lower stomach area)
- Frequent urination
- Pain during sex
- Lower back pain
- Reproductive problems, such as infertility, having more than one miscarriage, or having early onset of labor during pregnancy
How do I know for sure that I have fibroids?
Your doctor may find that you have fibroids when you see her or him for a regular pelvic exam to check your uterus, ovaries and vagina. Often, a doctor will describe how small or how large the fibroids are by comparing their size to the size your uterus would be if you were pregnant. For example, you may be told that your fibroids have made your uterus the size it would be if you were 16 weeks pregnant. Or the fibroid might be compared to a grape or an orange, an acorn or a walnut, or a golf ball.
Your doctor can do imaging tests, or tests that create a "picture" of the inside of your body without surgery, in order to confirm that you have fibroids. These tests might include:
- Ultrasound — Uses sounds waves to produce the picture
- Magnetic resonance imaging or MRI — Uses magnets and radio waves to produce the picture
- X-rays — Use a form of radiation to see into the body and produce the picture
- Cat scan or CT — Makes many pictures of the body from different angles to provide a more complete image
- Hysterosalpingogram (HSG) or sonohysterogram — Involves injecting X-ray dye into the uterus and taking X-ray pictures. A sonohysterogram involves injecting water into the uterus and making ultrasound pictures.
Besides imaging tests, you also might need a surgery to know for sure if you have fibroids. These could include:
- Laparoscopy — Surgery in which your doctor inserts a long, thin scope into a tiny incision made in or near the navel. The scope has a bright light and a camera. This allows the doctor to view the uterus and other organs on a monitor during the procedure. Pictures also can be made.
- Hysteroscopy — Surgery in which your doctor passes a long, thin scope with a light through the vagina and cervix into the uterus. No incision is needed. The doctor can look inside the uterus for fibroids and other problems, such as polyps. A camera also can be used with the scope.
What is emergency contraception (or emergency birth control)?
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 partner didn't pull out in time
- You missed two or more birth control pills in a row
- You were late getting your shot
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.
I had a hysterectomy. Do I still need Pap tests?
It depends on the type of hysterectomy (surgery to remove the uterus) you had and your health history. Women who have had a hysterectomy should talk with their doctor about whether they need routine Pap tests.
Usually during a hysterectomy, the cervix is removed with the uterus. This is called a total hysterectomy. Women who have had a total hysterectomy for reasons other than cancer may not need regular Pap tests. Women who have had a total hysterectomy because of abnormal cells or cancer should be tested yearly for vaginal cancer until they have three normal test results. Women who have had only their uterus removed but still have a cervix need regular Pap tests. Even women who have had hysterectomies should see their doctors yearly for pelvic exams.
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. The American College of Obstetricians and Gynecologists recommends the following:
- If you are younger than 30 years old, you should get a Pap test every year
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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 or three years
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If you are ages 65 to 70 and have had at least three normal Pap tests and no abnormal Pap tests in the last 10 years, ask your doctor if you can stop having Pap tests.
You should have a Pap test every year no matter how old you are 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:
- Women over age 65 who have had a number of normal Pap tests 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
What is human papillomavirus (HPV)?
Human papillomavirus is also called HPV. It is a virus that includes more than 100 types, over 30 of which are sexually transmitted. The types of HPV that infect the genital area are known as genital HPV. Most sexually active people will have HPV at some point in their lives, though most will never know it because it usually has no symptoms and goes away on its own. Genital HPV types are either low-risk or high-risk types. This does not have to do with the risk of getting the infection. It is about the risk of getting cervical cancer.
Both high-risk and low-risk types of genital HPV can cause changes or growths on the tissue of a woman's cervix. The cervix is part of the uterus that opens to the vagina. Growths are usually flat and invisible. Some types of HPV can cause cervical cancer. Approximately 10 of the 30 identified genital HPV types can lead, in rare cases, to development of cervical cancer. Most HPV infections do not progress to cervical cancer.
- Having high-risk HPV is not the same as having cervical cancer. Usually, these high-risk HPV types cause no health problems at all and go away on their own. Persistent high-risk HPV (infection that does not go away) is the most important risk factor for cervical cancer. The good news is that cervical cell changes can be found with regular Pap tests, and treated to prevent cervical cancer from ever developing.
- Low-risk types of HPV can cause genital warts, but do not cause cervical cancer. Warts can form weeks, months, or years after sexual contact with a person who has genital HPV. 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. While very rare, genital warts can grow in the mouth or throat of a person who has had oral sex with an infected person. The size of genital warts varies and some may be so small, you can't see them with your eyes. They can be flat and flesh-colored or look bumpy like cauliflower. They often occur in clusters or groups. They may cause itching, burning, and discomfort. It's also possible that warts may never appear. In fact, most people with low-risk types of genital HPV never know they are infected because they don't get warts or any other symptom.
How do I know if I have an HPV infection?
A Pap test can find changes on the cervix, caused by an HPV infection. To do a Pap test, your doctor will use a small brush to take cells from your cervix. It's simple and fast and the best way to find out if your cervix is healthy.
If you're 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 and is a test to help with cervical cancer screening. If you're younger than 30 years old and have had a borderline (ASC-US) Pap test result, your doctor may give you an HPV test. This test will tell you 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.
How do I protect myself from HPV?
HPV infection can infect male and female genital areas that are covered by a condom, as well as areas not covered by the condom. Using condoms may reduce the risk of getting genital warts and cervical cancer. But condoms may not completely protect you. The best way to protect yourself from HPV is to not have sex, or to only have sex with one uninfected partner who also only has sex with you.
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