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In general, you should either start taking birth control pills on the first day of your period or the first Sunday after the start of your period (not the end), whichever your doctor recommended. This ensures that you are not pregnant, and helps maintain your period on the pill close to the time it would normally occur. It is very important to take your pill at the same time every day, and take every pill. If you ever forget, take it as soon as you remember. If you miss more than one pill, take two pills a day until you catch up, but expect to get some irregular bleeding and expect that you will need to use back-up contraception with a condom. As you finish each pack of pills, make sure you have already received your next pack so you can go straight from one to the next.

While most women expect to have a decrease in their periods when they are on birth control pills, it is not unusual for the period to get so light that there is no obvious bleeding, even on the sugar pills. This is perfectly normal and not a cause for concern. There is no need to “take a break” from the pill to have a period. Your period should go back to how it was before when you stop taking the pill. Sometimes you may have light bleeding or spotting randomly on birth control, which is also perfectly normal. This can be due to irregular pill taking, sickness, stress, other medications, or can happen for no obvious reason. Most of the time, you will go back to normal in one or two cycles. There is no established amount of time that it is “safe” to take the pill, and depends entirely on your history and particular circumstances. Your doctor will discuss this with you when you come in for your annual exam.

If you have not had a period for a long time (not on hormonal birth control) or your uterine lining has built up, your doctor may give you a prescription for progesterone to help your period start. It is important that you take all the pills, even if your period starts while you are taking them. It may take up to two weeks past the time that you finish the last pill for your period to start. Every woman’s body may react a little differently.

Because hormonal birth control (including pills, the patch and the ring) affects the lining of the uterus, it is not unusual to have occasional breakthrough bleeding.  This is most common in the first three months of starting, if you have recently made a change in your medication, and if there have been any other health-related issues, even those not directly related to your period.  Finally, although we recommend that you always strive to take your pill on time every day, we understand that almost everyone has been late or missed a pill at one time or another. Of course, you will get your best results by being very consistent. For this reason, many women may prefer a non-daily birth control option.

When there is constantly new information about screening guidelines, it can be hard to know what is right for you. In general, women who have not had any significant Pap smear abnormalities in the past or have not required treatment for significant abnormalities (laser, LEEP or cone) may not need a pap every year. We continue to recommend that you receive a gynecologic exam every year including a breast and pelvic exam, as there is more to women’s health than having a Pap smear. It is also an opportunity for your doctor to review any other concerns you may have.

Many women will be diagnosed with a vaginal infection at some point, and some women have these frequently. The most common ones are either a yeast infection or bacterial vaginosis. There are quite a few similarities. Both can cause itching, burning, rawness or discomfort. Both are usually associated with increased vaginal discharge. While all women have some vaginal discharge, the amount can vary between different women as well as for the same woman at different stages of her life. You may be more susceptible if you have recently taken antibiotics or if you have a new sexual partner. There are over-the-counter medications that can be used to treat yeast infections or to help relieve the symptoms. While it is okay to use these once in awhile, if you don’t get better, or if you get frequent episodes, it is better to come in and have a test to make sure you are getting the correct treatment.

If you are 40 or over, you do NOT need an order for your regular screening MMG. You may call the center where you typically go and make an appointment. Please make sure they have the correct physician’s name when you have your mammogram performed so your doctor receives your report. However, if you are having a problem with one or both breasts, such as pain, a lump, or something else, please call your doctor first. In some cases, we may need to order a different/additional test, or we may need to see you first.