Conditions and Management

Raleigh Gynecology · March 13, 2023 ·

A vaginal ring, also known as a birth control ring, is a type of contraceptive device that is placed inside the vagina and works to protect pregnancy around the clock. There are two main types of vaginal rings, and they operate slightly differently. Here is a closer look at the vaginal rings available and how they work.

How Do Vaginal Rings Work?

The two main types of vaginal rings available are NuvaRing and Annovera. These rings contain the hormones estrogen and progestin, which are also found in many birth control pills and are similar to the hormones naturally made by your body. The ring is placed inside the vagina, where it releases the hormones that are absorbed into your body through the vaginal lining.

These hormones work to stop ovulation from occurring, which means there will not be an egg available for sperm to fertilize. This is what stops pregnancy from occurring. They also work to thicken cervical mucus, which can also block sperm and render it unable to swim to an egg, providing an additional layer of protection against pregnancy.

The ring should not be taken out during sex. In fact, it is made to be worn at all times, including while having sex. If you do take your ring out for any reason and it is left out of your body for more than two hours , you will not be protected from pregnancy.

NuvaRing

NuvaRing is a small and flexible ring that you place inside your vagina once a month. Women who use NuvaRing can decide whether they would like to get their period each month for added reassurance that they are not pregnant or skip it by using the ring continuously. NuvaRing contains enough hormones for 28 days of protection.

If you wish to get your period, you can wear the ring for 21 days or28 days depending on how often you want to get your period, before removing it for seven days. Then, place a new ring after seven days without using one, taking care to start and end ring usage on the same day of the week each time.

If you would rather skip your period, you can do so safely by keeping a ring in your vagina at all times. Every 28 days, you should take out your ring and replace it with a new one.

It is not unusual to experience some bleeding or spotting when you are trying to skip your period with the ring. This should go away after several months, but it is safe to use menstrual cups, pads, and tampons with your ring in place as long as you take care not to pull the ring out when removing them.

Annovera

Annovera functions very similarly to NuvaRing. However, it contains enough hormones to last for up to a year, or 13 cycles. It is normally left in the vagina for 21 days and then removed for seven days. Women can expect to get their period during the seven ring-free days. Then, the same ring should be replaced for the next 21 days.

The placement and removal days should always be the same day of the week. For example, if it is placed on a Sunday it should be removed three weeks later on a Sunday.

How to Use a Vaginal Ring

Using a vaginal ring is easy. If you are using Annovera, you need to wash the ring with a mild soap and lukewarm water before placement.

With clean hands, squeeze the sides of your ring together with your fingers and push it gently into the vagina. If you are unable to feel it while walking, it has been placed correctly. If it is uncomfortable, moving it around slightly or pushing it in deeper can help improve its placement. It is not possible to push it in too deep or lose it inside the vagina.

When it is time to remove your ring, you can simply hook your finger through it and remove it gently from the vagina. If you are using NuvaRing, it should be discarded after use. However, because Annovera can be used for multiple cycles, you should wash the ring with mild soap and lukewarm water and dry it thoroughly prior to placing it into its case for safekeeping until it is time to start using it again.

Reach Out to the Women’s Health-care Professionals at Raleigh Gynecology & Wellness

For more information about whether a vaginal ring is the right birth control method for you, reach out to the experienced women’s health-care professionals at Raleigh Gynecology & Wellness to schedule an appointment today.

Raleigh Gynecology · February 6, 2023 ·

Vaginal yeast infections are an unfortunate part of life for many women. These infections are caused when the candida fungus, which is a normal part of your vagina’s microscopic bacterial ecosystem, grows out of control.

In the US, the Centers for Disease Control and Prevention reports that vaginal candidiasis is the second most common vaginal infection behind bacterial vaginal infections, leading to around 1.4 million outpatient doctor visits each year.

Although a vaginal yeast infection is not considered a sexually transmitted infection, many people associate them with sex because they do tend to develop after vaginal intercourse in certain women who are prone to them.

Although the timing can sometimes be a coincidence as many other factors can also trigger yeast infections, there are still some steps that can be taken to keep these infections at bay.

How Does Vaginal Intercourse Lead to Yeast Infections?

It is important to understand how vaginal intercourse can result in a yeast infection. and are the result of a normal fungus in the vagina growing uncontrollably. In the case of vaginal intercourse, bacteria from your partner’s penis, finger, or sex toys can be introduced into your vagina’s ecosystem and disrupt it, triggering a yeast infection.

Ways to Prevent Yeast Infections

Here is a look at some effective ways of reducing your chances of experiencing a yeast infection after sex.

Take Precautions

If you are concerned about getting a yeast infection from sexual activity, a condom or dental dam can help minimize the spread of bacteria through sexual activity.

Wash Up Afterward

It is important to bathe after sexual activity if you are prone to yeast infections, taking care to avoid the use of perfumed soaps and hygiene products in the genital area as these can increase your likelihood of a yeast infection.

You should also avoid douching as these products can disrupt your vagina’s natural balance of bacteria by removing the beneficial bacteria there that serve to fight infections. Do not use a hot tub or take an extra hot bath.

Wear Breathable Undergarments

One effective way of avoiding yeast infections both after sex and in general is by sticking to breathable underwear. Look for underwear that is made of cotton as it can help keep you dry and does not retain heat and/or moisture.

Many types of lingerie are made with other materials, so it may be worth considering whether something you are wearing for sexual activity could be contributing to your yeast infection.

You should also make sure the clothes you wear around your genitals are as loose as possible after sex to reduce your chances of a yeast infection. This includes jeans and pants, as well as pantyhose and tights.

Eat Yogurt With Active Cultures

One easy way to reduce your chances of experiencing a yeast infection after sex is consuming yogurt that contains active cultures. These cultures add to your body’s healthy bacteria that keep yeast under control and infections at bay.

Avoid Partners With an Active Yeast Infection

Although penile yeast infections are not as common as vaginal yeast infections, they do exist and are not unusual. A yeast infection can show up on the penis despite not being considered a sexually transmitted infection.

It is important to keep in mind that having penetrative sex with an individual who is experiencing a penile yeast infection also raises your risk of experiencing a vaginal yeast infection. Likewise, you can pass a yeast infection onto your partner.

Therefore, it is best to avoid sex until your partner is no longer experiencing the symptoms of a yeast infection. This can also help prevent passing the same infection back and forth.

Avoid Sexual Activity With a Partner With Oral Thrush

Researchers have shown that your risk of a yeast infection increases when you receive vaginal oral sex because it introduces bacteria and candida from the gums, tongue, and mouth of your partner to your vagina. The risk is even higher if your partner has oral thrush, so avoid this type of activity until they have recovered.

What Are the Symptoms of a Yeast Infection After Sex?

Keep in mind that the symptoms of a yeast infection may take a couple of days or even a week to develop. If you feel discomfort immediately following sexual activity, it is unlikely to be a sign of a yeast infection.

Some symptoms to watch for include intense itching, irritation, redness, and a type of white discharge that resembles cottage cheese, either in your underwear or when wiping your vagina. You may also experience some pain while urinating, which is why yeast infections may sometimes be confused with urinary tract infections. Some yeast infections do not have any symptoms.

Reach Out to the Health-care Team at Raleigh Gynecology & Wellness

If you are experiencing yeast infections, a doctor can help you identify the cause and develop a plan to keep this frustrating problem under control. Contact Raleigh Gynecology & Wellness today to schedule an appointment with the knowledgeable women’s health-care professionals.

Raleigh Gynecology · December 19, 2022 ·

An IUD, or intrauterine device, is a long-lasting type of birth control placed inside your uterus to prevent pregnancy. Many women choose IUDs because they are more than 99% effective when it comes to preventing pregnancy. This means that in the course of one year, less than one of every 100 women using this device will get pregnant. Therefore, it is one of the most effective types of birth control available.

Nevertheless, it is still possible to get pregnant while using an IUD, particularly if it is expired. Unfortunately, if you get pregnant with an IUD in place, it raises your risk of miscarriage or ectopic pregnancy. Therefore, it is important to be vigilant and have your IUD replaced at the appropriate time.

Can an Expired IUD Slip Out of Place?

IUDs can slip out of place over time, and expired IUDs are particularly vulnerable to this problem. An improperly positioned IUD puts you at a higher risk of pregnancy.

You can check the positioning of your IUD yourself. First, wash your hands thoroughly and then sit or squat and insert your middle or index finger into your vagina. If your IUD is in the right place, you should feel the strings attached to the IUD but not any of the hard plastic casing of the device.

If you cannot feel the string, the string feels shorter or longer than it did before, or you can touch the hard plastic of the device coming out of your cervix, contact your doctor right away. They will use an ultrasound to determine the positioning of the device and will be able to insert a new one if it has slipped out of place. In the meantime, you may not be protected from pregnancy.

When Do IUDs Expire?

Your doctor usually informs you when you have the device inserted how long you can expect your IUD to provide protection from pregnancy. Copper IUDs can last for as long as 10 years, while hormonal IUDs can be effective for three to eight years depending on the brand and type in question.

It is important to remember that leaving an IUD in place after it has expired is never a good idea, even if you are not concerned about accidental pregnancy. Leaving it in for too long can complicate the removal process. It can also cause health risks, such as infections that may lead to sterility or potentially migrating into your abdomen.

Complications of Pregnancy With an Expired IUD

Here is a look at some of the major complications that may occur if you become pregnant with an expired IUD in place.

Ectopic Pregnancy

An ectopic pregnancy is one that develops outside of your uterus. One common cause of ectopic pregnancy is a fertilized egg growing in the fallopian tube. This is a serious condition that can lead to internal bleeding, infection, and possibly death if it is left untreated.

Unfortunately, getting pregnant while an IUD is in place puts you at a higher chance of having an ectopic pregnancy. However, it is worth noting that the overall risk of an ectopic pregnancy is low.

Miscarriage

Another potential problem women may encounter if they get pregnant with an expired IUD is miscarriage. For women who get pregnant while they are using an IUD, the device itself can raise the risk of miscarriage. This occurs when a pregnancy ends spontaneously prior to its 20th week, and when the fetus has not developed sufficiently to survive outside of the uterus.

What Happens if You Get Pregnant With an Expired IUD?

If you discover that you are pregnant with an IUD in place, it is important to contact your doctor right away. In many cases they will recommend to have your IUD removed as soon as possible.

IUD Removal: What to Expect

When your IUD has expired, it is important to have a professional like a gynecologist remove it. This procedure can be carried out at any time. This is a relatively simple and quick process that does not usually cause any complications. Your doctor will pull gently on the string attached to the device with forceps. The arms of the IUD will then fold upward as it slides out of the uterus. You may experience some cramping or light bleeding during or after the process. If you are concerned about pain, you may want to take an over-the-counter painkiller before your appointment to reduce discomfort.

If your IUD is removed due to an infection, you may need to take antibiotics afterward. However, for routine removals without infections or complications, you can have a new IUD inserted immediately at the same office visit.

Reach Out to the Contraceptive Care Professionals at Raleigh Gynecology & Wellness

Although IUDs are highly effective at preventing pregnancy, it is important to ensure you have them replaced when they are approaching expiration and regularly check to ensure the device is positioned properly. If you have any doubts about the integrity of your IUD or have questions about this method of birth control, schedule an appointment with the contraceptive care professionals Raleigh Gynecology & Wellness today.

Raleigh Gynecology · November 21, 2022 ·

One of the most effective forms of birth control available today is Nexplanon®. This is a type of birth control implant that is inserted in the skin of your arm, where it releases hormones that prevent pregnancy.

Many women choose it because it provides protection for as long as three years, making it a good option for those who might be prone to forgetting to take daily birth control pills. Read on to learn more about whether Nexplanon® may be an effective birth control option for you.

How Does Nexplanon® Prevent Pregnancy?

Nexplanon® is an implant that is in the form of a small and thin rod that is roughly the size of a matchstick. Your doctor inserts it under the skin in your upper arm. Once in place, it releases the hormone progestin, which can prevent you from getting pregnant in two ways. First, it thickens your cervical mucus, preventing sperm from swimming through it to reach your egg. Second, it also stops eggs from leaving the ovaries, meaning there will not be an egg for any sperm that gets through to fertilize.

How Effective Is It?

Nexplanon® is more than 99 percent effective in preventing pregnancy. On average, less than one out of every 100 women who use it will become pregnant. The main reason for its strong efficacy is the fact that it is essentially foolproof. Because it is placed inside your arm, you cannot use it incorrectly or forget to use it.

How Long Does Nexplanon® Offer Protection?

Nexplanon® can last for as long as three years, which means it is a “set it and forget it” approach. However, if you decide to get pregnant in the meantime or wish to change your form of contraception, your doctor simply removes the implant, and you should be able to get pregnant.

If your implant is inserted within the first five days of your menstrual cycle, you will be protected from getting pregnant immediately. If you get it at any other time in your cycle, however, you will need to use a different type of birth control during the first week. After that time, your implant will begin to offer protection that can last for up to three years. Be sure to follow your doctor’s advice on when it should take effect.

Does Nexplanon® Protect Against Sexually Transmitted Diseases?

Although Nexplanon® is a very effective way to prevent pregnancy, it is important to understand that it does not provide any degree of protection against sexually transmitted diseases. You will still need to use condoms each time you have sex to avoid spreading or contracting sexually transmitted diseases.

How Is the Implant Inserted?

Once your doctor determines that Nexplanon® is a suitable method of birth control for you, you will be given a shot that numbs a small area of your arm. Then, an inserter tool is used to slide the birth control implant under your skin. This process takes only a few minutes. You may feel some stinging or a small pinch when you receive the numbing shot, but you should not be able to feel anything while the implant is being inserted.

Once the pain medication has worn off, you may notice some aching in your arm where the implant was inserted, but it tends to go away quickly. Although you may experience some swelling, bruising, or tenderness around the implant site, they should subside in a week or two.

Does It Have Any Side Effects?

Although some people experience side effects from the hormones in Nexplanon®, many women use it without any problems. The most common side effect is spotting in the form of brown discharge or light bleeding, particularly during the first six to twelve months. For some, it can also cause long-term spotting or irregular periods. However, for most, it will make their period significantly lighter or go away altogether. Once your body gets used to the implant, these side effects will usually go away.

Some of the less common side effects include weight gain, headaches, nausea, breast pain, infections at the implant site, and ovarian cysts.

Doctors recommend giving your body a few months to adjust to the hormones in Nexplanon®. However, if you are unhappy with it after a few months, discuss your concerns with your doctor, who can help you determine if a different method of birth control may be more appropriate for you.

What Happens After Nexplanon® Is Removed?

Having your birth control implant removed spurs a change in hormones, which always carries the possibility of creating temporary side effects. Your body should eventually return to the way it was before you had the implant. This means that if the implant caused your period to stop, it will eventually come back, although it may take a few months for it to return to your usual cycle.

Keep in mind that you can get pregnant immediately after the implant has been removed from your body, so if you do not wish to become pregnant, you need to use another method of birth control.

Reach Out to the Women’s Health-Care Team

If you are sexually active and wish to avoid pregnancy, contact the women’s health-care team at Raleigh Gynecology & Wellness. We can help you determine which method of contraception best meets your needs and suits your lifestyle.

Raleigh Gynecology · October 31, 2022 ·

Sexual intercourse is meant to be pleasurable, but for some women, it can be a source of considerable physical pain. If you are experiencing pain during sex, you may find it reassuring to learn that it is not uncommon and is generally very treatable. Although it may be uncomfortable to talk about it, your doctor can help you find a solution. Here is a look at some of the management and treatment options for pain during sex.

Diagnosing Pain During Sex

Before finding the best way to address painful sex, it is important to identify its cause. Your doctor will begin by compiling a thorough medical history, asking you questions about when your pain begins, where you are feeling it, and whether it happens in every position or with every partner.

They may also ask you whether any nonsexual activities cause pain in the area and whether you are experiencing other symptoms such as itching, burning, or irritation. Your doctor might ask questions about your childbirth and surgical history. It is important to be forthcoming and answer these questions as truthfully as possible.

Next, they will carry out a pelvic exam to look for signs of skin irritation, anatomical issues, or infections. They may also conduct a visual exam of your vagina using a speculum to keep it open. If this causes you pain, you can ask the doctor to stop the exam. A pelvic ultrasound may also be used if certain causes of painful intercourse are suspected.

Treatment

The precise treatment your doctor will recommend depends on the cause of your pain. Here is a look at some of the most common approaches.

Medication

If a medical condition or infection is behind your pain during intercourse, treating the cause may be enough to bring about relief. If you are taking any medications that can cause lubrication issues, changing to a different medication may also lead to improvements.

Painful intercourse for postmenopausal women is often caused by insufficient lubrication due to low levels of estrogen in the body. Birth control pills, menstruation, pregnancy, breastfeeding, and some types of antiestrogen medications may also result in decreases in estrogen production that lead to dryness and pain during sex. Applying topical estrogen directly to your vagina may alleviate this problem; there are also other medications that can help.

Other Types of Treatment

There are also some nonmedication approaches that may help with painful intercourse.

Counseling or Sex Therapy

For some women, painful sex is psychological and may be linked to trauma or low self-esteem. Even in cases where painful sex has a medical cause, you may develop a negative emotional response to any sort of sexual stimulation, even after the pain has been treated, if sex has been painful for a long time. Moreover, in cases where you and your partner have avoided getting intimate due to your pain, it may be necessary to seek outside help in restoring sexual intimacy and improving your communication surrounding these issues. A counselor or sex therapists can be very helpful. In addition, cognitive behavioral therapy can help you to change any negative thought patterns and behaviors that you have concerning intercourse.

Pelvic Physical Therapy

For some women excess tension or dysfunction of the pelvic floor muscles contributes to painful sex. Referral to a special physical therapist with expertise in this area can help to alleviate this problem.

Changing Positions

For women who experience sharp pain during thrusting, switching to different positions may provide some relief. For example, doctors recommend that women try being on top as they may be able to regulate penetration to a more comfortable depth from this position.

Don’t Skip Foreplay

Foreplay can help to stimulate your body’s natural lubrication, which can make sex more comfortable. Try to delay penetration until you feel completely aroused to see if your pain subsides. Many women report that sex is less painful when they are relaxed and can take their time.

Use Lubricants

There are many personal lubricants on the market that can help to make sexual intercourse more comfortable. Water or silicone based lubricants are frequently good options. If you are using latex condoms for birth control or STD prevention, be sure to avoid oil-based lubricants as they may lead to condom breakage.

Avoid Irritating Products

If you have pain during sex, it could also be due to irritation from certain types of products. Avoid using vaginal perfumes, scented toilet paper, sanitary pads, and bubble baths. Switch to underwear that is 100 percent cotton, and try a gentler laundry detergent to see if any of these products could be related to your pain.

Reach Out to the Women’s Healthcare Professionals

There are many reasons you may be experiencing painful sex, but you do not have to continue suffering. The women’s healthcare professionals at Raleigh Gynecology & Wellness can help to identify the cause of your painful intercourse so you can manage it effectively and restore normal sexual function. Call us today to set up your appointment with a gynecologist or to schedule an appointment online.