Routine Gynecologic Care

Hormonal contraception methods are very reliable in preventing pregnancy. Hormones can be introduced into your body through the various methods described below. Which method of hormonal contraception best suits your needs depends on a range of factors, including your overall health, age, plans for having children and other factors.

How Hormonal Contraception Works

How hormonal contraception works depends on the types and combination of hormones used. Each method will prevent pregnancy in one or more of the following three ways:

• Prevents ovulation by stopping your ovaries from releasing eggs.
• Thickens your cervical mucus to impair sperm from reaching an egg.
• Thins the lining of your uterus to prevent any fertilized egg from attaching itself to your uterus.

Description Of The Types of Hormonal Contraception

Each contraception method described below differs in the way it delivers the hormones into your body. They may also differ in the hormonal composition and dosage.
Hormonal contraceptives are very reliable when they are used properly. The most reliable forms of hormonal contraception are those that reduce the possibility of human error. For example, when the woman forgets to take a contraceptive pill every day or fails to replace a hormonal patch or vaginal ring in time, an egg may be released and fertilized, resulting in pregnancy. However, when the contraceptive method is used properly, studies show that only about 1 out of 1,000 women get pregnant per cycle.

Combination Birth Control Pills

Combination birth control pills contain both progestin and estrogen. Different combination contraceptive products are taken on different schedules. One of the most common products requires taking a single pill once a day for 21 to 24 days, depending on the product used. It is not taken for four to seven days to allow your menstrual period to occur. Then, you will resume the same cycle of taking a pill each day with a break for four to seven days, and so forth.
Another combination contraceptive product has a schedule of taking a pill each day for 12 weeks, then not taken for one week. On this schedule, you will have menstrual periods only four times each year. With yet another product, you take a pill every day. With this product, you will not have a period, but you are more likely to experience irregular bleeding.

Progestin Only Pills

Progestin-only pills are taken every day at the same time of day. Progestin-only pills are prescribed when taking estrogen may be harmful to a woman’s health. Often, progestin-only pills are suitable for certain women who suffer from migraines, high blood pressure, or diabetes.

Hormonal Patch

The hormonal patch is a skin patch that contains estrogen and progestin. It is attached to your skin with an adhesive. The patch should be left in place for one week. After one week, the patch should be removed and a new patch placed on a different area of your skin. This weekly cycle must be repeated on the same day of each week for three weeks. For the fourth week, no patch is used to allow your menstrual period to occur. This weekly cycle should be repeated each month to use the hormonal patch as your contraception method.
The patch is effective immediately if you start using it during the first five days of your period. Otherwise, you need to use a backup method of birth control for the first seven days of starting the patch.
Note that the patch may be less effective in women who are overweight.

Vaginal Rings

Similar to the hormonal patch, the vaginal ring contains estrogen and progestin. The vaginal ring is a small flexible, soft, transparent device that you place in your vagina.
Two types of vagina rings are available:

• One that must be replaced each month.
• One that must be replaced only once a year.

Contraceptive Implant

The contraceptive implant is a matchstick-sized rod containing progestin. Your healthcare provider will insert it under the skin of your upper arm. It releases the hormone slowly into your body and remains effective for up to three years. It is a highly effective method of hormonal contraception.

Hormonal Shots

The hormonal shot requires an injection of a progestin hormone by a health care provider once every three months. The injection is a highly effective method of hormonal contraception.
Also, it does not increase the risk of developing breast, ovarian, or invasive cervical cancer. It reduces the woman’s risk of developing endometrial cancer, pelvic infections, and iron deficiency anemia.

Talk With Raleigh Gynecology And Wellness About Hormonal Contraception

Hormonal contraceptive methods are safe and highly effective for most women. Find out which method is most suited to your needs by consulting with Raleigh Gynecology and Wellness specialists. They can answer your questions about the various methods available and schedule an appointment to get you started on a reliable contraception regimen.

Ella, also known as the morning-after pill, is an emergency one-dose contraceptive pill. It contains 30 mg of ulipristal, which delays your ovulation. If you have had unprotected sex, taking Ella emergency contraception can prevent unplanned pregnancy.

How Effective Is Ella Emergency Contraception?

The ulipristal in Ella emergency contraception is a non-hormonal drug that prevents you from conceiving by interfering with the function of reproductive hormones in your body. Ulipristal is a selective progesterone receptor modulator.

Ella works by delaying or preventing ovulation, which means your body will not release an egg, thus depriving sperm the ability to fertilize an egg. Ella may also work by preventing a fertilized egg from attaching to your uterus.

Ella reduces your chances of getting pregnant by 85 percent if you take it within five days after unprotected sex. It is the most effective morning-after pill available. Ella emergency contraception significantly reduced the pregnancy rate in clinical trials from an expected rate of 5.5% (the number of pregnancies expected without
emergency contraception calculated based on the timing of intercourse with regard to each woman’s menstrual cycle) to an observed rate of 2.2%.

Certain factors can impair the effectiveness of Ella. Obesity appears to be one such factor based on clinical trials. Obese women using Ella were twice as likely to become pregnant compared with non-obese women. Ella emergency contraception works better than other morning-after pills if you weigh up to 195 pounds. However, it seems to be less reliable for women who weigh 195 pounds or more. Other factors that can affect Ella are certain medications and herbal supplements. Before prescribing Ella for you, your healthcare provider will ask you what medications or supplements you are taking. Depending on what prescription medications you are taking, your healthcare provider may recommend a different product for you.

Also, be aware that Ella is formulated to prevent conception and not to induce abortion. Other products will induce abortion, such as RU486, also known as M&M, Mifeprex or mifepristone.

When Should You Take Ella?

You can take Ella any time during your menstrual cycle, with or without food. For Ella to work at its optimum effectiveness, you need to take it immediately after having unprotected sex. It is most effective when taken immediately after but can be effective if taken within 120 hours (five days) of unprotected sex. It works by preventing ovulation, and the sooner you take it after sex, the more reliably it will work. Other emergency contraception products are available, but they are not as long-lasting as Ella. They are FDA-approved to be effective for only up to 72 hours (3 days) after unprotected sex.

How Do You Take Ella?

Ella is a single-dose pill to be taken after unprotected sex. Although Ella remains effective at preventing ovulation for up to five days after it is taken, it should not be relied upon as an effective means of contraception for additional acts of unprotected sex during those five days. The reason is that some sperm from that latest sex can survive after the 5-day window closes. You may ovulate soon after that time period ends. If any sperm is still viable when you ovulate, you can become pregnant. You should not use Ella more than one time in the same menstrual cycle.

Who Should Not Take It?

If there is any chance you might be pregnant, you should not take Ella emergency contraception. It is uncertain whether Ella can increase your chances of spontaneous abortion or cause harm to a fetus, though no evidence proves that it does. Your health care provider will give you a pregnancy test before prescribing Ella for you.

Does Ella Emergency Contraception Have Any Side Effects?

Some women experience side effects after taking Ella. Common side effects include changes in your period. Your next period may be heavier or lighter than usual and will likely be earlier or later than usual. Other common side effects include:

• Headache (18%)
• Nausea (12%)
• Abdominal and upper abdominal pain (12%)
• Uterine pain during menstruation (10%)
• Fatigue (6%)
• Dizziness (5%)

If your period is late by one week or more, you should consult with your health care provider to determine whether you are pregnant. If you have severe abdominal pain three to five weeks after taking Ella, you need to consult with your health care provider to rule out an ectopic pregnancy.

Where Can You Get Ella Emergency Contraception?

It is only available by prescription. It can be filled at most pharmacies or online at ellanow.us.

How Much Does Ella Cost?

The price of Ella depends on where you purchase it. You should expect to pay at least $55 for Ella at your local pharmacy. If you use an online prescription service, you can buy it for about $67, but you will have the convenience of free shipping and next-day delivery.

Talk with the Experts at Raleigh Gynecology and Wellness for More Information about Ella and Hormonal Contraceptives

It is a good idea to have Ella on hand as a back-up to cover you should your regular contraception method fail for any reason. Contact the women’s health experts at Raleigh Gynecology and Wellness for more information about Ella emergency contraception and other hormonal contraception methods. They can answer any of your questions and schedule an appointment.

Hormonal contraception is a highly effective way to prevent pregnancy. Women can choose from various hormonal contraception methods, all of which are safe with minimal-to-no adverse side effects. Many women choose hormonal contraception because it is reliable and convenient.

How Does Hormonal Contraception Work?

Whichever form of hormonal contraception you use, the hormones work in similar ways to prevent pregnancy. The hormones used for contraception are a small amount of synthetic estrogen, progestin or a combination of both. Those hormones work by changing the normal levels of estrogen, progesterone, and certain other hormones in your body. This can prevent pregnancy in three ways:

• They stop your body from releasing an egg (ovulation). Without an egg to fertilize, you cannot get pregnant.
• They change your cervical mucus so that sperm cannot swim through it to reach an egg and fertilize it.
• They change the lining of your uterus so that any fertilized egg cannot attach itself.

What Are the Different Forms of Hormonal Contraception Methods?

Hormonal contraception is available to women in a variety of forms. They are:

• Pill
• Patch
• Vaginal ring
• Injection
• Intrauterine device (IUD)
• Implant

Your healthcare provider can evaluate which of these contraceptive methods is safest for you based on your health history and best suits your lifestyle.

What Is the Effectiveness of Hormonal Contraception?

Hormonal contraception is exceptionally effective at preventing pregnancy. The most effective method is the implant. The implant is placed under the skin of your upper arm by your healthcare provider. Once implanted, it protects against pregnancy for three years. It is over 99% effective because the implant eliminates human error risk—there is no pill to remember to take or device to insert properly. In contrast, using a condom (one of the most popular forms of non-hormonal contraceptive techniques) is less than 90% effective.

Make Hormonal Contraception Effective Immediately

Hormonal contraception becomes effective very quickly. Whether it becomes effective immediately when you begin the regimen or within a couple of weeks depends on where you are in your menstrual cycle when you start the contraception. If you begin during your period, most hormonal contraception methods are effective immediately. Your health care provider can provide you with specific information about that and assist you with scheduling as needed.

Are There Possible Side Effects?

Many women experience some side effects from hormonal contraception, particularly during the first few months while their bodies adjust to the hormones. As time goes by, any negative side effects often subside. Some women experience no negative side effects at all. The nature and extent of side effects vary with each individual.

Common Physical Side Effects

Among the most common physical side effects that women notice with hormonal contraception are changes to the duration and volume of period bleeding. Frequently, hormonal contraceptives will cause your periods to become lighter and shorter in duration. For that reason, hormonal contraceptives may benefit women who normally have heavy periods, problems with menstruation-related anemia or iron deficiency, or irregular periods. Hormonal contraceptives can also provide relief to women who have painful menstruation caused by endometriosis.

Another common side effect is the changes in your complexion. Estrogen can be an effective way to treat acne. Other hormones in hormonal contraceptives may cause you to develop acne, melasma or experience other negative changes to your skin’s appearance. Those negative side effects can usually be resolved by changing to a hormonal contraceptive that uses a different formula.

Depending on the contraceptive you use, other side effects commonly experienced can include nausea, headaches, breast tenderness, weight gain, and libido changes.

Effect On Breast Cancer Risks

Research on the effect hormonal contraceptives have on your breast cancer risk is mixed. Researchers believe that different formulations of the hormones may have different effects on breast cancer risks and women with a family history of breast cancer. Your healthcare provider can discuss this with you and assess your risk profile.

Common Mental Side Effects

The hormones in some contraceptives can reduce the mood-regulating neurotransmitter, serotonin, anin the brain. Some women report changes in their moods while using contraception that contains progestin. It is unclear whether the hormonal contraceptives in fact cause mood changes.

The relationship between hormonal contraceptives and depression has not been clearly established. Researchers believe that the effect is likely different for different women. Nonetheless, they believe the overall mental health risks to women using hormonal contraceptives are small. In fact,, women who have severe PMS or a major depressive disorder may experience positive changes to their mood from hormonal contraceptives.

Talk with Raleigh Gynecology and Wellness for More Information about Hormonal Contraceptive Options

Hormonal contraceptives are extremely popular because they are highly effective and convenient to use. If you are interested in learning more about what type of hormonal contraceptive would be best for you, contact the experts at Raleigh Gynecology and Wellness. They are available to answer your questions and schedule an appointment with one of their experienced women’s health specialists.

Knowing how to prepare for a mammogram is crucial for the best experience possible. A mammogram is one of the best tools available for early detection of breast cancer. According to the Center for Disease Control (CDC), breast cancer is the second most common type of cancer in women in the United States. Annual mammograms should be part of every woman’s health regimen.

Preparing For Your Mammogram

Mammograms are performed using a safe, low-dose x-ray machine designed to take images of your breast tissue. The mammography x-ray machine is equipped with flat surfaces called compression paddles. The compression paddles compress each breast so that all of your breast tissue can be x-rayed. During that time, you need to remain still so that the images are clear and you will not have to do it over.

Having a mammogram done is easy, but there are a few things you will need to do to make sure yours goes smoothly:

Schedule Your Mammogram When Breast Tenderness Will Be Low

To enable the x-ray machine to capture an accurate image of your breast tissue, your breast tissue needs to be spread out as much as possible, which is the function of the compression paddles. The x-ray technician will position you in such a way that the compression paddles can compress your breasts and flatten them without too much discomfort.

One way that you can minimize the discomfort is to schedule your mammogram at a time when you are not experiencing unusual tenderness or soreness in your breasts due to the onset of your menstrual cycle. If possible, you can try to reschedule your appointment to another time of the month. Usually, the week following your menstrual cycle is a good choice.

Bring Previous Mammogram Images

If you are going to have your mammogram performed in a new facility, they will probably ask you to provide your prior mammograms. Your radiologist will want to compare them with your new images. You can arrange to have them sent by your doctor or you can request to have them placed on a CD to bring with you to your appointment.

Take A Mild Pain Reliever Before Your Mammogram

Some women find that taking an aspirin, acetaminophen or ibuprofen about an hour before the mammogram helps with the discomfort of the mammogram.

Avoid Using Any Deodorant Or Body Lotions

On the day of your mammogram do not apply any deodorants, antiperspirants, powders, lotions, creams or perfumes under your arms or on your breasts. Those products often contain metallic particles which your mammogram can detect and cause false readings. You may have to redo the mammogram in such a case.

Dress Comfortably

You will be asked to remove any jewelry such as necklaces and earrings for the mammogram. You will have to leave these items in a secure location along with any other valuables you bring into the exam room. To minimize risk of loss, it may be better to not wear any jewelry into the facility.

You will also have to remove your clothing from the waist up for the mammogram. You will be given a hospital gown to cover up until you are in the x-ray room. Most women choose to wear a two piece outfit to the mammogram so that they only have to remove their top and bra; you can remain dressed from the waist down.

Budget Enough Time

The mammogram itself only takes a few minutes to complete; however, some facilities are very busy and you may have to wait a while before they are ready for you. Also, after your x-ray, you will have to wait until the technician determines that the images are clear and of sufficient quality for the radiologist. If not, you will have to have one or more images re-done before you leave. In most cases, the entire process can be completed in an hour or less.

Radiologist Will Send Written Report To Your Doctor

Do not expect to learn the results at the time of your mammogram. The x-ray images of your breast tissue will be analyzed by a radiologist. The radiologist will send a written report of the analysis and any findings to your doctor. In analyzing the images, the radiologist will look for any evidence of cancer or abnormal non-cancerous tissue. Those findings usually require further testing and examination. Most abnormal findings on mammograms are not cancer.

Mammogram facilities are required by law to send your results within 30 days to you, although it usually takes one or two weeks. Ask the technicians at your facility when you can expect to learn your results.

Schedule An Appointment With Raleigh Gynecology & Wellness

Mammograms are an important, non-invasive tool for identifying changes in your breast tissue and early detection of cancer. Regular mammograms are critically important to women’s health, and an annual mammogram is the best practice for most women over age 40. To schedule your mammogram or to discuss any questions or concerns you have about them, contact the specialists at Raleigh Gynecology and Wellness.

Many of the conditions that affect women’s health can be present without any obvious signs. Because of this, annual gynecology exams are one of the best ways a woman can keep tabs on her health. An annual GYN exam can catch critical risks and lead to improved health through preventive maintenance.

If you are considering scheduling a gynecology exam, it can be helpful to know what to expect. Your health is personal and you deserve to be fully informed. Below we’ve laid out what an annual GYN exam consists of so you can schedule your next appointment with clarity and comfort.

What to expect

The exam starts with your provider collecting a comprehensive medical history including your family history. Vital signs like your blood pressure, heart rate, height, and weight will be measured. You will also be asked about your periods, pregnancy history, sexual activity, contraception needs, history of GYN problems, history of GYN surgeries, and any current symptoms you are having.

Your provider will listen to your heart and lungs, feel the thyroid gland in your throat, and feel your abdomen. You will also have a breast and pelvic exam. The pelvic exam consists of three parts: an external examination of the vulva, an internal examination of the vagina and cervix with a speculum, and an examination of the uterus and ovaries with a gloved hand. During the speculum exam, cells may be gently brushed from the cervix and sent to the laboratory for examination; this is a Pap smear. The exam will also focus on evaluating any symptoms you may be experiencing. If you find the pelvic exam extremely uncomfortable or anxiety-provoking, tell your provider as they would want to try to improve your experience in any way possible.

Finally, you and your provider will discuss ways to improve your health including lifestyle changes, screening tests, or vaccinations based on your age or other risk factors.

Schedule an Annual GYN Exam With Raleigh Gynecology & Wellness

Annual GYN exams are important to overall health and preventative maintenance. In some cases, they can be lifesaving. If you are a woman over the age of 21, it is recommended you schedule a full GYN exam annually. While it can sound overwhelming, the reality is that the right gynecologist can make an annual exam quick, painless, and insightful.

Our medical staff is here to help you get the care you need in a setting that is comfortable. At Raleigh Gynecology, we strive to make our patients feel comfortable and heard while we provide care. We help patients understand the full benefits of an annual GYN exam. Be proactive about your health and schedule an appointment with Raleigh Gynecology & Wellness today.