Birth Control

When to Call a Doctor

Different birth control methods have different side effects and possible complications. It is important to understand the risks of the birth control method you use. Talk to your health professional if you have concerns about side effects.

Call your health professional if you have symptoms of pregnancy, such as having missed one or more periods or having your period but with a lot less bleeding than usual. Take a home pregnancy test. If the test is negative but you still suspect that you are pregnant, schedule an appointment with your health professional.

If you are an adult, the law protects the privacy of your health information. Your gynecological exam and test results are your private information. Your health professional will not share your private information with anyone but you unless you give him or her permission to do so.

If you are a teen, your privacy depends on the laws in your state. Most state laws protect a teen's privacy and freedom to see a health professional for birth control services. Some states, however, require most teens to have a parent's consent for prescription birth control. For information about your state's laws, see Minors' Access to Contraceptive Services at www.guttmacher.org/statecenter/contraception.html.

Call your health professional immediately if you have any of the following symptoms:

Hormonal methods

• Sudden or severe abdominal pain
• Sudden or severe chest pain
• Sudden shortness of breath or difficulty breathing
• A severe headache
• Sudden eye problems or changes in your vision
• Severe leg pain (anywhere, most likely in your calf)

Intrauterine device (IUD)

• Symptoms of pregnancy, such as missing a period or tender breasts
• Fever of 100°F (37.8°C) or higher
• Pain in the lower abdomen
• Bad-smelling, heavy discharge from the vagina
• Vomiting not caused by stomach flu

Pregnancy after sterilization is rare. However, when it does happen, the risk of tubal (ectopic) pregnancy is higher than normal. If you have had a tubal ligation or tubal implants and now have possible pregnancy symptoms, have a pregnancy test right away. An ectopic pregnancy can become life-threatening.

If you have an IUD or have had a sterilization procedure, your health professional will give you instructions to follow.

Who to See

Most methods of birth control require at least one visit to your health professional for an exam and to get a prescription. Some methods may require a visit to a specialist. Women who are seeking birth control can see:

• A family medicine doctor.
• A gynecologist.
• A nurse practitioner.
• An internist.
• A certified nurse-midwife.
• A physician assistant.

Family planning clinics, local health departments, and university health clinics can provide counseling, exams, and prescriptions or referrals. These types of clinics might be easiest for teens to use.

Tubal ligation or implants are usually done by a gynecologist or family medicine doctor. Vasectomy is usually done by a family medicine doctor or a urologist. Either procedure may also be done by a general surgeon.

What to Think About

You can buy condoms and spermicides at a drugstore or grocery store without a prescription. Be sure to read the directions on the package insert and always use condoms correctly.

When you go to your health professional for birth control, you will probably have a physical exam to make sure that your reproductive organs are healthy and normal. Usually, a pelvic exam and Pap test are done at this time. (A Pap test is a check for early signs of cervical cancer.) However, it is not always necessary to have an exam before starting prescription birth control.

Your health professional will also look at your medical history to see if you have any conditions that could be made worse or could cause problems with a specific birth control method.

For teen girls: Some teenage girls are worried about visiting a health professional for birth control.

• If you are concerned about having a pelvic exam or keeping your health information private, talk to your health professional or a family planning clinic counselor.
• If you have not been sexually active before now, a pelvic exam may not be necessary.
• If you have been sexually active, it's very important that you are screened for sexually transmitted diseases (STDs) every year. This can be done with a urine test. You may not need a Pap test and pelvic exam until 2 to 3 years after you become sexually active.

Natural family planning does not require a visit to a health professional; it requires careful attention and dedication. This is one reason why many couples become pregnant when using it for birth control. In fact, this method is best used for conceiving a planned pregnancy. To learn about natural family planning, look for a natural family planning or fertility awareness class at local women's clinics, hospitals, and churches.

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Author:	Bets Davis, MFA	Last Updated: May 22, 2008
Medical Review:	Joy Melnikow, MD, MPH - Family Medicine Kirtly Jones, MD - Obstetrics and Gynecology
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