Expert: Pat G - 8/5/2011

Question
QUESTION: Hey!

I'm 20 years old and very sexually active. I have one partner but since we are in a long distance relationship, we get to meet once a month or so. He usually comes for 3 to 4 days. Initially we used condoms but it just seemed too uncomfortable and less intimate,so we stopped using them. Every time he ejaculates inside me. On day 3 of his visit and our sexual escapades I make sure I take an ipill, or the emergency contraceptive within 72 hours of the first day of our intercourse. However, I have heard that taking too many ipills in a month or so is harmful and can seriously hamper my menstrual cycle. I've decided to start taking birth control pills, but am not completely sure as to how to go about it. Can I start any time of the month or is there a specific time? When and how many pills should I take , and after how long is the medicine effective.
I called a medical professional and the doctor suggested Ovostat Gold. I would like to verify the information she gave me before I go forward with my decision. She said that its advisable to wait 3-5 days after the last day of my period before I start taking the pill. And once I do take it, i take it for a full 30 days and then stop and wait for my period. Once I am done with my period i repeat the cycle. She also mentioned that six hours after my first pill, it is safe to have sex.
I would like to know the implications of starting the pill before my period..im supposed to get it on the 12 of this month, so will it be a problem if I start it right now, as in the 4th?
Another thing I was confused about was this- once I am done with my 30 day pack, and I start waiting for my period, what if my perio comes 2 weeks later? should i be worried? what is the normal time frame between which I should expect my period? Furthermore, in those couple of days right before my period when I am off the pill, if I do have sex can I still take my ipill if I do happen to have unprotected sex? What are the implications of that?
And lastly, will the pill make me put of weight? If yes, should I cut down on carbs and follow a high protein, fibre diet? Moreover, I know this question will sound silly but will my breast size increase as a side effect? If yes, would it be an increase in breast fat or an actual growth?
Much thanks.

ANSWER: Hello, Shania,

You are living a very, very dangerous lifestyle. I don't have a lot of time to talk to you at the moment, though I can talk to you more later. All of these pills are highly toxic, and can cause any number of medical consequences, including death. And you live in a part of the world where if you should become pregnant, you will be forced to have an abortion in all likelihood. Abortion can also kill you, or cause you grave damage, and it can harm your future children. It can prevent you from ever having any children.

You are asking me to tell you how to take these pills safely. I am not able to do that, because these pills are not safe. Not only that, but the instructions you have been given do not sound wise to me. I think you would be at risk.

At least you are aware that condoms are not the answer. I am glad for that. But why put your entire life and future at risk? It makes no sense. Sure, sex causes pleasure. But he is not looking out for your well being, and he is using you for his own pleasure. If he truly cared about you and respected you, he wouldn't be doing this. If you love each other and you want to spend your life together, get married! If not, make yourself available for someone who will truly cherish you.

You should follow a diet which is low in carbs in general. The pills can cause you to develop larger breasts simply because they alter your hormones. It depends to a large extent on your individual metabolism, as to whether these pills will cause you to put on weight.

I'm sorry I can't go into all these details and tell you how to get away with what you are trying to do. It's not possible. And not only are you at risk from pregnancy, but the pills also depress your immune system. If he is carrying any kind of sexually transmitted disease, you can catch it. And since he is often gone, and may not have told you about his prior history, and if he has slept with anyone else at all, you are at risk.

If you insist on continuing your reckless lifestyle, go to a doctor directly. Don't seek information over the internet. I cannot examine you or take your medical history. I don't know if you have a health condition that will make you especially vulnerable to consequences from these drugs. I do know that the ipill is a huge dose of hormones, and taking it repeatedly as you are doing is bad news. Please either go to a doctor, or seriously consider the warnings I have given you. I care about you, and I hate what you are doing to yourself. You deserve better. Please stay safe.

---------- FOLLOW-UP ----------

QUESTION: I was expecting a reply of that sort, but I would like to clear a couple of issues before I proceed. First and foremost, I am fully aware of the implications of having unprotected sex - both STD's and the risk of getting pregnant. As for living a dangerous lifestyle , if you referring to my young age and the fact that I have an active sex life please know that I very well know what I am getting into. He gets himself tested once every 6 months for STD's and I trust him enough to know that he is not using me or having sex with other women while he is away. When someone of my age engages in sex its easiest to blame the man for 'using me' or 'seducing me' but rest assured that I want, encourage and engage in it with as much desire as he does. I am not entirely sure what you mean by 'if he cared about you and respected you he wouldn't be doing this'. If you mean 'this' as in having sex, then I really am baffled that someone as learned and qualified as you would dismiss sex before marriage as something to be looked down upon and disrespected.

Ofcourse, frivolous sexual relationships with multiple partners is most definitely nothing to be proud of, but I am as serious about him as it can get. As for marriage, eventually we do plan on getting married but once we both have settled down .

Secondly, you mentioned putting my life at risk. By having unprotected sex, I am putting my life at risk- you are absolutely right. I knew that frequently taking emergency contraceptives could be very very dangerous for me, that is why I asked you to help me understand how to take birth control pills or combined oral contraceptive pills . As far as I have read on the internet and heard, combined oral contraceptives are not dangerous or harmful to health. On the contrary it helps to regulate your periods, protects you again pregnancy , reduces symptoms of polycystic ovary syndrome, and decrease the risk of anemia,decreases the risk of ovarian cancer in later life by 50%.It also reduces the risk of ovarian cancer by 40% and the risk of endometrial cancer by 50% compared to never users. Thus, I am thoroughly baffled when you say that it can 'depress my immune system'.

I considered the warning you gave me way before since I knew that depending on the i pills wasn't logical that is why I have asked you to elaborate and explain to me how to take COCP's. As for your concerns about my 'reckless' sex life, please know that I enjoy it as a connection of body and soul- not just a one night stand pleasure central. I have long since left abstinence behind so you would be wasting your breath if you tried to convince me to stop. But your concern and advice is much appreciated. I know you want me to be protected and safe , and not run the risk of abortion- and that is exactly what I want to do,thus, I would be glad if you helped me clear the air about how to take COCP's.
ps. I came across one of your answers on google when I was researching on COCP's, and although my question doesnt have anything to do with 'abortion' i still decided to ask you since you seemed specialized in working through the issues 'emotional, spiritual, practical'. As well as boyfriend and family issues. Thanks a lot for your time and effort to write such a elaborate and detailed reply- as a mother of seven, i know that your genuine concern stems from your heart :).

Answer
Hello, Shania,

I figured you had made a deliberate decision to have sex. However, it is really NOT in your best interests. There are several problems. The first is that sex has deeper meaning. It has been shown that having sex before marriage makes it harder to trust your husband when you do get married. I have personally seen way too many cases where people who were intent on getting married had sex for awhile and then broke up. It just isn't the same. The second problem is that it appears evident that you are not ready to welcome a child. You want to take birth control so you can avoid abortion. What I don't understand is why anybody would love someone but not welcome the result of that love. I realize lots of people feel this way. But in my opinion, it isn't logical. If you do take birth control and it fails, this is when the trouble starts. You will be facing a situation which could be very dangerous for you, if you are from Bangladesh, and you are in the country, and cannot go elsewhere for awhile. And as it seems you are aware, abortion is dangerous. But there is a popular myth that birth control pills are not dangerous. You have indicated you believe this. Please know that pharmaceutical companies make lots of money selling birth control pills. They won't tell you the truth about the consequences they can have. A lot of studies are falsified. Yes, many women seem to get away with using them. However, they may pay dearly without even knowing the reason. Not only that, but we are aware that birth control pills don't work as reliably if the couple isn't married. They don't know why yet, but that's the case.

I told you these things because I DO care about you. If you two really do love each other, you should go ahead and get married. Don't wait to "get settled". Or, take steps to get settled right away. The emotional and medical consequences of what you are doing are just too risky. And it has too much chance of destroying your relationship one way or the other. Most men don't even really know how they will feel if the woman they are having sex with gets pregnant. That's a complication most think they can avoid just by using the right methods, so they don't weigh the possible costs. Even if a woman decides to have the baby, there can be serious consequences to the relationship. I am currently living through such a situation since the two children who had babies out of wedlock are now having serious relationship problems. For one, it has been a nightmare. The mother has turned completely against him, and they're fighting in court. You really cannot anticipate what the consequences will be, but one of the reasons I answer questions here is because I have studied and observed for decades, and I know what the possibilities are.

Asking anybody over the internet how to take the pills so that they will be safe and accomplish what you want is not a good idea. You need to discuss this with a doctor who can examine you personally, test your hormones, and take a medical history. Regardless, the mindset of the medical profession is very different from mine. The doctor may assure you that taking birth control is safe. Unfortunately, the medical profession has been corrupted by greed, bribery, and fraud. This is a major reason why most people think birth control pills are safe. It is hard to say how many women suffer long term consequences, but you have to look at the risks involved of various courses of action. The risk of taking birth control may be small, but the risk of not taking it and not having sex is zero. Compared to zero, taking them and suffering a consequence is huge. It is 100%. You don't know whether or not you will be one of the women who does have a problem. But if you are able, look up the drug you want to take on the internet, and look at the side effects. And do ask a doctor the question you have asked me.

Good luck. I hope things work out for you. Take care.