Expert: Doctor Early Options - 10/10/2007

Question
QUESTION: Hello Dr. J,

I would like to ask for your assistance.  I was 5 weeks pregnant when I took Misoprostol and within 1-2 hours I started to bleed.  I took the tabs on Sept 16.  Its been a week that I bleed then it was on between Sept 23-24 that my bleeding stopped because I still have some spotting.  I tried a Home Pregnancy Test after the bleeding stopped and it was negative already.  Then on the 10th day that my bleeding stopped I took another kit and it is still negative. Few days after me and boyfriend started to have sex again but we used condom.  Then on Oct 3 I took a test and still its negative but yesterday Oct 6 we had anal sex and my boyfriend touch me on my vagina and when I went to the toilet to wash myself there is like a saliva type of thing on my vagina and I wonder if its a sign of ovulation or fertility.  Is it a cause for being pregnant again?  I dont want to go to the same emotional and physical situation I have been through like what happened to my first medical abortion.  I need help because I am worried that I might be pregnant again.  What is the chances of having anal sex with another pregnancy?  I am in country where in the laws are strict and its hard to find a doctor I can trust regarding this that is why I am just relying on home pregnancy test.  Also what is the sign of a successful medical abortion?  Before my breast are so tight and even a slight touch on my nipples it hurts a lot but right now its soft and even when I touch my nipples its not hurting anymore.  Also before when my boyfriend usually puts his legs on my belly like the spoon position when sleeping my belly hurts like I find his legs so heavy that it brings pain to my tummy but right now when he puts his legs I dont find it that heavy its like normal one.  Being worried about the anal sex we had I started to drink Vit. C because I have searched on the website that it can also be used as contraceptive, am I doing it the right way by drinking 1 500mg of Vit. C every day since after we had anal sex? What can you advise me on this matter I really need help and I am getting so paranoid of my situation and it brings me sleepless nights and Im getting so restless.  Thank you very much for your support.

ANSWER: Dear Ms. M,
You don't need to worry - the first termination with misoprostol was successful- you had 2 negative pregnancy tests and your symptoms of pregnancy went away.  It's very very unlikely, but possible that you could have gotten pregnant again.
You could take the morning after pill - have you heard of this?  This can be taken within 5 days of unprotected sex to avoid pregnancy.  The sooner you take it the better it works. Do you have Plan B in your country? Or a pack of birth control pills? Or family planning clinics where they have the morning after pills?  If you can find any of those, I can tell you how to use them.  
If not, don't worry too much - it's highly unlikely that you've gotten pregnant again. You can check a pregnancy test in a week to be sure. In the worst case, it sounds like the misoprostol worked for you, and it's completely safe to do it again.  
Doctor Joan

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QUESTION: Hi Dr. J,
I hope you can still remember me. I dont know how to get in touch with you since my last email message, I was prompted to ask for a new question but I cant find in this site from will I start that is why I just used my first question to you as a way to get in touched with you again.  The last answer you have told me is that if I can purchase yasmin i need to take 5 tabs and another 5 tabs after 12 hours.  Unfortunately there is some shortage of the pill here in my country, I have searched pharmacies but when I have found one my time has lapsed already.  You have mentioned that the emergency contraception should be taken within 5 days after unproctected sex.  You have told me that its most unlikely to get pregnant again since my boyfriend didnt ejaculate in my vagina since we did anal sex only.  I am just curious about the thing they called pre-cum from guys.  Does this thing contains also sperms?  I have friends who told me that pre-cum can also have sperms that is why even though the guy didnt ejaculate on the vagina but the pre-cum was able to pass through there is a chance of being pregnant is this true? I had medical abortion last sept 16 and I believe it was successful because of my last day my bleeding I took the pregnancy test and it shows negative and on the 10th day after my bleeding stop I tested again and it negative.  You have mentioned to me that I can do a test again on Oct. 13 and if its negative I am fine.  I really dont want to go to the same situation again, the thing wherein in I took misoprostol.  I want to be fine now and I am guilty that I committed a serious sin but I am sorry for what I have done that is why I am so cautious right now.  Your a great help to me with the explanation you have given to me.  I hope you can still enlightenment me with this.  Its really hard to find doctors whom I can trust here in UAE as their laws are strict when it comes to women who are not yet married.  Right now I have purchased yasmin already but it was not in time with your advise of taking it.  I searched for several pharmacies and it took the time I have left.  However, how can I use yasmin once I have my period?  I have read on the prescription that there are so many things to be considered before taking it.  Right now I cant go that easy to a gyne or ob for consultation because I am afraid that they will ask for marriage certificate first before they can help me out wherein I dont have the certificate yet since me and my boyfriend are not yet settling down.  Can you give me pointers and important information that I need to look for and ponder about before taking yasmin?  I will be glad to hear from you soon.

ANSWER: Dear Ms. M,
Your friends are correct - pre-cum does contain sperm, but if he doesn't ejaculate in your vagina, your chances of getting pregnant are very small.  I think you will be fine, and would just check your pregnancy test on October 13th.  
You can take the yasmin for birth control, starting the Sunday after your next period starts.  There is nothing to be afraid of - just try to take it at the same time every day - either in the morning or the evening.  Then you won't need to worry about getting pregnant again.  You can also try any other brand - there is nothing special about yasmin. You will expect your period on the last 7 days of the pills, and start the next pack.  
Ms. M, I am not one to judge one way or the other, but I don't believe this is a serious sin - most women end up going through an abortion at some point in our lives. I see many women in this situation and they are all decent, caring women trying to do the best that they can in a difficult life situation. You took care of it and ended it before it developed.  Life is not ideal, and as women we have to do the best that we can to take care of ourselves and our families.  You can look forward to being excited about a pregnancy in the future, when you are able to take care of a child.  
Good luck to you!
Doctor Joan

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QUESTION: Doctor Joan,
You are such a great help I dont know how to thank you for the things valuable information you have given.i just like to ask when do you think I will start my period since I did medical abortion on sept 16 and it last bet sept 23-24? i just like to clarify if my period starts automatically i need to take yasmin already the same day that my period starts or i need to wait till sunday of that week? what if my period starts on a sunday will i take it immediately? im sorry if i asked so much and being dumb on this medication.this will be my first time to take pills and i dont know really know anything about this medicine.also you told me there are other brands that i can use.for your preference which brand is the most effective and less side effects? i think the common pills available here in this country where i am residing right now is yasmin and diane35, is there other brands that you can refer to me?thank you so much dr.j i hope you wont get tired to help me out.

Answer
Dear Ms. M,
Your questions are not dumb - it is upsetting to me that your country is so against abortions, but then doesn't help women to prevent getting pregnant.  How do women get on birth control in UAE?  I am curious to understand these issues in other countries to see if I can be of help.  
As far as what to do: you can either take yasmin or diane35, whichever is less expensive and more available.  It is hard to say when you will get your period, but probably in the next 2 weeks.  As far as when to start - it is ok to start the first day of your period, whichever day that is, as long as you remember to start your next pack four weeks from that day. For example, if you start on a Monday, you will see that there are 3 weeks of one color pill for the first 3 weeks, then 1 week of pills when you will likely bleed, then you will start your next pack on Monday.  The reason I said to start on Sunday is that most packs are labeled to start on Sunday so it just makes it easier to know to take it that day.  
I hope this is helpful.  
Doctor Joan