You can find the first part of this series here.

*Disclaimer: This blog is intended for informational purposes only. The information on this blog should not be used as a substitute to medical advice or medical treatment. As always, your Primary Care Provider, a doctor, or another health professional is your best resource for specific questions and medical advice. If you believe you or a loved one are experiencing a medical emergency, please contact 911.*

Myth: Getting an IUD is painful.

72.4% of 228 voters said “different for everyone” – that certainly seems to be the case!

There is really no way to predict whether or not having an intrauterine device (IUD) inserted will be painful for you. Each person has their own pain threshold, and some people are more sensitive to pap smears or even sexual intercourse – this may mean that procedures down there are also uncomfortable or painful. Additionally, any history of sexual trauma or abuse may cause both physical and emotional pain during the procedure. Remember that there are many birth control options that can work for you if this one (or any other) doesn’t – explore them with your PCP, who is familiar with your health history.

I think with first-time IUD users there is fear of the unknown. Remember before your first pap smear? Didn’t you feel nervous about whether or not it would be painful? I know I did. For many women it is painful or uncomfortable, others barely notice. IUD insertion seems even more scary because it’s not quite as quick as a pap smear can be – but it’s often only about 5 minutes or less, depending on your physician and sometimes, your anatomy. The procedure does start out the same though – with the speculum!

A speculum is inserted into the vagina and then a tool is used to insert the teeny, tiny IUD into your uterus via the cervix. Now if you’ve had a baby, a membrane sweep, or have had a cervical check of any kind (or any similar procedure non-pregnancy related), you probably know that the cervix opening is not exactly pleasant for many people. This is related to the cramping you may experience with IUD insertion. Even reliable sources may tell you this doesn’t last long, but from hearing personal stories – this is simply not the case for everyone. Some people are very uncomfortable after, others not. Some mild cramping may continue on after the procedure, and a heating pad might help. Again – there doesn’t seem to be anything that can predict what you might feel but you know your own pain tolerance and your own history, this may give you clues to your experience.

A key recommendation I’ve given and heard from others is to take the pain medications your doctor recommends prior to your insertion appointment. This can often help with cramping.

Other possible side effects include dizziness after the procedure, and some may faint. You might go home and need to rest and relax (do it if you can!).

Spotting is not uncommon (like with other forms of birth control), but it should go away in under 6 months.

Myth: Birth control protects you from STDs/STIs.

98.7% of 226 voters said false – I probably should have been more specific with the question, but this is mostly correct because of my generalized statement! Most birth control forms do NOT protect you from STDs/STIs. One old and reliable form does though…

The only form of birth control that protects you against sexually transmitted diseases (STDs)/sexually transmitted infections (STIs) is the condom. As with every type of birth control, correct use is key for protection. Condoms are often best used in combination with another form of birth control for extra protection against pregnancy. However, you can still just use them on their own, or use them in combination with the FAM method during fertile days for example.

Both the male and female (internal) condom can protect against STDs, however a male condom may be easier to use correctly consistently. Totally preference based, as with most birth control choices. Note: this is in reference to synthetic condoms only.

It is important to note that condoms are not effective against all types of sexually transmitted infections. STIs that spread from skin on skin contact may not be affected by condom use, depending on location (herpes, warts, and syphilis). They will be effective (about 98% if used correctly) against chlamydia and gonorrhoea, which are increasingly common. They are also protective against human immunodeficiency virus (HIV) transmission.

The only way to be 100% protected against STDs/STIs is via abstinence. Or having fewer partners (per the CDC), which frankly is a very judgmental take and I don’t think anyone should be shamed for the number of partners they have.

If you’re not down with abstaining, then beyond using a condom you can also:

• Get vaccinated against HPV
• Have an open conversation with your partner (if possible – this is of course not an option for everyone in which case the next step may be useful…)
• Be tested if you’re concerned or as needed (sometimes they are asymptomatic)

Remember that if you do test positive, there are lots of options for treatment. Also – it is very common! There is a ton of stigma around this subject, but there shouldn’t be.

Here is a good guideline for when you can get tested after potential exposure. Contact your local public health unit or HCP for more information about the process of testing, what to expect, or if you have any questions.

Myth: I don’t need birth control while I’m breastfeeding, since breastfeeding is nature’s birth control.

98.7% of 235 voters said this was false. It is certainly not the perfect method, because it is somewhat complex. I’ll explain why relying on this can be risky.

The “lactational amenorrhea method” (LAM) is a real thing that is actually ~98% effective, but it comes with a lot of caveats.

The conditions you have to meet for LAM to be effective are:

1. Be 6 months or less postpartum;
2. Exclusively breastfeeding with no long time gaps (<4 hrs between feeds) both in the daytime and overnight;
3. You have not had your period return.

So see why this might be problematic? If you don’t meet all this criteria… it is likely to fail. Also, the time period is only 6 months so it may be easier to try another birth control method if you’re looking to prevent pregnancy for the longer term.

Some people don’t like the pill because they have to remember to take it. With criterion #2, you have to remember to breastfeed. You have to be able to exclusively breastfeed, which is NOT an option for many people due to work obligations or different breastfeeding struggles. One benefit of the LAM method would be financial, in that you don’t have to pay for another birth control method. It may also be an option that is consistent with your personal beliefs or cultural practices. It is a method used in many developing countries because of this, and its easy accessibility.

The take-away message here is: Just because you are breastfeeding doesn’t mean you are protected against pregnancy. This method works within a specific time period, if EBF is followed strictly and you have not resumed your period postpartum. Something that could be discussed more in-depth with your provider, but if you feel that you won’t be able to EBF as stated above then I’d suggest exploring other methods that work better with your lifestyle and schedule.

Myth: Birth control is only for people who are sexually active.

I’m happy to report that 98.7% of 223 voters said this was false. Birth control, as I mentioned in my first post, has many different uses!

Beyond pregnancy prevention, the different methods of hormonal birth control can be used for other purposes. I can’t say a condom has many other uses except maybe making a balloon!

Birth control pills tend to be the most commonly used for other medical conditions (however IUDs, the patch and so on can also be used), to help with the symptoms, such as:

• Polycystic Ovary Syndrome (PCOS)
• Endometriosis
• Dysmenorrhea, or painful periods
• Acne
• And many others

So if you see someone younger using birth control, just remember it’s none of your business why they’re using it. But also they may be using it for an off-label purpose. Either way, no one needs judgment for using it. Please remember that you should only use the pill (or other birth control) as prescribed by your physician.

Myth: I can’t get pregnant if I have sex during my period.

95% of 220 voters said this was false. You can. It’s *generally* unlikely because of the average cycle length, but it is possible.

Many people have a cycle that lasts on average, 28-30 days. If your cycle is say, 28 days long, you are estimated to ovulate around the 14th day however this is different for everyone and is a rough estimate.

Some people have shorter cycles or irregular cycles though, so they would ovulate much earlier or at a time they couldn’t necessarily predict. Since sperm can live in the body for up to ~5 days, it would be possible for someone with a very short cycle to get pregnant during their period. It is also possible for this to happen to someone with a very regular cycle, as things like stress, illness and weight loss or gain can impact ovulation.

So what should you do if you don’t want to get pregnant? Don’t have unprotected sex during your period. Use the form of birth control that works for you – and yes, the pill is still an option in this situation as long as you are taking it correctly.

Keep an eye out for part 3 of this series!