Frequently Asked Questions
How long will irregular bleeding last after a Mirena IUD or Nexplanon is inserted?
Bleeding and spotting may increase in the first 3 to 6 months and remain irregular for 6-9 months. Periods over time usually become shorter, lighter or may stop altogether. If you should have concerns about the timing or amount of bleeding you are experiencing contact your OB/GYN provider.
Missing birth control pills and when to restart:
If you miss one hormone pill, take it as soon as you remember. Back up birth control is recommended for 7 days following missed or late pills.
If you miss two or more hormone pills, take 1 pill as soon as you remember you forgot them. Then read the pill label or call your doctor about instructions on how to take your missed pills. Pregnancy is more likely. So use a backup method of birth control for 7 days.
If you miss pills and have had sex without a backup method of birth control, you can use emergency contraception, such as Plan B. You can use emergency contraception for up to 5 days after having had sex, but it works best if you take it right away. Emergency contraception is often available without a prescription but if have trouble contact your OB/GYN provider.
How often should a woman have a menstrual cycle?
A woman that is not currently using hormonal contraception should have a menstrual cycle at least every 3 months to decrease the lifetime risk of endometrial cancer. If one cycle is late or missed take a pregnancy test. If the pregnancy test is negative, continue to monitor for another month. If still no menses, call for appointment. It is common to have light or even absent menstrual cycles with the use of hormonal contraception. If pregnancy test is negative continue to use current contraceptive method. Make appointment for additional concerns.
Concerns about vaginal discharge, itching or burning:
Vaginal infections are common in women and typically if over-the-counter products have not been helpful in resolving symptoms then an appointment is recommended for evaluation. Vaginal discharge with either internal or external itching is usually caused by an overgrowth of yeast in the vaginal area and OTC anti-fungal treatment may be used. If symptoms do not resolve, change or worsen an appointment is recommended. If a woman is experiencing discharge with odor that is worse following intercourse then a prescription may be warranted as diagnosis of Bacterial Vaginosis is likely. Anytime a woman has vaginal discharge with fever, chills, nausea and/or vomiting, pelvic pain or other signs and symptoms of concern we recommend an appointment be scheduled for further evaluation.
How much is too much menstrual bleeding?
Concern arises if a patient is saturating a regular maxi pad every hour front to back or if she is passing blood clots the size of an egg or larger and referral to the emergency room is recommended for further evaluation and management. If you are using tampons switch to a maxi pad as this is a better gauge of menstrual flow for evaluation of heaviness.
Is it ok to color my hair when I’m pregnant?
Due to limited absorption of hair dye chemicals into the scalp and lack of evidence that hair dye is associated with fetal harm, no contraindication to this process has been published. That said, if you are still concerned, consider waiting to color your hair until the second trimester, when your developing baby is less vulnerable. Also, instead of using an all-over hair color, consider a process like streaking, highlighting, painting, or frosting, in which the chemicals have little or no contact with your scalp. (Any hair-coloring agents absorbed into your system would come through your skin, not through your hair shaft.) Ensure that hair coloring process is performed in a well-ventilated area to decrease long term exposure to the fumes.
Pain reliever in pregnancy:
Tylenol is preferred in all trimesters of pregnancy.
Concerns about decreased fetal movement:
Sometimes in the busyness of the day it is difficult to remember to keep track of your baby’s movements but good fetal movement is very reassuring to us that baby is likely doing well. If you have concerns about movement we recommend that you consume a cold, high-sugar drink like a Coke/Pepsi and lie down in a quiet room and place your hands on your belly. You should feel 5 movements within 1 hour. This would be reassuring. If you do not experience adequate movement then a phone call to your provider is warranted.
Round ligament pain:
If a provider has diagnosed your pain as being consistent with round ligament pain in pregnancy you may try the following to help relieve symptoms: warm bath, Tylenol, belly band or pregnancy belt for support. Rest and modified activity is also recommended as these ligaments are easily irritated with excessive activity. If you suspect that the pain you are experiencing is round ligament pain scheduling an appointment is recommended to rule out alternate more concerning causes for your pain.
What is Zofran®?
Click to read about Zofran® in Pregnancy
This article is not intended to provide specific medical advice and is not to be used or relied on for diagnostic or treatment purposes. Rather, this article is provided as an information resource only to help you better understand your health. It does not create any patient-physician relationship. You are urged to consult with a qualified physician for specific medical advice, diagnosis and treatment and for answers to your personal medical questions.
Which prenatal vitamin to take:
Any over-the-counter with DHA or fish oil is recommended
Is it okay to eat fish and shellfish?
Fish and shellfish are an important part of a healthy diet. Fish and shellfish contain high-quality protein and other essential nutrients, are low in saturated fat, and contain omega-3 fatty acids. A well-balanced diet that includes a variety of fish and shellfish can contribute to heart health and children’s proper growth and development. So, women and young children in particular should include fish or shellfish in their diets due to the many nutritional benefits.
However, nearly all fish and shellfish contain traces of mercury. For most people, the risk from mercury by eating fish and shellfish is not a health concern. Yet, some fish and shellfish contain higher levels of mercury that may harm an unborn baby or young child’s developing nervous system. The risks from mercury in fish and shellfish depend on the amount of fish and shellfish eaten and the levels of mercury in the fish and shellfish. Therefore, the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) are advising women who may become pregnant, pregnant women, nursing mothers, and young children to avoid some types of fish and eat fish and shellfish that are lower in mercury.
By following these three recommendations for selecting and eating fish or shellfish, women and young children will receive the benefits of eating fish and shellfish and be confident that they have reduced their exposure to the harmful effects of mercury.
- Do not eat Shark, Swordfish, King Mackerel, or Tilefish because they contain high levels of mercury.
- Eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are lower in mercury.
- Five of the most commonly eaten fish that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish.
- Another commonly eaten fish, albacore (“white”) tuna has more mercury than canned light tuna. So, when choosing your two meals of fish and shellfish, you may eat up to 6 ounces (one average meal) of albacore tuna per week.
- Check local advisories about the safety of fish caught by family and friends in your local lakes, rivers, and coastal areas. If no advice is available, eat up to 6 ounces (one average meal) per week of fish you catch from local waters, but don’t consume any other fish during that week.