Contraception (birth control)

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Why your Ob-Gyn should be board-certified

Wednesday, July 22nd, 2009

It’s almost impossible to judge a professional’s skills if you’re not a member of that profession. Only a radiologist can say whether another radiologist accurately read a CT scan. Only a dentist can attest to the quality of the crown another dentist fits over a molar.

So how do you, a layperson, judge the qualifications of your doctor? If they drive fancy cars, wear designer clothes, and charge the highest fees in the community, you can be sure they’re successful. But does that mean they’re qualified? You can ask your girlfriends or your sister or mother to recommend someone. You can determine whether you have rapport with a physician. But that won’t tell you about qualifications, either.

If you want to know whether the kind, caring person you select has the minimum qualifications, there’s one way to determine that. Go here to see whether your doctor is board-certified.

Board certification isn’t mandatory. Once a doctor gets a medical degree and a state license to practice medicine and surgery, he or she can practice any specialty. No law requires a doctor to complete a four-year residency in a specialty, such as ob-gyn, in order to be called a specialist. Nothing prevents a doctor from giving him or herself the title of obstetrician or fertility expert or perinatal specialist or really, almost anything.

But only board certification assures you that the doctor has earned that title.

A board certified doctor has gone a giant step further than a physician who hasn’t passed her boards. After completing a residency program, passing a written test in the specialty, and practicing for a year or two, she’s gathered up all her cases and submitted them to an august body known as the American Board of Obstetrics and Gynecology. Before these distinguished university professors and chairs of departments, she’s been extensively questioned about real and hypothetical situations and asked about diagnoses, patient management and treatment.

As an oral examiner for the American Board of Ob-Gyn since 1997, I’ve certified hundreds of new ob-gyn candidates who have proven their capabilities under difficult circumstances. And there were some who did not pass because they didn’t meet those high standards.

So I speak from experience when I say that board certification is the minimum you should expect from your doctor.

- Yvonne S. Thornton, MD, MPH

Protecting yourself from herpes

Tuesday, June 30th, 2009

The other day, a friend told me a joke:

“What’s the difference between love and herpes?”

I said I didn’t know.

“Herpes is forever,” she said.

While I’m not as cynical as my friend – I’ve been in love with my husband for 40 years and will love him for as long as I live – she’s right about one thing. Once you get herpes, you’ve got it for good.

So, what can you do to protect yourself?

Condoms offer better protection against HIV and pregnancy than against genital herpes. That’s because herpes lesions can appear just beyond the genitalia, in areas the condom doesn’t cover.

If you or your partner has herpes, the best protection against passing it on is suppression therapy – acyclovir or Valtrex. Whenever the infected person feels the tingles and other sensations that usually signal an imminent herpes episode, avoid sexual contact.

And if you’re just starting a new romance, be sure to have a frank talk about herpes and other intimate issues before you decide to take it to the next level. Remember, while it may be difficult at first to determine whether a relationship has staying power, you can be sure that herpes does.

- Yvonne Thornton, MD. MPH

Pregnancy and the pill

Tuesday, June 16th, 2009

For many women, taking the pill is more a matter of delaying pregnancy until the time is right rather than preventing it all together.

So, the big question becomes, how long after you stop taking the pill can you expect to become pregnant? No two women are alike but, generally speaking, pregnancy is possible the next time you ovulate. You may ovulate within two weeks after finishing up your last package of birth control pills. So, theoretically, you could become pregnant almost immediately. However, as we all know, there are many variables. Some couples try for years to become parents without success.

It almost seems an unfair trick of the heavens that it’s sometimes the women who don’t want to become pregnant who easily do.

That means, if you’re dead set against pregnancy, and you stop the pill, you need to begin another form of contraception immediately. I actually recommend that my patients begin using an alternate contraceptive before getting off the pill so they get into the habit of using it.

Otherwise, you may have to get into the habit of changing diapers.

- Yvonne Thornton, MD, MPH

Can you use the “morning after” pill as your main form of contraception?

Wednesday, May 20th, 2009

Some women wonder whether, since the morning after pill (a.k.a. “Plan B”) can prevent pregnancy, they can take it whenever they have intercourse and skip other forms of contraception.

Here’s the short answer: No.

Okay, now for the longer answer. Plan B delivers a wallop of hormones – at least twice the amount that you’d get in a high dose birth control pill. We doctors just don’t know what effect such a massive dose of hormones might have on a woman’s body over time, including an increase in the risk for blood clots and strokes. That’s because there have been no studies done on using the morning after pill as anything but a one-shot emergency contraceptive.

If you try to use Plan B as ordinary contraception, you will be, in effect, going into the “do-it-yourself” research business, with yourself as chief guinea pig. You’ll be risking your health while not developing a responsible approach to birth control. There are plenty of effective, tested contraceptives on the market. Use this medicine only for the purpose it was intended to serve.

- Yvonne S. Thornton, MD, MPH