Forums » Ask a doctor for free health information

I need some advice about sex.

    • 117 posts
    October 1, 2014 12:33:27 PM PDT
    Hi! I'm 18 and a virgin and I was wondering what I need to do before I lose my virginity to my boyfriend? What are some things I should be sure of before I do it and how do I know I'm ready?
    • Moderator
    • 1957 posts
    October 1, 2014 6:10:30 PM PDT

    Greetings C, 

    1. Ask your partner to go with you to the health clinic to be tested for sexually transmitted infections. 

    2. This video has instructions for doctors to help eliminate barriers to contraception. I would encourage you to watch it. 

    3. Use condoms. 

    4. Assess your plans. for example, if you want to have sex and get pregnant, you should not use birth control. If you feel pressured to have sex, or physically threatened then that could be a sign of an abusive relationship. However, given your calm typing demeanor, I do not think that is the case.

    5. Have you setup your doctors appointment yet? 

    Kind regards.


    This post was edited by DrSocial Admin at May 30, 2015 8:21:50 AM PDT
    • 117 posts
    October 1, 2014 7:31:41 PM PDT
    Thank you! He already has and things came out well. And the video did help :) we already have condoms. I don't want to get pregnant but I should be getting birth control hopefully soon. It's mutual that him and I want to do this and I feel I'm ready. All that's left are really nerves about some little things. I have not setup my doctors appointment yet but I definitely need to soon. I'm a terrible procrastinator especially when it comes to this kind of stuff but it will get done! Thank you again! :) also I've heard it hurts when you have sex for the first time. Do you know if it's true or if there's any reason for this? If it is true how can I prevent it or at least make it better?
    • Moderator
    • 1957 posts
    October 1, 2014 8:15:57 PM PDT

    Legal disclaimer: we do not have a doctor-patient relationship and we cannot give specific instructions of care to you, but we can give you our best effort to find high-quality information that you can consider. If we are wrong, or you don't like what we say, feel free to leave a message and let us know how we can improve the quality of the service. In addition, we encourage other people in the community to contribute their knowledge to the questions that are asked. 

    For example, if you have a rare disease, and had a rare surgery, please simply state "back surgery," and if needed we can explore that further. If your neighbor or best friend reads this, will be they be able to identify you based on the information given? If yes, please remove the information or change it slightly. 

    BAD example: I live in Boston, Dr. Patel at MGH hospital diagnosed me with a schwannoma tumor last month, then I traveled to Tokyo and taught english for a year. 

    Acceptable example: I live in the United States, I had a tumor & surgery, then I traveled abroad for work.

    --------

    I have heard that. There may be literature related to it. I am not instructing you to take a medicine, but if you wanted to take Ibuprofen or Tylenol before that would be reasonable. 

    -

    Please do make an appointment. Call the doctors office tomorrow; you may even be able to visit an acute care clinic, such as those inside Walgreens to pick-up (be prescribed) oral contraceptives. 

     

    Kind regards,

    -BrettMD

    • 117 posts
    October 1, 2014 8:38:14 PM PDT
    Okay. I definitely will. I just have to get everything with my mom cleared up before I can make an appointment. I don't really know how to feel about my family doctor but I'm hoping maybe having this conversation with her and telling her I finally want gardasil will help me feel better about her.
    • Moderator
    • 1957 posts
    October 1, 2014 10:08:18 PM PDT
    Greetings K,

    Please repost this to a new thread, the button to do it is on the upper right, if you have trouble, reply and I will help you move it.

    Kind regards.
    -BrettMD
    • 117 posts
    October 1, 2014 11:10:11 PM PDT
    Do you have any idea how to improve my thoughts about my family doctor?
    • Moderator
    • 1957 posts
    October 2, 2014 8:52:06 AM PDT

    Greetings C, 

    Your comment caught me by surprise. It seems like something a medical board would ask; a group of doctors that has yet to learn that committing fraud against doctors such as Dr. Adem is not good.

    You should not make a special effort to endear yourself to your doctor.

    If you are not satisfied with the doctor-patient relationship you have with your doctor or you do not trust your doctor because they committed fraud repeatedly (for example, if your doctor was on the Missouri Medical Board), then that would be understandable. Again, if your doctor was on the Missouri Medical Board, it would be understandable why you did not trust them, given their repeated acts of fraud.

    In summary, if you are not satisfied with the doctor-patient relationship that you have with your doctor, please find another physician. 

    Please speak with your mom when you choose. 

    Best regards.


    This post was edited by DrSocial Admin at May 30, 2015 8:22:56 AM PDT
    • 117 posts
    October 2, 2014 12:25:40 PM PDT
    I'm not sure why but the past few years I haven't been able to trust my doctor. I think it's been ever the incident with my dentist... I've had trouble trusting anyone with me after that. Besides that some of the things my doctor has said just doesn't sit well in my mind. She has just kind of rubbed me the wrong way. My mom really likes her though and so I can't decide if I should tell her I want a new doctor or not.
    • Moderator
    • 1957 posts
    October 2, 2014 5:41:10 PM PDT

    Thank you for the reply C, 

    I apologize for referring to the medical board so much. Having to deal with them and their gossip-based investigations so frequently is frustrating; if they would do their job and investigate patient harm that I reported, then things would be much better. Yet I digress,

    What is most important is that you feel comfortable with your doctor. Now if she rubbed you the wrong way, then you may want to find another doctor. Recognize that no doctor is perfect, they are people, but if you feel that she has overstepped her role as a physician or something along those lines, why not try another doctor. There are several hundred thousand physicians in the USA, so I would encourage you to search for another.

    ---

    Oral contraceptives  and weight gain: 

    Breast Tenderness

    An IUD would also be reasonable and the NEJM showed that after gathering more information, many women preferred that. So it may be good to discuss it with your doctor and then decide what you prefer. 

    Kind regards.


    This post was edited by DrSocial Admin at May 31, 2015 3:16:42 AM PDT
    • Moderator
    • 1957 posts
    October 2, 2014 5:42:15 PM PDT

    Greetings C,

    In regards to
    1. Weight gain:
    Weight — Many women and their clinicians believe that OCs cause weight gain. However, available data suggest that this is not the case.

    As an example, in a study of 49 healthy women initiating treatment with an OC containing 30 mcg EE plus 75 mcg gestodene, anthropometric measurements before and after the initiation of OC use were compared with those in 31 age- and weight-matched women [127]. Baseline body mass index (BMI), percent fat, percent water, and waist-to-hip (WHR) ratio did not change significantly after six cycles in the OC users. A similar number of women gained weight in both groups (30.6 percent of users, 35.4 percent of controls); the typical weight gain in the OC group was only 0.5 kg. The weight gain in these women was due to accumulation of fat, not body water. Approximately 20 percent of women in both groups lost weight.OCs cause weight gain. However, available data suggest that this is not the case. As an example, in a study of 49 healthy women initiating treatment with an OC containing 30 mcg EE plus 75 mcg gestodene, anthropometric measurements before and after the initiation of OC use were compared with those in 31 age- and weight-matched women [127]. Baseline body mass index (BMI), percent fat, percent water, and waist-to-hip (WHR) ratio did not change significantly after six cycles in the OC users. A similar number of women gained weight in both groups (30.6 percent of users, 35.4 percent of controls); the typical weight gain in the OC group was only 0.5 kg. The weight gain in these women was due to accumulation of fat, not body water. Approximately 20 percent of women in both groups lost weight.
    A systematic review of 49 trials (only four of which had a placebo group), did not find evidence supporting a causal relationship between use of combination OCs (or contraceptive patch) and weight gain [128]. The majority of trials that compared pills of variable types and doses (EE doses 20 to 50 mcg) showed no significant difference in weight between groups. The authors concluded that the available data exclude a large, but not a small, effect of OCs on weight.
    -----
    In regards to breast size: In the study they did not perform quantitative analysis of breast volume. However, there was breast tenderness that was more common in those who discontinued the medication. As to whether there is some increase in breast size from oral contraceptives, similar to how there is in pregnancy, I do not know.

    http://www.uptodate.com/contents/risks-and-side-effects-associated-with-estrogen-progestin-contraceptives


    This post was edited by DrSocial Admin at May 30, 2015 8:25:43 AM PDT
    • 117 posts
    October 2, 2014 6:17:19 PM PDT
    Thank you so much! It's fine. I actually find all of the medical board references kind of interesting. Do you know if getting the iud is painful? I My mom has the mirena iud and she says she loves it but I'm not very sure. Also if I eat a healthy diet and exercise like I am now do you think weight gain won't effect me once I get birth control? And I know this question isn't birth control related but what age is it recommended to get your first pelvic exam?
    • 117 posts
    October 2, 2014 6:21:43 PM PDT
    Oh and as for my family doctor I may just go back to my old one. My last one I had from when I was a baby till about 13 and then she moved to another family practice and we couldn't find her. We just recently found her again. I really liked her. We see her all over the place and catch up with each other when we do. She has daughters around my age so she's pretty easy to talk to too.
    • Moderator
    • 1957 posts
    October 2, 2014 9:44:52 PM PDT

    Greetings C, 

    1. Is the IUD Painful: There are some reports of cramping after having it inserted. 

    1a. https://answers.yahoo.com/question/index?qid=20080408195828AAyyVCm

    1b. http://www.webmd.com/sex/birth-control/intrauterine-device-iud-for-birth-control

    2. If you eat a healthy diet and exercise:  According to the study, the weight of women stayed the same, it is even possible that you could lose weight. 

    3. Pelvic Exam: this is a somewhat of a moving target. 

    Pelvic Exam Not Recommended

    If you really wanted to a pelvic exam and were concerned about your ovaries, then it would be possible for you to receive one. However, many people do not seek out pelvic exams. They can be a bit uncomfortable. I don't know definitively, but I have heart that people having colonscopies, also feel a bit uncomfortable. Having multiple hands and or instruments inserted into orifices can be unpleasant. Same for EGDs. Thus, if there isn't an important reason to do it, then probably better not to do it. 

    A pelvic exam generally consists of more than only a pap smear and involves palpation of the ovaries. 

    As for the pap smear, the recommendation is to obtain the first one at age 21. 

    Pap Smear Guidelines Start Age 21

    Kind regards.


    This post was edited by DrSocial Admin at May 30, 2015 8:27:19 AM PDT
    • 117 posts
    October 3, 2014 1:34:20 AM PDT
    Thank you! I think I might consider the iud just because I won't have to remember quite as many things. So since my periods aren't very regular yet and don't come at the same time every month will both the pill and an iud help with that? Also is it normal for my periods to still be irregular? They've never been regular since I started at 12 and I'm 18 now.
    • Moderator
    • 1957 posts
    October 3, 2014 9:11:09 AM PDT

    Thank you for the question C,

     

    Legal disclaimer:  we do not have a doctor- relationship and we cannot give specific instructions of care to you, but we can give you our best effort to find high quality information that you can consider. If we are wrong, or you don't like what we say, feel free to leave a message and let us know how we can improve  quality of service.In addition, we encourage other people in the community to contribute their knowledge to the questions that are asked. 

    For example, if you have a rare disease, and had a rare surgery, please simply state "back surgery," and if needed we can explore that further.  If your neighbor or best friend reads this, will be they be able to identify you based on the information given? If yes, please remove the information or change it slightly. 

    BAD example:  I live in Boston, Dr. Patel at MGH hospital diagnosed me with a schwannoma tumor last month, then I traveled to Tokyo and taught english for a year.  

    Acceptable example: I live in the United States, I had a tumor & surgery, then I traveled abroad for work

    -----

    A menstrual period is from the first day of menses to the first day of the next menses. 

     

    - Most girls have their periods that occur less than 40 days, ~3 years after menarche (first period). 

    So by the time girls are about 15, the interval between menses is less than 40 days. Whether there is some variability I will have to check the literature. For example, 28 days, 29 days; and then 33 days. I will have check the literature. Given that there are sometimes anovulatory cycles, My thoughts are that the data has great variability. In summary, I do not know, but I will try to find out. 

     

    1. When was your most recent menstrual period?

    2. The time before that?

    3. The time before that. 

     

    4. Please tell me a bit more about what you mean by irregular. 

    5. Please see this video and consider keeping a menstrual cycle diary.

    6. With regards to the pills. There are different regimens, but yes, it would likely* help your periods be more regular. Alternatively, you could stop having monthly periods depending on the regimen that you choose. 

    7. The IUD may or may not depending on what type you choose. Sometimes menses decrease in duration/quantity of blood loss; it depends on whether the IUD is a hormonal or non-hormonal IUD.

    http://www.webmd.com/sex/birth-control/intrauterine-device-iud-for-birth-controla

     

     

    Best regards,

    -BrettMD


    This post was edited by Brett Snodgrass at October 3, 2014 9:13:41 AM PDT
    • Moderator
    • 1957 posts
    October 3, 2014 9:15:20 AM PDT

    Here is more information on the Pelvic Exam. The article is free.

     

    http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Gynecologic-Practice/Well-Woman-Visit

     

     

    Kind regards,

    -BrettMD

    • Moderator
    • 1957 posts
    October 3, 2014 9:25:23 AM PDT

    Here is a link to a menstrual cycle diary. I think that they also have apps for this. 

    http://www.cemcor.ubc.ca/files/uploads/Menstrual_Cycle_Diary.pdf

    • 117 posts
    October 3, 2014 12:09:36 PM PDT
    Thank you! And I actually do already mark on the calendar the first day of every period just so that I can try to predict when the next one will start. It doesn't work very well through because it comes at different lengths of time every time. The only way I ever really know is that my breasts get really sore I can tell I'm having really bad mood swings and get really sad and it seems I get a lot more tummy aches right before and during too. I'm just glad I really don't deal with too many cramps.
    1. It was September 24th.
    2. August 17th was the time before that.
    3. July 25th was the time before that.
    4. I just mean that they are kinda unpredictable. I'm not sure if that would be classified as irregular but I just couldn't find a better way to put it. Thank you for all of the helpful information!
    • Moderator
    • 1957 posts
    October 3, 2014 1:48:03 PM PDT

    July 25 to August 17 = 23 days

     

    August 17 to  September 24  = 39 days. 

     

    You may want to complete the cycle diary and discuss it with your doctor. Also you may want to discuss with your doctor whether you have 

     

    http://en.wikipedia.org/wiki/Premenstrual_dysphoric_disorder

     

    Best regards,

    -BrettMD

    • Moderator
    • 1957 posts
    October 3, 2014 1:54:19 PM PDT

    Your cycle is irregular, the Oral contraceptives may help with that. You may want to discuss it with your doctor too. I will try to look up more later. Given the aformentioned information, I would suggest that you keep track of your menstrual periods. and discuss additional factors with your doctor. I do not know what percent of adolescents & teenagers have such variation in their menstrual cycles.

     

    Since I don't know off the top of my head, I would encourage you to ask another doctor. You may want to Google "Ask a doctor for free," then run that question by them. 

     

    Please consider keeping me updated.

    Kind regards,

    -BrettMD

    • 117 posts
    October 3, 2014 2:20:54 PM PDT
    Okay! Thank you so much! What I'm experiencing does sound like PMDD. I'm kind of unsure about how I should mention all this to my doctor though.
    • 117 posts
    October 3, 2014 2:47:23 PM PDT
    Could thyroid problems effect menstrual cycles?
    • Moderator
    • 1957 posts
    October 3, 2014 8:12:37 PM PDT

    Could thyroid problems affect menstrual periods? 


    You ask excellent questions. I encourage you to go to medical school if you are interested, able, etc.

    ---

     

     

    Severe hyperthyroidism (Free T3 greater than 30, see photo) has been associated with a slightly* (but still not common, only ~3%) higher incidence of a lack of menses for several months. However, the signs & symptoms of Premenstrual syndrome can overlap with those caused by thyroid abnormalities. Therefore, the doctor may be interested in checking your thyroid hormone level.

     

    Whenever myself, Juan Rosai, or anyone says something without a reference, always be cautious that they could be wrong. 

     

    What I mean is that there are myths, and stories, that are propagated in medicine. Many doctors, even myself are susceptible to them. There are some who have said things such as "the most common cause of amenorrhea, is thyroid abnormality," or something along those lines. I asked for the reference when I heard that, but they didn't know it. Therefore, "we have always done it this way," or "we have always thought it was the thyroid," should be viewed cautiously. 

     

    Here is a nice study examining relationships between both hyperthyroidism and hypothyroidism, and menstrual cycle disorders. http://www.ncbi.nlm.nih.gov/pubmed/20938101

    Since symptoms including mood changes can be seen in disorders of thyroid function, the doctor may be interested in checking thyroid function regardless of whether menses itself is altered by the thyroid. 

     

    Kind regards,

    -BrettMD


    This post was edited by Brett Snodgrass at October 3, 2014 8:18:55 PM PDT
    • 117 posts
    October 3, 2014 8:52:58 PM PDT
    Well thank you :) and I actually was looking into going into the medical field but I was mostly looking at respiratory therapy. Then I decided that I don't like needles so I probably wouldn't like seeing them everyday. When it comes to how I thought about the thyroid question is I thought I had heard something about the two being related. Also my mom has been thinking I have a thyroid problem for awhile now and we just haven't brought it up to my doctor. Some things going on with me kind of seem like I might have a problem with it.