On BCPs but condom broke
The pill should be enough to protect you from pregnancy. I wouldn't recommend taking a morning after pill, just continue with your pills. I assume it's pregnancy you are worried about and not sexually transmitted diseases. In the case or STD's, you probably are still ok if the semen was only on the outside of the vagina and you had no open sore areas.
Cumulative contraception failure over 5 years
This seems to be a non-sequitur. The statement about an 18% failure rate applies to a birth control method such as withdrawal (which isn't a very good method). If the failure rate is as high as 18%, the author is right. The cumulative pregnancy rate over 5 years will be over 50% and by probability, actually 63%.
For all methods of birth control, there is a theoretical pregnancy rate (assumes perfect use) and an actual rate (imperfect use by humans who forget). Of the major contraceptives only diaphragms and cervical caps approach 18% failure rate in actual use. Depo-ProveraŽ runs 0.3% in actual use while birth control pills run 3%.
The longer a woman uses a method, presumably she gets more perfect in its use and therefore her pregnancy rate approximates that of "perfect use" which for pills would be 0.1% and for Depo-ProveraŽ is about the same.
I agree that the statement is misleading.
Pill brand change - will I get starting side effects again?
It's hard to say but I do not think so. The nausea and breast tenderness that you describe are usually general effects that women get in starting pills in general. If your body has already adjusted to those you probably won't get them again.
AlesseŽ and NordetteŽ have the same two components in them, levonorgestrel and ethinyl estradiol. The doses are slightly different, however with NordetteŽ having slightly more estrogen and less progestin. The net result is a more estrogenic pill (but not probably by much).
Nausea on the pills
Yes. Pills can cause this. It is thought to be a direct irritation of the stomach. Often we will have women switch to taking in morning because for some reason the meals make them less irritating. Taking the pills in the evening can be sort of like having "morning sickness".
Side effects when going off the pill
It's hard to say. Most of the time you return to how you were doing before you went on the pill. If you have been on pills more than 5 years though, it may be different just because your body has changed over that time. You sort of have to wait and see.
The chances of being pregnant but having periods
0.1% (1:1000), actually I wish I could be that exact but it is an extremely low chance.
It depends upon the definition of reasonably. I would say one normal period if NO pills have been missed but as you know it can rarely happen. 3 menses after would be almost certain in my book.
Well, the cost of a home pregnancy tests seems like a small price to pay to put your mind at ease, rather than worry for months about whether you may or may not be pregnant. If you are in this situation now, are you having any symptoms of pregnancy? If so, you need to have a test to be sure, and also to ease your mind.
Late menses changing pill brands
Changing the pill can result in the period being different by a day or at most two. Also, sometimes a higher progestin pill can cause less bleeding during menses, almost to the extent of skipping bleeding altogether or just spotting.
Can birth control pills cause night sweats?
Generally they do not do this but the only way to tell for sure is to stop them for a cycle. Progestins can raise the basal body temperature slightly so I don't want to say absolutely that they don't.
More likely culprits are: room temperature is warmer than you are used to, increased evening meal/calories, ingestion of substances that vasodilate (alcohol, medications, hot peppers, caffeine). Medical problems include low grade fevers, hyperthyroidism.
It is unlikely to be premature menopause since the pills would be functioning as estrogen replacement even if you were in premature menopause.
Increased mucous discharge after 4 year IUCD use
It's difficult to say. Be sure to check a pregnancy test because that could explain it. However, it is not that likely that you are pregnant. This may be a symptom that persists for only a short time and then goes away after the next menses or it could be more permanent. The bleeding can come from IUD irritation (even after 4 years), cervical inflammation, or even uterine bleeding secondary to hormonal fluctuation. It actually doesn't sound like a pregnancy. As long as the mucous is not yellowish in color and there is no pain associated, you might just wait to see the next cycle if this persists.
Will the doctor do a tubal even if I have no children?
There are always some doctors who might have a moral objection to tying tubes so young, but for the most part, doctors will perform the procedure as long as they are convinced that this is a well thought out decision and that you are unlikely to change your mind about it and "regret" having it done. Most "regret" rates at having tubal ligation are in the 2-3% range for all women (circumstances change later in life, e.g. a new medicine comes along that totally keeps manic-depression under control with no worsening from hormones). Women who have a higher "regret" rate approaching 5-10% are those less than 25 years of age and those women having marital/partner discord.
While you are under 25 years of age and might have a slightly higher regret rate, talk to your gynecologist about all the reasons you have to want this. It may take more than one visit, but most doctors understand this; you are not the first woman who has had these problems and made these decisions. They are tough decisions but you can get a tubal ligation done if that's what you think is best for you.
