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Sexual Health

Sexual Health

Birth control became widely available in the 1960’s, and since then it has been a simultaneously wonderful and controversial thing. There are many forms of birth control, including the pill, the patch, the ring, the shot, the arm implant, and the IUD, which not only help to prevent unwanted pregnancies, but can also help to alleviate period cramping/pain, lessen heavy periods, control hormonal acne, and so much more. While the past 60 years have brought about many updates and improvements in the world of contraceptives, so too have those years brought many questions and uncertainties, which ultimately led to misconceptions and myths. It is these incorrect ideas that still today cause women who could benefit from birth control to avoid it at all costs.

So let’s bust some of these common myths so that you can feel confident, healthy, and happy with your birth control decisions!

1. Birth control can lead to infertility or make it more difficult to conceive in the future.

    • False: Being on birth control will not make it more difficult for you to become pregnant in the future. Once you stop your birth control, whether that be the IUD, arm implant, patch, pill, or ring, you can technically become pregnant right away or shortly thereafter. The shot may take slightly longer than the other types of hormonal contraception to leave your system, even still, it does not cause infertility.
      • Disclaimer: It may be more difficult to become pregnant if you come off of birth control and you already had a condition that makes it difficult to conceive (for example, polycystic ovarian syndrome). However, birth control does not cause or worsen these conditions.

2. Birth control causes weight gain.

    • False: Birth control is zero calories, ladies! Birth control itself does not cause weight gain. However, the shift in hormones associated with any form of hormonal contraceptive can cause a transient increase in weight due to fluid retention, especially just before menses. Therefore, that temporary extra pound or two you see on the scale is likely just that- temporary! Research on this subject has largely discredited the idea for almost all types of contraception, with the exception of depo-provera, or “the shot”, which has been linked to weight gain. If you experience weight gain, talk to your provider to determine if there may be a better form of birth control for you!

3. You have to take the birth control pill at the exact same time every single day.

    • Kind of false? This depends somewhat on what type of birth control pill you are taking. If you are taking the “mini-pill”, i.e. progestin-only birth control pill, it’s important that you take your pill as close to the same time every day as possible. This is because progestin primarily works by thickening your cervical mucus and thinning the endometrial lining, while doing an okay job at suppressing ovulation. It is this inconsistent ability to prevent ovulation that makes it so important to be taken at the same time everyday. However, birth control pills that have both estrogen and progestin (which are much more commonly prescribed), do a better job at reliably preventing ovulation, and thus have a bit more wiggle room for error. Ideally you will get into a routine and take your birth control pill at the same time everyday (i.e. when you’re brushing you teeth in the morning, when you’re plugging your phone in at night, etc.), but if you were to forget to take a combination hormone pill for a few hours, it is recommended that you just take it as soon as you remember. If you forget to take a pill within a 10-12+ hour time frame of when you typically take it, it is recommended that you use back up contraception for a period of time. Forget your pill and not sure what to do? Give us a call or come on in and see us!

4. It’s unsafe to be taking or using a form of birth control that doesn’t allow you to get your period.

    • False: It is not unhealthy or “dangerous” to be on a form of contraception that causes you to skip or entirely get rid of your periods. This happens largely because of the progestin in the birth control that causes a thinning of the endometrial lining within the uterus, meaning there is no lining to be shed. This can also happen when you take continuous combined hormonal contraceptives, like the pills, patch, or ring. This essentially means that you take consistent hormones and never have a withdraw bleed, or period, like you normally would on say, the placebo week of birth control pills. Being on continuous birth control means skipping periods, and may be beneficial for women with painful or heavy periods. This is something that should always be discussed with your provider prior to attempting, whether it be with pills, patches, or the ring.

5. The arm implant, IUD, and/or ring can travel throughout the body, and therefore are dangerous.

    • Mostly false: The IUD, arm implant, and ring are all very safe (otherwise we wouldn’t be prescribing them on a daily basis, y’all!). First of all, the ring sits within the vagina, so there’s no way for it to enter into other parts of your body. The IUD sits within the uterus and is very safe! It is rare, but possible, to have the IUD poke through the wall of the uterus, thus allowing it to travel into other parts of your body (again, very rare). The arm implant sits just below the skin and may move slightly one way or the other, but in the vast majority of patients, stays right where it is placed, and only rarely is displaced and travels into other parts of the arm/body. Obviously the key word in this myth buster is RARE, and the take away that these forms of birth control are safe and effective.

These are just a few of the very common misconceptions surrounding birth control. Have more questions about birth control or need more myths busted? Make an appointment with your provider today to discuss all of your birth control options!


Have you heard of Dyspareunia?  It’s more commonly referred to as painful sex.  Seven Oaks Women’s Center wants to take the stigma out of the condition and help women get back to enjoy a healthier sex life.  It is more common than you think. At some point in their lives, 3 out of 4 women will experience episodes of painful sex.

Almost everyone finds it difficult to talk about with their friends, and maybe even their doctors. Whether you have experienced chronic dyspareunia and have gone from one doctor to another, or are simply uncomfortable talking about intercourse, it can be a difficult discussion to have. Many women are afraid the answer will be that there are no options to help them feel better.

Sex is not supposed to hurt unless you want it to. Some women think it is “normal for them” to not be able to enjoy sex because of pain. Minor soreness or tingling/burning after particularly rough or fast, intense sex can be normal. However, recurrent, undesired pain in the vulva, vagina, or pelvis is not normal.

There are many conditions, some more common during specific phases of life, that can lead to painful sex.

  • Infection. One of the most important things to evaluate first is to rule out sexually transmitted diseases, a yeast infection, or other bacteria that can cause painful sex. This can be done during a pelvic exam in the office, and by vaginal or vulvar cultures.
  • Hormonal changes. As many as 50% of menopausal women will experience painful sex as a result of low hormone levels, particularly estrogen levels. Estrogen begins to decline in the years prior to menopause, or perimenopause. Estrogen is a hormone that has receptors all over womens’ bodies, but when it is low, the specific vaginal effects can be painful sex, having irritable vaginal tissue that bleeds easily after sex, vaginal dryness or irritation outside intercourse, and difficulty lubricating. Women who are breastfeeding and women who are on certain medications that decrease estrogen levels (treating certain cancers) may also experience painful sex as a result of low estrogen. There are several options for replacing vaginal estrogen, including oral pills available now. Also, replacing other hormones, such as testosterone or prasterone, can be treatment options.
  • Skin disorders. The vulva and vagina can develop a chronic reaction to something that is contacting the area, even if this is a product that has been used for several years, including latex condoms. This can cause chronic irritation and pain. It is important to never clean inside the vagina, and use only hypoallergenic soaps and cleansers to the vulvar area – these have no dyes and no fragrances. There are other skin conditions that can affect the vulva such as psoriasis or lichen sclerosis. These can be diagnosed during an exam, and sometimes require a biopsy of the affected area.
  • Vaginismus. This is a contraction, tightening, or closing of the vaginal muscles that is out of a woman’s control. This can cause pain during penetration and during intercourse. There are options to treat this condition, such as pelvic floor therapy.
  • Vulvodynia. This is chronic pain at the vaginal opening. This can cause soreness, burning, stinging, irritation, rawness even outside of intercourse.
  • Scar tissue after having a baby. It takes time for the vagina and perineum to heal, but if pain is persistent, it is worth talking about the discomfort.
  • Endometriosis. This is a chronic condition that can also cause heavy and painful periods. Endometriosis can cause pelvic pain with deep penetration. This is usually a more complicated discussion, but treatment options can include hormonal treatments, and at times laparoscopic surgery.
  • Ovarian cysts. Also cysts typically cause pain with deeper penetration, but may also cause pain outside sex. This would be important to evaluate with an ultrasound.

Other Factors

So many things can affect our sexual response to make sex uncomfortable. For women, we know sex is not as easy as flipping an “on-switch” most of the time. If there is a long “to-do” list, if there was an argument with your partner, if stress, guilt, fear, or shame are feelings at the time, these can affect the body’s ability to relax, be aroused, and enjoy sex as well. Mental health can be a significant contributor.

Also somewhat unfair, some antidepressant medications, medications for birth control, blood pressure medications, allergy medications – all of which we use to take better care of ourselves – can potentially decrease natural lubrication and translate into painful sex. If a male partner is having difficulty maintaining an erection, this can lead to longer, and at times painful intercourse.

Things you can try before talking to a gynecologist

  • Try lubrication. Coconut and olive oil are easily available products that are safe and hypoallergenic, but not compatible with condoms. With condoms, use a silicone-based lubricant as water-based lubricants may dry out more quickly and can cause more friction.
  • Talk with your partner and be open about the issues. Be specific about when and where the pain is, specific positions that may be more painful, and what is more enjoyable for you. Try activities such as mutual masturbation or oral sex if they are less painful. Make adequate time for sex when both partners are not anxious or tired so that it does not have to feel rushed. Easier said than done when children are at home!
  • Use an ice or frozen gel pack wrapped in a soft towel for mild vulvar discomfort after intercourse, or can try a warm bath.

Dealing with chronic pain during sex can seem hopeless and frustrating, but the best thing to do if you are concerned is to talk to a gynecologist, and all of us at Seven Oaks would love to start the conversation with you!

Want to make an appointment? Have questions about insurance?

Call (210) 692-9500

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We proudly serve patients needing gynecology services, obstetrics and overall women's health in the following areas of Alamo Heights, Olmos Park, Castle Hills, Medical Center, Hill Country, Stone Oak, Hollywood Park, Downtown, Bulverde, Spring Branch, Leon Springs, Boerne, Alamo Ranch and many other neighborhoods in the greater San Antonio.