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Effective contraception for 5 days in TYPE1 DIABETIC.

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Hi,

I need suggestions for effective contraception that I can easily come off, please consider the following:

* I am 24, a virgin and will be having sex with a virgin (my fiance) so I do not need to worry about STDs.
* I have not taken or used any type of contraception before
* I only need to be protected from pregnancy for a period of 5 days straight (when I will be meeting him from abroad for a week)
* I am a type 1 diabetic with very good sugar control and no complications, my hba1c is 6.3, and over all, generally quite healthy
* My main health problems are digestive issues, I do get IBS and indigestion frequently. Furthermore, I do have a tendency towards vaginal thrush infections and depression/anxiety at times (and UTI a couple of times a year).

SO considering all this, do you think it is worth it to go on a contraceptive pill? - to protect me for 5 days only. if so which one is the best for my situation?

Please note - I do not have 3 months to adjust to the side effects of the pill. I really cannot afford to have any spotting/bleeding or vaginal thrush infections for the 5 days I will be seeing him (in 2 months time - late January 2015). I do not mind if the side effects last for a week or two - but not for the entire 2 months - I understand this might be hard to predict.

Is there a pill that will not significantly aggravate my existing conditions and minimize the prospect of any breakthrough bleeding/spotting in between periods. Can I please get some names/brands so I can suggest them to my doctor when I go in to see them next.

Apart from this, Do you have any further suggestions for other contraception? I have done a little bit of research and wanted to ask how effective the 'morning after' pill is?
Is it a good idea for me to take this for the 5 days I require contraception - are there any immediate side effects? We can use a condom but I will feel paranoid the whole time if that is the only thing we rely on.

I have waited a VERY long time to have sex and waited for the right person, I really do not want thrush, headaches or a period during this time.

Thanks a lot

Note: I have had type 1 diabetes since I was 15 - approx 9 years, generally good control. 

Category: OBGYN

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Category: Infertility Specialist
 23 Doctors Online

Hello,
Thanks for posting your query at DoctorSpring.com
Thank you for a very wonderfully and comprehensively phrased question too, smacks of a lot of intelligence and insight, commendable at your age.
Detailed as you have been, before suggesting anything else, I wish to ask you for a few more details -
1. What is your height and weight ?
2. Where do you reside , so that I can name locally available options.
3. Are your cycles regular, and when you would be meeting him ( the 5 purported days ) - what phase of the menstrual cycle are you likely to be in ?
These 3 details will impact how I answer you.
Looking forward to hearing from you.
Regards.


Patient replied :

Dear Dr Aarti,
Thanks for your response,
1. My height is 5' 6 and a half , I am 62 kilos and quite an athletic build, I gym frequently.
2. I live in Sydney, Australia
3. My cycles are quite regular, ie. I get my period every 28-30 days. My periods generally last about 4-5 days, I do get quite heavy bleeding and cramps on the first day/ day before. A couple of times this year they have been up to a week late, but seem to have normalised in the last 4 months or so.
The five days I will see him are between the 19th to 23rd of January. My last period was on the 12 - 15th November, I am due for my next period roughly on the 11th of December. (in 15 days), I have two cycles between now and when I will be meeting him.
Assuming everything is normal - 19th January will be roughly 10 days after my period starts - so in theory I should not be bleeding during this time.
Thanks,


Hello,
Thank you for the response.
Well, frankly, if you plan to be sexually active just for 5 days, oral contraceptive pills do not make much sense.
The side effects are trivial, but yes, unpredictable, and spotting / bleeding at that time cannot be written off , it just MIGHT happen.
Again, I value your confidence, and understand that you both are virgins, but protecting yourself against STDs ALWAYS makes sense.
A condom is the best option for you, why would you be paranoid about it ?
IT is an excellent method if consistently used.
To be more on the safer side, you could use condoms with spermicidal lube inserted into the teat, or spermicidal jelly inserted in the vagina prior to intercourse PLUS a condom.
The emergency contraceptive pill is to be taken within 72 hours of unprotected sex, repeated dosage within 5 days would reduce its efficacy.
Again, it causes unpredictable menstrual bleeding, further would confuse you.
GIven the sporadic nature of intercourse planned, it is not worthwhile subjecting your body to hormones in the conventional pill, or in the emergency pill.
My best advice is the condom PLUS spermicide.
Let me know if it is workable for you.
Regards.


Patient replied :

I think I may go with the condom option instead,
However, if I do chose to go on the pill, which pills would you suggest ?


Hello,
Loette or Microgynon 20 ED is an excellent one with minimal hormonal content.
Remember to start on the 1st or 2nd day of your cycle.
Remember to take the pill at the same time everyday to prevent erratic spotting / undesirable side effects.
ANother option if you have decided to take hormonal contraceptives is the patch or ring.
THe patch / ring also contains hormones, and eliminates the need to remember to take a pill each day.
THe patch / ring is 3 weeks in, 1 week out.
Patch is like a Bandaid stuck on to the buttocks, torso or arms, and changed each week for 3 weeks and then a patch free week during which you bleed.
The ring is inserted into the vagina for 3 weeks, and then removed for a week ( no need for a new ring each week ).
These options are costlier than the pill.
OrthoEvra is the patch and NuvaRing is the vaginal ring.
All the best
Please feel free to discuss further.


Dr. Aarti Vazirani
Category: Infertility Specialist
Experience: 
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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