Medical Articles, Medicine Information.

Access to treatment for sexually transmitted infections is vital to one out of five teenagers. More than half of all students in grades nine to 12 have had sexual intercourse at least once. Nearly three-quarters have had sexual intercourse by grade 12. Each year, 3 million teenagers contract sexually transmitted infections. Many of these infections have no symptoms. Left untreated, they can cause serious health problems including infertility and cervical cancer.

Minors can be treated for sexually transmitted infections without parental consent in all states. Some states set no age limits. Minors can receive treatment at Planned Parenthood health centers, other family planning clinics, and “sexually transmitted disease clinics” sponsored by hospitals or local health departments.

Public health laws require health care providers to report certain infections, regardless of the age of the patient. Sexually transmitted infections that must be reported include syphilis, gonorrhea, chlamydia, herpes, HIV, and AIDS. In most cases, names are not reported. The information is used by public health officials to track the spread of infection.

Some urban public schools are linked to special health clinics to offer teenagers assistance with sexually transmitted infections, safer sex information, pregnancy concerns, and other health-related matters. There are now more than 500 of these across the country—some located in school buildings. They have helped reduce teen pregnancy and sexually transmitted infections.

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Is it safe to have sex with only one partner? Maybe. The ideal for many people is to do so. Women and men don’t need to worry about getting sexually transmitted infections:

• if neither partner ever had sex with anyone else

• if neither partner ever shared needles

• if neither partner was ever infected

Most of us have more than one sex partner during our lives. We may not plan it that way, but it happens. We may also get an infection from ne partner and carry it to another. The partners who gave it to us:

• may not have known they were infected

• may have hoped they wouldn’t infect us

• may not have been totally honest about their sexual histories

Some of us have only one partner, but our partner may “cheat.” Many women who got HIV from having sex thought they were their sex partners’ only sex partners.

We may want to give up safer sex because we’ve decided with our sex partners to have sex with no one else. But first we must be sure that neither partner is infected. Some infections, such as HIV, may take 10 years or more before symptoms develop. The early symptoms of many infections may go unnoticed. That’s why mutually monogamous partners must be sure to be tested for sexually transmitted infections before they give up safer sex.

Establishing trust in a sexual relationship is very important. We should be able to talk openly and honestly with our partners about our sexual histories and theirs. We should know whether our partners have had infections, and they should know about any infections we’ve had, before we agree to have unprotected sexual intercourse. Unfortunately, however, nearly one out of three people will lie about their feelings in order to have sex with someone else. A similar number will lie about their sexual histories. Only slightly fewer will lie about whether or not they have HIV!

When it comes to safer sex, we must rely on ourselves, not on our partners. Unless we have a very long, committed relationship that is built on open communication, we are the only people we are absolutely sure we can trust. Believing you are your sex partner’s only sex partner will not make it true. Here are some questions to think over:

• Do I know how my partner spends time away from me?

• Is my partner always open about everything with me—including the past?

• Does my partner get upset if I want to have a “serious” talk about our relationship?

• Does my partner keep secrets from me?

• Does my partner ever say, “I’m just going out,” or, “It’s none of your business”?

• Is my partner always respectful to me?

If you have a relationship that is secretive, has little open communication on serious health issues, and is lacking in equality and respect, you may very well be at risk for sexually transmitted infection.

We all want partners we can trust. The key is to make sure our partners earn our trust. We should never just give it away. Whether or not our partners have HIV won’t matter if we accept responsibility to protect ourselves. We shouldn’t take someone’s word for something so dangerous until we’ve been through an awful lot together—and even then we must be careful.

Women are at greater risk of getting an infection than men are. The vagina and rectum are more easily infected than the penis. A woman’s chance of being infected by a man with HIV is twice as great as a man’s chance of being infected by a woman with HIV.

Moreover, women generally have fewer symptoms than men. They are less likely to know that they are infected. Lots of damage can be done, even if there are no symptoms. Many women develop PID (pelvic inflammatory disease) because they don’t know they have gonorrhea or chlamydia. PID increases the risk of sterility and ectopic pregnancy.

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Since our interest in sexual behavior is in the context of its consequences for adolescent women, a pertinent question is: To what extent do sexually experienced adolescent women at–tempt to avoid pregnancy through use of contraception?

Although most sexually experienced unmarried adolescent women interviewed in 1971 had used contraception at some time, they took many chances. Over half of them had not used any contraception at their most recent coitus, and only two out of ten used contraception consistently. Younger sexually experienced women (fifteen- and sixteen-year-olds) were more likely to have never used contraception than older adolescents (seventeen- to nineteen-year-olds). Those adolescents who did use contraception generally began using it sometime after the first coitus. The earlier the age was at the first coitus the wider the gap was between first intercourse and first contraception. For most adolescent women, sex is a sometime thing and this may be an important factor in the low levels of consistent use of contraception. Sex is either unanticipated or it is not proper to go “prepared.” The data on the use of contraception as well as on the methods of contraception by frequency of intercourse were consistent with this line of interpretation. About forty-six percent of the women who had intercourse less than three times a month had used contraception at last intercourse compared to two-thirds of those who had intercourse six or more times a month. The choice of contraceptive methods also depended a great deal on the frequency of intercourse. Among the women who had not had intercourse in the month prior to interview, over half had used either the condom or withdrawal at their most recent experience, and only fourteen percent used the pill. In contrast, half the women with the highest frequencies of intercourse (six or more times a month) had used the pill at their last intercourse.

There is also considerable misconception about the risks of pregnancy. Seven out of ten sexually experienced women did not use contraception because they did not think they could become pregnant, because they had intercourse at a time of the month when they could not become pregnant, because they were too young to become pregnant, or because they had sex too infrequently to become pregnant. Some who believed they could not become pregnant because of the time of the month were correct in their judgment, but many were clearly misinformed about the risk of unprotected coitus.

One in ten of all fifteen- to nineteen-year-old women (married as well as unmarried) interviewed in 1971 had become pregnant before marriage. The overwhelming majority (about three-fourths) of the women indicated that the pregnancy was unintended. Yet, about nine out of ten of those who did not intend the pregnancy had not used contraception at the time of conception. A premarital pregnancy very often precipitates marriage, at least among whites. Over half the white young women who became pregnant premaritally married before the outcome of the pregnancy. The divorce rate among such marriages is reported to be much greater than among other marriages of young people (Schofield).

A comparison of the contraceptive use of sexually experienced, never-married women interviewed in 1971, with those interviewed in 1976 shows a dramatic increase in the proportion using contraception both consistently and at last intercourse. The increased use was seen for adolescent women of all ages and among both blacks and whites. In 1976, the younger respondents, those aged seventeen and under were more likely to have used contraception at last intercourse than were those over seventeen in 1971. Moderating this picture of improved contraceptive practice is the fact that there was also an increase in the proportion who never used contraception.

Along with the increased use of contraception there was a change in the methods of contraception. The pill was the most commonly used method by both blacks and whites and for all groups. About half the sexually experienced women in the 1976 survey named the pill as the method most recently used compared to less than a fourth in 1971. The condom, withdrawal, and douche, popular in 1971, were not as much in demand in 1976.

The increased permissiveness in sexual behavior has been paralleled by the increased effort at avoiding a premarital pregnancy, both by greater use of contraception and also by use of more effective methods. In 1976 the sporadic engaging in sex did not seem to be as great a deterrent to the use of contraception as it did in 1971. The greater use of oral contraception also suggests an increased willingness by adolescent women to be “prepared” for the occasion. Another factor in the greater use of birth-control pills may be that they are more readily available to young unmarried women now than they were in 1971.

Although the use of contraception has increased considerably, about half the sexually experienced adolescent women interviewed in 1976 had not used contraception at their first intercourse, and the gap between age at first intercourse and age at first contraception was wider in 1976 than it was in 1971. However, those who do not use contraception the first time but do so subsequently, tend to use more sophisticated methods like the pill and the IUD. In 1976, of the women who had not used contraception at their first intercourse but did so subsequently, six out of ten used the pill or IUD as their first method, and only three out of ten used the condom or withdrawal. In contrast, six out of ten women who used contraception at their first intercourse used the condom or withdrawal. This difference in the quality of contraception between those who delayed first use and those who did not was not a matter of age at the time contraception was first used or of experience with pregnancy, although pregnancy was frequently an incentive to more effective contraception.

Although the increasing use of the pill and the IUD among adolescent women should help prevent undesired pregnancy, the desirability of early and continued use of these contraceptives is questionable because of known and suspected risks of serious side effects. A question may also be raised about the increased prevalence of venereal diseases among adolescents which seems to coincide with the decline in use of the condom. The detrimental effects of the present contraceptive practices of adolescents, combined with the likelihood that the prevalence of sexual intercourse will continue to increase, suggest a need for the development of contraceptives suitable for young adolescents.

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Erotic awakening is of two kinds, autoerotic and sociosexual or interpersonal erotic. Since Freud and Kinsey, if not before, we have been aware that autoeroticism—erotic gratification obtained from the self without the participation of another person—can be present from the first year of life. Interpersonal awakening comes at different ages for different persons depending on biological-response capacity and maturation, temperamental tendencies (cuddler or noncuddler, for instance), and experience.

Erotic awakening is a vague and mystical concept. What it means is that someone who previously lacked the capacity for erotic experience now possesses that capacity. One has “new life” so to speak; something is there that was not there before. Puberty is sometimes looked upon as establishing the biological-response base for the first erotic event. But we know that the capacity for at least the rudiments of erotic awakening is present from birth or shortly thereafter. Erotic awakening comes when that which is “dormant” or “asleep” is aroused to action. The experience may be feeding at the breast of the mother, being handled or caressed at a tender age, a first kiss, or later “falling in love,” first coitus, or first coitus with orgasm. Some parents consciously or unconsciously treat their offspring as though the erotic capacity were present from birth, as indeed it is. Such parents act as though what they do to and with the infant or child will affect the time at which they experience their erotic awakening and that after awakening they will in fact be different. This belief no doubt explains much of the style of infant and child care that mothers give their offspring, starting with the decision to suckle or not to suckle the infant.

Besides direct erotic encounters with peers, there are many events which stimulate the growth of sexual curiosity and aid in sexual awakening of the infant or child. Among these events are the presence of a puppy in the home, seeing a litter of kittens for the first time, seeing members of the family in the nude, noticing the differences in men’s and women’s bodily characteristics, seeing the changes that occur in a pregnant woman, the presence of a new baby, or a chance bit of information concerning the coming of babies or other sexual events.

Despite such apparent sexual precocity, children aged three to four have some difficulty learning that there are genital differences between the sexes. They do not appear to form clear concepts of genital differences until ages five to seven. From a sample of children mostly from a lower socioeconomic level, whose parents indicated that many of them had not been told about basic anatomical differences, Conn, and Conn and Kanner, were able to elicit knowledge of genital differences from only fifty percent of children ages four to six years and from seventy-two percent of children ages seven to eight. Among children of parents with more formal education, Butler found a similar degree of ignorance among children of four to five years of age. Although fifteen of seventeen children had been informed by their parents of anatomical differences, Butler was able to elicit awareness of genital differences from only five of the fifteen children. Ketcher found in a study of 226 three- to nine-year-olds that children most easily make sex differentiations based on the clothing worn by each sex, followed by differentiation based on hair styles, and lastly by observing differences in genitalia and breasts. Age seemed to be the most important factor in ability to differentiate between the sexes, and younger girls were better than younger boys in this regard. Children report that before their first witnessing they had assumed that the genitals of all people were alike.

The young child who has been told which male and female attributes are used in producing a baby still remains perplexed as to how the elements come together. Even children who have observed parental coitus do not find this sufficient to create an articulated sexual image of the mother or father, whatever else it might do.

By age five, children are easily aware of most of the non-coital content of the marital relationship—cooking, cleaning house, caring for children, going to work. They practice many of the marriage and family roles through “playing house.” They also have a good idea of the field of future eligible mates, opposite-sex peers of the same generation but not of the same family. Broderick found that the majority of five-year-olds he studied were already committed to their own eventual marriages. This majority increases through each age group throughout childhood.

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When a child is born, the program of sexual development and differentiation, previously controlled by genetic, hormonal, and constitutional events, passes to the behavior environment. There, social and cultural influences govern the continuing development and differentiation of psychosexual functioning. The principle of sexual bipotentiality, which pertains to reproductive anatomy and to the neurosexual centers located in the hypothalamus, applies also to psychosexual and sociosexual behavior. The social program of rearing resolves behavioral bipotentiality as masculine or feminine in early life.

In the first two years of life, behavioral components of adult sexual behavior begin to emerge, and the sociosexual and psychosexual components of adult eroticism are initiated. Childhood constitutes a period of preparation and rehearsal of the part-responses that are eventually chained together into adult sexual pair-bonding. It is characteristic of mammals for behavior segments to appear and to be rehearsed and practiced prior to their functional integration into the life cycle. Sexual behavior is no exception to this rule, judging from observations of animals, from accounts of primitive societies in which childhood sex play and sex rehearsals are permitted, and from the retrospective accounts of human adults.

There are three phases of psychosexual development in the neonatal and infancy period. The first, common to both sexes, is related to pair-bonding of the infant and the parent; it begins in the delivery room with parental participation in childbirth. The second comprises genital activity rehearsals, also present at or even before birth, and clearly observed in the genitopelvic responses of the male neonate. The third is a masculine and feminine differentiation phase which begins in the delivery room with the announcement of the infant’s sex.

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What does it do?

The reason we should be jumping up and down about PID is that infection in the pelvis can permanently damage the tissues which are inflamed. For example, fallopian tubes may be kinked and blocked by infection and subsequent scarring in the pelvis. Abscesses may form in the tubes or elsewhere.

The chances of having permanent damage to the pelvic organs varies. More severe infections may damage the tubes more man milder infections. Not every woman who has PID ends up with blocked tubes. However, the incidence of damage increases with subsequent infections. This means that with the first episode, your risk of tubal damage is about 10 per cent. For the second episode it is about 30 per cent, and if you have three episodes of PID your chance of having tubal damage is about 75 per cent. The fact that you have damaged tubes is likely only to be found if you are being investigated for chronic pelvic pain or infertility. Tubal damage from PID is a major cause of infertility in our society.

The other risk you face with damaged tubes is that you have a greater chance of having an ectopic pregnance. This can be a life-threatening event, and the routine treatment usually involves further damage to the affected fallopian tube.

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You have a range of options for your antenatal care and delivery, including public or private hospital, birth centre, home birth, midwife, GP or specialist care. Availability and health insurance may limit your options. Despite the apparent differences, the fundamentals of antenatal care are similar, wherever they are offered.

The first antenatal appointment will usually be arranged for when you are seven to twelve weeks pregnant and this visit is usually the longest. You will be asked details of your past history and your family history, as there are some conditions which may affect, or be affected by pregnancy. It is important to know about diseases and genetically inherited conditions which run in your family or your partner’s family. You will be examined by a doctor, who will listen to your heart and lungs, and will usually take a pap smear and perform a pelvic examination. You will also be weighed, give a urine sample, and have some blood tests performed. These include a blood count (checking specifically for anaemia and iron deficiency), and screening tests for hepatitis, syphilis, rubella (German measles) immunity, and your blood group. These tests ate usually done on everyone because certain conditions can cause harm to the baby, and if they are identified, the appropriate management can be started. It is preferable to check for rubella immunity before getting pregnant, and if necessary be vaccinated at least three months before getting pregnant. If you are found not to be immune when you are actually pregnant you can be vaccinated when this pregnancy is over, so you will be immune in the future.

Knowing your blood group is important in pregnancy (but rarely at other times) because there is a condition called Rh immunisation which can affect some pregnancies (see further this chapter).

Appointments for a further visit and any specific tests required will usually be organised. The tests generally include an ultrasound at about eighteen to twenty weeks gestation. The reason behind the timing of this scan, which is usually the only one most women will have during a pregnancy, is that it is the best time to see the development and anatomy of the foetus. If there is a physical abnormality it is highly likely to be visible on this scan. Earlier scans do not give anatomical detail so well. If there is a major abnormality or problem it is better to know about it at eighteen to twenty weeks, rather than later, in case some action is needed. Assessing the gestation of the pregnancy at this stage is accurate to within seven days or so, and will show twins, triplets, etc.

Some practitioners also do a routine test for a bug called group B strep (streptococcus). A cotton-bud swab test is used to find out if this bug is present in the woman’s vagina at twenty-eight weeks gestation. It is a bug which often lives there and does no harm. In pregnancy, however, there is a small chance that during delivery the baby will come in contact with it, and a small number of babies may develop an infection. To prevent this happening, women found to have this bug at twenty-eight weeks can be offered an antibiotic during labour, and the baby can be given a dose of antibiotic when born. This substantially decreases the risk of infection to the baby.

When all of these things have been arranged, you will be given another appointment for about four to six weeks time. Visits for antenatal care are typically spaced about a month apart until twenty-eight weeks, then every two weeks until thirty-six weeks. After that, weekly visits would be recommended.

Your blood pressure will be checked at each visit Raised blood pressure developing in pregnancy may be associated with pre-eclampsia, or it could simply be pregnancy-induced hypertension (high blood pressure), both of which need watching, and sometimes treatment.

You will also be weighed and have your abdomen examined to measure the growth of the foetus. When the foetus is over twenty-eight or so weeks, the doctor or midwife will listen to it’s heartbeat, using a special little trumpet-like stethoscope or mini ultrasound machine.

Any abnormalities found in the course of the visits can be investigated, and any incidental problems dealt with. These visits are also when you can ask any questions you might have during your pregnancy, and when you can find out what to expect.

If problems arise during the pregnancy and you need extra medical care, you can contact your own doctor or, if you are attending a public hospital, you will have the facilities of the hospital’s emergency department available twenty-four hours a day. If you need admission to hospital before the baby is due, this can be arranged.

When the time comes to go to hospital to have your baby, you will be cared for by midwives (specially trained obstetric nurses) and your own doctor or a hospital doctor, depending on what type of obstetric care you have chosen. If your baby needs specialist care, a paediatrician can be involved.

A postnatal visit at six weeks after delivery is usually arranged, to check on the health of the mother and baby.

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People can have sexual contact and not exchange these fluids. Not all sexual contact necessarily involves intercourse. However, genital contact being what it is, and the tendency for sexual stimulation to lead to a situation likely to transmit fluid (like intercourse or ejaculation), a safer way of having sexual contact is while using a condom. When used properly, the condom can reduce (but not totally eliminate) the risk of transmission of diseases which are spread sexually (to say nothing of the added bonus of stopping sperm!).

Condoms need to be used properly in order to be maximally effective. That means putting the condom on at the beginning of foreplay, because the secretions which come out of the penis before ejaculation (orgasm or ‘coming’) can still be infective. Putting on the condom does not need to be an interruption to foreplay; in the right hands, so to speak, it can be quite fun.

The condom is a neat little thing, a thin, strong latex sheath all rolled up ready to be put onto an erect (hard) penis. In the tip of the condom is a little nipple-like pouch, which is there to catch the semen when a man ejaculates. It is important to squeeze the air our of this pouch before the condom is rolled onto the penis, or the air trapped inside can heat up, expand, and the condom can burst, and that is no fun at all.

The condom is put on the tip of the penis, and carefully rolled all the way down to the base, so the entire penis is covered. It is important to avoid tearing the condom with your fingernails as it is rolled onto the penis.

Although condoms are usually already lubricated, additional lubricant (water-based, like K-Y Jelly, not oil-based like Vaseline or baby oil) is a very good idea. It helps to prevent friction, which can weaken the condom (particularly during anal intercourse). It makes it more comfortable for both participants, as well as safer. Some people use a spermicidal jelly as a lubricant, and as extra protection against becoming pregnant. (Oil-based lubricants weaken the latex, and are more likely to make the condom ineffective.)

When a man has an orgasm and ejaculates, the penis, which has been hard and erect, becomes floppy again fairly quickly. If the condom is not removed promptly and carefully, there is a chance there will be some spillage of semen, and that is not desirable. So the penis should be removed from wherever it has been, while the condom is held on so that nothing spills, and the condom does not slip off. The condom should be removed from the penis, any fluid wiped off the penis, and the condom disposed of in the bin (not down the toilet—it is not very good for the plumbing or the environment). A new condom must be used each time you have sexual contact, as they are definitely single-use items.

If you find condoms break, even with lubricants, buying a thicker condom may be a good idea. There are several different types on the market.

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Vasectomy. The permanent sterilisation of a man is a technically easier procedure. The vas deferens are the tubes that carry sperm from the testes (balls) to the seminal vesicles, where sperm are stored. These tubes are relatively accessible, as they are in the scrotum (the skin sac that the testes are in). Cutting and tying the vas deferens can be done under a local anaesthetic, and is pretty hazard free. Sometimes bruising may be apparent, and, rarely, infection. Questions regarding the possibility of prostate cancer being linked in some way to vasectomy have been raised by some researchers. Further work is being done to establish whether or not there is a relationship, but it seems there is not. Future studies will hopefully sort this out.

Vasectomy has no effects on sexual performance. The man is still able to have sexual intercourse, to orgasm and ejaculate. The only difference is that there are no sperm in the ejaculate. It is important to make sure the ejaculate is free of sperm before relying on the operation for contraception. It is usual for a man to undergo one or two semen analysis tests to make sure the sperm are all out of the system, and until this has been done another form of contraception should be used. The semen analysis may be performed at two or three months, or after a certain number of ejaculations. Doctors may differ in their recommendations regarding when, and how many times, to test the ejaculate, but the process is the same.

Doctors tend to be more cautious about performing this operation on younger men for the same reasons outlined above in relation to younger women and sterilisation. The success rate of reversal of vasectomy is also variable, and it is not recommended that it be considered a reversible method.

In general it is a very safe, relatively cheap, and effective form of permanent contraception. Like tubal ligation, it is becoming more popular as people are looking for effective contraception with a very low side-effect profile. If permanency is desired, it is a pretty appealing option for many couples.

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Dysmenorrhoea is the word doctors use to say ‘painful periods’. It can be ‘primary’ (painful from within a year or so of the first ever period), or ‘secondary’ (initially not painful, then periods become painful years after the first period), and ends in ‘orrhoea’, which is an ending on many medical words, meaning ‘lots of’.

A significant number of women have period pain during their reproductive lives. About 10 per cent of women are incapacitated for one to three days each month. Days are lost from school, work, and other usual activities because of period pain. It is no wonder that so many people seek treatment.

Primary dysmenorrhoea is fairly common, although it may not become apparent until the ovaries are working properly, a year or so after the first period. It is usually not associated with any underlying problem, and in many cases gradually lessens with time. Very rarely there may be a physical cause, like a problem with the shape of the uterus, or the cervix not letting the blood out well enough.

If periods have been pain free for years and become painful much later it may indicate an underlying cause, like endometriosis or infection, so it is worth having this investigated. Often there will be associated pain at other tames too like mid-cycle and with intercourse. The pain is more likely to occur before the period, rather than starting with it, although this is not always the case.

Period pain may not feel the same to every person, even though the processes causing the pain may be the same. It will usually start dose to the rime bleeding starts, and may be felt in the lower abdomen, the back, the legs, and accompanied by nausea, dizziness, vomiting, headache and tiredness, all of which may be mild, moderate or severe.

Treating the problem begins with working out if it is primary or secondary. If it fits into the pattern of secondary dysmenorrhoea it should be investigated, and any underlying cause found should be treated. If there is no underlying cause, there are treatments available, with varying success achieved.

The most tried and true method is still the hot water bottle. Local heat does seem to help, but it can be a bit inconvenient if you need to be out and about.

It is, however, a cheap, simple, often helpful remedy, with no chemicals and no side effects (if you are careful not to bum yourself). Relaxation, yoga, and exercise have also been said to help, and arc worth trying.

The most simple medicinal treatments are either aspirin (trade names: Aspirin, Aspro, Buffet Disprin, Ecotrin, Solprin, Spreo, SRA, Winsprin), or paracetamol (trade names: Panado), Tylenol, Panamax, Paralgin) taken to the manufacturers’ recommendations. There are specific anti-uterus-pain medications on the market, such as mefanamk acid (Ponstan, Mcfic) and naproxen (Naprosyn, NaprogesicK and these are available over the counter (no prescription required) at pharmacies. These are related to the antinflammatory drugs used for arthritis, and like all anti-inflammatory drugs should be taken with food to avoid irritation to the lining of the stomach. They should be avoided by people with a history of stomach ulceration, and you should not take aspirin while taking these medicines; paracetamol would be preferable. These anti-uterus-pain tablets work by preventing the increase of a chemical, called prostaglandin. Prostaglandins have been found to be associated with painful periods. As anti-prostaglandins are a sort of ‘preventative’ medication, they work best if you use them just before, or at the very beginning of the period and continue using them for as long as needed.

Some people find that anti-spasm medicines, often used for spasm in other parts, like the bowel, are useful. One available on prescription is hyoscine-N-butylbromide (trade name: Buscopan).

The vast majority of women who have painful periods are able to cope with the methods outlined. Unfortunately some can’t, and in some cases the oral contraceptive pill is prescribed as a treatment for painful periods (and heavy periods), as one of the beneficial side-effects of the pill is that it tends to give lighter and less-painful periods. This is because it suppresses ovulation. Whether or not the pill is a suitable treatment for a particular person is a decision based on individual circumstances; it may not be ideal for everyone.

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