Dear Doc | Can breastfeeding be a form of birth control?

Q I had my baby six months ago. I am still breastfeeding and my periods have not come back as yet. I always heard while I was growing up, that once you're breastfeeding you can't get pregnant again, but some people are telling me that's not true. Can I really get pregnant if I'm breastfeeding?

A YES! You most certainly can get pregnant while you are still breastfeeding. This is usually something discussed with patients at their six-week clinic after having a baby.

The reason that myth arose, however, is it is true that you may not release an egg (ovulate) for several months (or even longer) after giving birth, especially if you are exclusively breastfeeding your baby.

The fact that breastfeeding delays the return of ovulation and menstruation, this formed the basis for a contraceptive method called the Lactational Amenorrhoea Method (LAM).

However, in order to use this method properly, certain criteria have to be met.

1. Your baby must be younger than six months old.

2. You have to breastfeed the baby at least every four hours during the day and every six hours at night.

3. Breastfeeding must be exclusive, meaning you cannot supplement breastfeeding with formula.

It is also interesting to note that pumping instead of nursing, also makes LAM less effective.

LAM can be up to 98 per cent effective during the first six months after delivery when you meet the above conditions exactly. But as the baby gets older, the rate of effectiveness decreases.

Keep in mind, however, that you can start ovulating again at any time without knowing it. You also ovulate before you see your menses. This means it is possible to become pregnant before even seeing your first period after having your baby.

So if you don't want to have another baby just yet, your best bet is to use a reliable form of birth control as soon as you become sexually active after giving birth. Do not wait until you have a period to start a reliable birth control method.

 

Do I have a bladder infection?

 

Q Dear Doc, I am very concerned about something I am noticing recently after starting a new relationship. We recently took things to the next level and we are now sexually active, but I think after the second time we had sex, he gave me something.

My belly bottom keeps cramping and I pee very often, and it also cramps a lot when I do. Added to that, the pee looks funny and smells very bad. At first, I thought it was a bladder infection and took something I had left over for one. But it happened when we had sex again! Now I'm sure it is something he gave me, and I'm very afraid to confront him about it. Please help me figure this out.

A You may have been correct the first time. It does seem that you are having bladder infections based on what you have said, and it is what we call a 'honeymoon cystitis'.

Honeymoon cystitis is a condition that not only affects women on their honeymoons, but occurs whenever vaginal intercourse leads to urinary tract infections (UTI), also called a bladder infection. It is typically caused when the thrusting of the man's penis irritates the wall of the bladder (through the front wall of the vagina). This results in the massaging of organisms into the bladder, which multiply and cause infection.

The ideal way to avoid sexually related UTIs is to urinate right before and after intercourse. Some women find that they can't urinate immediately after sex, likely because the muscles that control the release of urine won't relax. Postmenopausal women also have difficulty urinating after sex because of the changes that occur to the vagina and urethra, due to low oestrogen.

You may also ask your partner to be gentler during lovemaking. You can try changing positions, perhaps with you on top, and using a vaginal lubricant to keep the vagina moist, and make after-intercourse urination a regular part of your routine.

You can also take preventive steps, such as drinking enough fluids so you go to the bathroom every few hours.

If the problem continues, I recommend you see your gynaecologist for a complete examination. They may recommend taking a single antibiotic pill immediately after intercourse to help prevent sex-related cystitis.