• I forgot to take my pill today. Can I get pregnant?
• The condom broke - what should I do?
• Where do I get the Morning After Pill?
• At what part of my cycle can I get pregnant most easily?
• Can I get infected by anything through oral sex?
• How do I know if I have a Sexually Transmitted Infection?
• Help! I think I'm pregnant. What do I do?
• When can I get an abortion? What does it cost? Do my parents need to know?
• My boyfriend wants me to have sex. I don't know what to say.
• Is it O.K. to masturbate?

1. I forgot to take my pill today. Can I get pregnant?
If you only forgot to take one pill the chances of you getting pregnant are not very high. If you are really worried, you could consider using a back up method for the rest of your pack of pills. A back up method could be using condoms, spermicidal foam, contraceptive sponges or contraceptive gels. Here are some notes about what to do if you forget to take your pill(s):

1. If you forgot to take your pill at your regular time today, take it as soon as you remember.
2. If you forgot to take 1 pill for a whole day, take the pill you forgot with the pill you would normally take for that day: double up.
3. If you forgot 2 pills in a row, take 2 pills on the day you remember, then take 2 pills the next day. It's a good idea to use a back method for the rest of the pack of pills.
4. If you forget more than 2 pills, you should stop taking the rest of your pack of pills and use at least one of the barrier methods (condoms, foam, gels or sponges). When you stop taking your pills, you will have your period. Start you next pack of pills on the Sunday after your period starts. Continue using one or more of the barrier methods until you have completed one full pack of pills without missing any. You will probably start to menstruate.

2. The condom broke - what should I do?
If the condom you were using broke, you may be worried about two things: sexually transmitted infections (S.T.I.) or an unintended pregnancy. You can be tested for STI's at a clinic or at your doctor's office.

If you want to prevent an unintended pregnancy, you may choose to take Emergency Contraception or the "Morning After Pill". This has to be done within 72 hours of having sex. Emergency Contraception is available at many clinics, hospital emergency facilities and maybe your family doctor's office, although it may be a good idea to call ahead to see if they have any on hand before you go to see them.

3. Where do I get the Morning After Pill?
The Emergency Contraceptive Pill (ECP), also known as the “morning after pill”, is a hormonal, emergency method of birth control. ECP can help to prevent a pregnancy after unprotected sex, forced sex, or failed contraception (like a condom breaking). ECP reduces the risk of pregnancy when taken up to 5 days after unprotected sex, but is more effective the sooner that it is taken. “Plan B” is the government approved emergency contraceptive pill available in Canada.

ECP is available directly from a pharmacist without a doctor's prescription. You can even get it in advance. Most pharmacies should have “Plan B” in stock, but it is a good idea to call ahead to make sure. Before you are given ECP, you will need to have a consultation with the pharmacist. The pharmacist will ask questions about your monthly cycle and when you had unprotected sex. This information is confidential. You can also get ECP from your local sexual health clinic, doctor, or health care provider. You have the right to obtain and use ECP. It doesn’t matter how old you are, and you don’t need parental consent. For information about where ECP is available, contact Planned Parenthood Waterloo Region.

The cost of ECP can range from $25 to $50, depending on where you live and where you get ECP. ECP may be more expensive directly from a pharmacy (the average cost is around $40). It may be available at a lower cost from your doctor or local health care centre. Some insurance plans may cover ECP.

Out of 100 women who use ECP, 75 to 98 do not get pregnant. After you take it, you need to use another kind of birth control every time you have vaginal sex. The sooner you take it after the activity that put you at risk – especially in the first 72 hours - the more effective it will be. If you are able to take the birth control pill safely, you can take the Emergency Contraceptive Pill. When you receive “Plan B”, it will have two pills. Take the first pill right away. You will take the second pill 12 hours later.

You might get an upset stomach and you might throw up. Eating something and taking one Gravol tablet 30 minutes before you take the second pill may help you to feel less nauseous. You might also want to try taking the second pill with a glass of milk. If you throw up within an hour of taking a pill, you will have to take another dose. You might bleed a bit after taking ECP. This may not be your period. You might get your period before or after it usually comes.

If you are already pregnant, ECP will not work. ECP will not cause an abortion or miscarriage. ECP is not an abortion pill. Taking ECP while pregnant will not result in an abnormal pregnancy. If your period is two weeks late or if it is different, call your doctor or clinic. You may need a pregnancy test. ECP will not protect against sexually transmitted infections (STIs).

4.At what part of my cycle can I get pregnant most easily?
Each month your body releases an egg from one of the ovaries 14 days before you would expect to get your next period. Ovulation (when the egg is released) is the easiest time of a cycle to get pregnant. At that time of your cycle, your cervix makes a type of mucous that is very clear and stretchy ( it looks like the clear part of a raw egg). That type of mucous makes it easier for sperm to swim inside your vagina, through the cervix and finally reach the fallopian tubes. That is not the only time a woman could get pregnant though.

Sperm can live in a woman's vagina for between 2 to 7 days. If a couple had sex a few days before or a day after ovulation, the sperm could still fertilize the egg. After ovulation, the ovum (the egg) only lives for about 24 hours. Once the egg breaks down and is absorbed by the body, the chance of getting pregnant is gone. The difficulty is knowing exactly when a woman has ovulated. There is no perfect way to know. If you learn about and understand what happens to your body when you ovulate, it may be easier to estimate about when the egg has been released and could be fertilized.

There is a way to narrow down when you will likely ovulate that is called the Symptothermal Method (or Natural Family Planning). By taking your body temperature before you get out of bed in the morning, noticing the changes in your cervical mucous and keeping track of when you ovulated in your last cycle, you can see that your body will have its own pattern. The problem is that many women have cycles that change every month, which makes this a tricky way to avoid getting pregnant. If you only watch one of the indicators (e.g., body temperature), your guess at when you expect to ovulate will be less accurate. It is important to be aware of all the signs that your body is giving you.

5. Can I get infected by anything through oral sex?
The short answer to that question is yes. Some of the sexually transmitted infections (S.T.I.) you could get through oral sex are:

• Herpes
• Gonorrhea
• Chlamydia
• Syphilis
• Human Papilloma Virus (Genital Warts)
• Hepatitis B
• H.I.V.

Bacterial infections such as Gonorrhea, Chlamydia and Syphilis may be treated with antibiotics. It is important that both the infected person and their partner take the medicine to clear up the infection or they may just pass the infection to back and forth to each other. For women, untreated Gonorrhea or Chlamydia in the vagina may lead to Pelvic Inflammatory Disease (P.I.D.) which can lead to infertility. For men, untreated Gonorrhea or Chlamydia may lead to fertility difficulties due to scaring of the vas deferens. If Syphilis is never treated, it could lead to death.

Viral infections like Herpes, Genital Warts, Hepatitis B and H.I.V. are not curable. Once you have been infected, the virus remains in your body for a life time. There may be times when there are no symptoms of the infection, but it is still there and can be passed on to a partner. If you have a viral infection, the infections may be more active if you are stressed out or are already not feeling well physically. The following chart will let you know how what kind of test the doctor will need to perform to know if you have a Sexually Transmitted Infection.

6. How do I know if I have a Sexually Transmitted Infection?
If you have any pain in your lower abdomen, burning or pain during urination or sex, bleeding between periods or an abnormal discharge, you may want to have S.T.I testing done. An abnormal discharge will look, smell and feel different from the body fluid you would normally produce. It may look greenish or yellowish or may smell bad. An open sore, bump or rash that you have never seen before may also be a sign of an infection. If you are feeling particularly itchy in the genital region, there in a possibility of an infestation like Crabs or Scabies or another infection like genital warts. Symptoms of Syphilis or Hepatitis B make you feel like you have the flu. You may have a headache, a fever, a sore throat and feel generally tired. It is also important to know that you may have a sexually transmitted infection and have no symptoms. If you are concerned, S.T.I. testing may be done at a clinic or at a doctor's office.

7. Help! I think I'm pregnant. What do I do?
The first thing you could do if you thought you were pregnant is to find out for sure. When a woman becomes pregnant, her body starts making a hormone called HCG. Pregnancy tests are looking to see if a woman's body is producing HCG. It is usually suggested that you wait until you are at least one week late in starting to menstruate before taking a urine pregnancy test. If the test is taken sooner, the amount of HCG may be too low and the test will give you a false negative (show that you are not pregnant when you truly are). Pregnancy tests at drugstores are urine tests and may be accurate if you follow the directions. A problem with the home pregnancy tests is that the test may give you a false negative between 25 to 38 percent of the time or a false positive (show that you are pregnant when you are not) about 16 percent of the time. By going to your family doctor or a clinic, a pregnancy test can be done by testing a blood sample, which is more accurate than the urine tests. A laboratory test is about 99% accurate. If you choose a home pregnancy test, it may cost about $15 - $20. A pregnancy teat at Planned Parenthood Waterloo may be done for free ( although we appreciate donations). Blood tests may be free at some clinics or may cost you a few dollars (likely less than $10).

If you are pregnant, you may need to consider your options: parenting, adoption or abortion. Many sexual health centres, like Planned Parenthood, offer a service called Options Counselling. Option Counselling gives women facing an unintended pregnancy a chance to talk about all pregnancy choices in unbiased setting. This is you opportunity to find out all of the facts about parenting, adoption and abortion so that you can make an informed choice for you at this point in your life.

8. When can I get an abortion? What does it cost? Do my parents need to know?
An abortion is a relatively minor surgical procedure to end a pregnancy. The decision to have an abortion can be a difficult one to make for some women. Every woman with an unintended pregnancy deserves the opportunity to fully explore all her options and her feelings about her situation. She also deserves excellent medical care and emotional support, whatever choice she makes.

Abortions are usually done after the 7th or 8th week after conception in hospitals or in free-standing clinics. If the abortion is done in a hospital, the woman may need at two appointments before the abortion. She may need to meet with the doctor the day before the procedure if an ultrasound is required and or to possibly have a laminaria tent placed in the opening of the cervix. The laminaria tent will slowly expand to open the hole in the cervix. When the abortion is performed, the woman may be under general anaesthetic. She will not be awake or able to feel what is happening to her body. If the abortion is performed under general anaesthetic, she will need consent of a parent of guardian if she is under the age of sixteen.

At a free-standing clinic local anaesthetic is used, therefore no consent from a parent or guardian is needed - regardless of age. The woman will be awake but with the use of mild pain killers, will usually experience discomfort similar to menstrual cramps during and after the procedure. If a woman chooses to have an abortion at a free-standing clinic, she need only miss one day from school or work. On the day that the abortion will take place, the ultrasound, expanding of the opening in the cervix and abortion will all take place in one day. Most women recover quickly after an abortion and are able to return to school or work the next day.

A woman can get pregnant again within 3 weeks of having an abortion.

The cost of having an abortion is covered I you have an Ontario Health Insurance Plan card (OHIP or Health Card).

9. My boyfriend wants me to have sex. I don't know what to say.
If you are not ready for sex that is O.K. You may want to discuss with your boyfriend how you are feeling. People want to have sex for many reasons. You might want to find out why your boyfriend wants the two of you to be intimate. Is he getting pressure from his friends? Is he curious? Is he looking to make the relationship a more intimate committed one? Maybe once you talked to him about it, the two of you can discuss whether having sex right now is a good idea. Perhaps you could talk about what you both feel comfortable with. Maybe it's holding hands, kissing, touching above the waist, touching below the waist, oral sex or whatever you both can agree on.

If your boyfriend does not respect your feelings and choices, you may want to re-think being in a relationship with him. If you don't feel you are being respected, listened to or valued, it may not be a healthy relationship to be in. This is your choice about your body. Be assertive and stand by whatever decision you make for yourself.

10. Is it O.K. to masturbate?
Masturbation is a personal choice. Some people are comfortable touching themselves and some are not. Both are O.K.

Some people say that masturbation causes physical harm (e.g., hairy palms) or makes you go crazy. Neither are true. If you enjoy masturbating, that doesn't mean you are a pervert. As babies and young children, many people touched or rubbed their genitals for self-pleasuring and exploring their own bodies. As children grow, they usually begin to understand that masturbation should be a private activity. Parents and other adults may feel uncomfortable with genital touching or may be afraid that it may happen in a public place. Instead of talking with children about times and places that are better for touching their own body, adults may discourage self-pleasuring all together.

Masturbation may actually add to a person's healthy sexuality. By becoming comfortable exploring your own body you will notice sooner if there is a change in your body (e.g., a bump that wasn't there before). Masturbation may also teach you how and where you like to be touched. Once you know your own body, it is much easier to explain to a partner what makes you feel good. Some people choose to masturbate because they want to enjoy sexual feelings but do not want to take the chance of having an unplanned pregnancy or getting a sexually transmitted infection.

If masturbation is something you enjoy and it is not violating others comfort (e.g., masturbating in public), then it is O.K. If you are not comfortable touching your own body, that's O.K. too.