Talking sex with your doctor isn’t always easy. Whether you are afraid she or he will judge you,  you just don’t feel comfortable sharing the intimate details of your life between the sheets, or you can’t think straight with a speculum between your legs, many people get tight lipped in the doctor’s office. But that doesn’t mean you don’t have questions.

We thought we’d help and every Thursday our friend Dr. Lissa Rankin will be answering your questions. The ones you couldn’t ask your doctor in person and didn’t really trust the Yahoo community to answer for you. Just leave your questions in the comments, or send em over to us. (We’ll keep it all anonymous for you.) Dr. Lissa will answer anything – really, anything – about sex and other lady things. Don’t be shy; she’s waiting for ya!

Q: I’ve been on the pill (normal combination pill) for 3 years. I am very happy with it. I never miss a pill, but I take it at very different times during the morning. Does this decrease the effectiveness?

A: It’s always better if you can take your pill as close to the same time as possible, but if you normally take it at 8am and the next day, it’s not until 11am, that shouldn’t make much difference. The one exception is very low dose pills like Yaz and Mircette (pills with 20 micrograms of estrogen). In this case, it’s more important to try to remember to take your pill at the same time.

Q: I was also wondering, is it possible to use the pill with the Mirena IUD? Would you recommend it?

I hear you, sister. I’m assuming you DO NOT want to get pregnant! While I appreciate the sentiment, I would not recommend using a Mirena IUD with a birth control pill. Both contain hormones that act differently. And since both the Mirena IUD and oral contraceptives are highly effective, I don’t see the reason to assume the risks of both. If you’re particularly worried about pregnancy and want to use double protection, consider condoms plus the Pill or condoms plus an IUD. But adding two hormonal methods together can really mess up your system.  

Q: And finally, when I’m having sex with my boyfriend we sometimes start without condoms and then later he’ll pull out and put a condom on and continue. How effective is this in preventing pregnancy when used in combination with the pill? We’re in a monogamous relationship & have been tested, so I’m not worrying about STDs.

A: If you’re religious about taking the pill, and you’re using the withdrawal method and you’re sort of using condoms, chances are good that you will be protected from pregnancy. But mostly, that’s because of the Pill, which in and of itself is highly effective. In general, withdrawing before ejaculation is not an effective method of birth control because sperm are present in the pre-ejaculate released before orgasm.  So if you want to do everything possible to protect yourself, put the condom on before you start fooling around and leave it on until you’re done and can safely remove it.

It’s all about assessing your own personal risk tolerance. No birth control is 100%, which means that sex can always result in pregnancy. That said, it sounds like you’re being very conscientious to try to avoid an unwanted pregnancy, and I commend you for that.

Is your partner opposed to wearing a condom during sex? My gut tells me that maybe you would be feel a bit more comfortable if he did. If so, maybe it’s worth having a chat with him about this. Remember, it’s your body, and if anybody gets pregnant, it will be you. Listen to your heart, and honor your body.

Get to know more about Dr. Lissa on her website, www.owningpink.com

I have been addicted to Diet Coke for years. I used to start off with a jumbo fountain D.C. on my way to class at 10 AM, followed by another one at lunch and yet another (mixed with rum) for an evening snack. There was nothing on this planet that could come between me and my beloved Diet Coke. In fact, I wasn’t sure there was any way I could love it any more.

But, dear readers, there is: it seems that not only is Diet Coke the tastiest, most delectable treat on this planet….

It is also an effective spermicide!

Oh yeah! You heard me. That stuff you have been drinking by the gallon also happens to be strong enough to kill those little impregnators. Could there be a more perfect beverage? I think not.

Sure, this fact may worry some people (“blah blah how can I put something in my body that is strong enough to kill sperm blah blah blah?), but I couldn’t be happier! Just think of the possibilities:

No need for condoms or birth control when you have a 20 ouncer in the fridge! (Note: not quite sure how one would go about using that 20 ouncer as a contraceptive….) Or better yet, Coca Cola condoms! They taste like Diet Coke (which will make me much more happy to get near ‘em) and have the same effectiveness at preventing pregnancy as a can of D.C.!

This changes everything.

Up = no babies.

Downs = weight gain, extreme emotions and severe migraine headaches.

For a while, the ups far outweighed the downs, but it soon got to a point where the headaches became debilitating (thus making me unable to have sex anyway), and I had to call it quits with the little pill. I tried other forms of birth control – the Nuva Ring, which was just too weird, and abstinence, which was just not realistic – and none of it worked.

I figured I was doomed to be sans BC forever, until my doctor told me about the IUD.

What is an IUD?

Basically, it’s a small object that is inserted through the cervix and placed in the uterus to prevent pregnancy. The doctor inserts the IUD onto your cervix where it stays for up to 10 years. If you want to get pregnant, you simply head back to the doctor and have it removed and your period and ovulation schedule return to normal. The IUD is 99.9% effective at preventing pregnancy and you never have to remember to take a pill again!

It sounded too good to be true, but my doctor assured me that it was safe, covered by insurance and the best option for someone like me. So I did it.

The strange thing about the IUD is that it has to be inserted when you are on your cycle. So, not only do you feel kinda gross and bloated, but you have to hop into the stirrups and lay spread eagle in front of the doc. Not your finest hour.

I got a little squeamish when I went into the room and saw the equivalent to a wee wee pad lying on the table. “It gets a little messy,” the nurse told me. Barf. I laid on the table, gripping my sweatshirt nervously, and the doctor went to work.

The procedure took all of 5 minutes, but they were probably the longest and strangest five minutes of my life. There was a speculum, some very long Q-Tips and the IUD itself. I felt extreme cramps (the kind that usually require a heating pad, my couch and Season 1 of Friends on DVD), and extreme embarrassment as I wondered how messy things were getting down there. And before I knew it, the whole thing was over.

No more pills, no babies, and, in about a year, no more periods at all!

The idea of having a strange plastic thing inside my body is a little weird, but it is far outweighed by the fact that I can enjoy my sexual freedom without the monthly fear that I may be a mom sooner rather than later.

If the pill works for you, then stick with it. But if you are like me and can’t handle the hormones in the birth control pill, an IUD is definitely worth looking into. And don’t worry; when the whole thing was done, my wee wee pad was perfectly clean.