Introduction

Tufts University Health Service provides a full range of women's health services, including annual gynecologic examinations, testing for sexually transmitted infections, emergency contraception, HIV testing, consultation about contraceptive choices, prescribing of birth control pills, help with both planned and unplanned pregnancy, diaphragm fittings, IUD insertions, evaluation and treatment of vaginal infections, information about HPV immunization, and treatment for urinary tract infections, genital warts, and many other issues.

Routine care can be set up by making an appointment with one of our clinicians. Call the main number at Health Service and tell the receptionist that you want to schedule an appointment. Annual gynecologic examinations, contraceptive counseling and birth control prescribing, and routine STI testing are examples of concerns that are managed by appointment. Routine appointments are usually accommodated within one to three weeks. Urgent issues, for example vaginal infections, urinary infections, and emergency contraception or pregnancy concerns are accommodated on a same day basis in our Walk-In Clinic.

FAQs for Women's Health

I want to start birth control pills. What should I do?
If you are not taking birth control pills, and are interested in starting them, call the main number at Health Service (617-627-3350) and set up an appointment. At your appointment, the clinician will get a medical history from you, answer your questions and give you a prescription if desired. The visit is completely confidential! You do not need to have a pap smear before being started on birth control pills, but depending on your medical history, your clinician may recommend a pap smear or STI (Sexually Transmitted Infection) testing at your next visit.

Why do I have to come to Health Service to be prescribed birth control pills? Can't it be done on line or on the phone?
Birth control pills are prescription medications in the US. That means you need to meet in person with a clinician who can determine if pills are safe for you and what the best choice would be. Birth control pills are generally quite safe, but there are some women for whom they are dangerous and should not be prescribed. We need to have a face to face consultation before starting any prescription.

What if I'm not sure what kind of contraception I want?
Call Health Service and set up an appointment to talk with a clinician about various forms of birth control. Although birth control pills are the most commonly used form of contraception among our students, there are other good options: the Nuva Ring (which is gaining rapidly in popularity), the IUD, a diaphragm, and condoms.

I already have birth control pills prescribed by my doctor at home. How can I get them at school?
If your doctor practices in the US, he or she can call a prescription into any pharmacy in the country. Out of state doctors can prescribe in MA. Although we do not have a pharmacy at Health Service, we do work with a local pharmacy, Inman Pharmacy in Cambridge, that delivers prescriptions to Health Service and you can pick them up here. Here are some suggestions:

1. Your doctor can call or fax your prescription to Inman Pharmacy, and specify that the prescription should be delivered to Tufts. If you have never had a prescription filled at Inman Pharmacy, you will need to provide them with a copy of your insurance card and credit card (so they can charge you). For more details about the pharmacy program, see our pharmacy program page, or come to Health Service.
2. Your doctor can give you a paper copy of your prescription, and you can bring it to Health Service. We will fax it to Inman Pharmacy for you.
3. If you don't want to use Inman Pharmacy, you can take your prescriptions to any pharmacy of your choice. There is a CVS and a Rite Aid in nearby Davis Square.
4. See if your health insurance has a mail order pharmacy program. This is very convenient for students—a three month supply of the medication gets shipped directly to you. Go on-line with your insurance, or call the customer service number to investigate.
5. If you have an active prescription on file at a pharmacy near home, you can ask to have the prescription transferred to Inman Pharmacy. Call Inman Pharmacy and they can tell you what needs to be done.
6. If Health Service is going to be your primary care provider (your doctor is from another country, or you are switching insurance) and you need a refill, you will need to schedule an appointment at Health Service. We can start prescribing your birth control pills after getting a medical history and performing an evaluation.

How do I contact Inman Pharmacy?
Phone: 617-876-4868
Fax: 617-547-9521

Do I have to use the pharmacy that delivers prescriptions to Health Service?
No, you can use any pharmacy of your choice. The Inman Pharmacy program is offered for convenience. Many students also take prescriptions to other pharmacies (although those pharmacies do not offer the delivery service). There is both a CVS and a Rite Aid in nearby Davis Square.

Help! I'm about to run out of pills! What should I do?
If you are currently taking birth control and there are no more refills on your prescription, that usually means you need another appointment with your doctor! Here's what you should do:

1. Call the doctor's office who prescribed the pills!
   1. If we prescribed them, call us at Health Service. We can call in a prescription for a one month refill, to give you time to schedule the appointment you need—this may be a quick follow up appointment, or it may be your yearly GYN examination
   2. If your doctor at home prescribed them, call that doctor. They can call in a refill to Inman Pharmacy until you can make your follow up appointment with them.
2. If your doctor won't give you a refill, you can schedule an appointment at Health Service to have us prescribe your pills. If you run out of pills in the meantime and you need contraception, be sure to use a back up method such as condoms!
3. If you have an active prescription at your home pharmacy, you can have your prescription transferred to Inman Pharmacy. Call Inman to request a prescription transfer: 617-876-4868.

How do I get Emergency Contraception (EC)?
Emergency contraception can be used up to FIVE days after unprotected sex and significantly reduces the possibility of pregnancy. It is 75% to 95% protective, and is most effective if taken within 24 hours of unprotected sex. You can access EC either from Health Service when we are open, or from pharmacies where it is available behind the counter without a prescription for women 17 years and older.

• Getting EC at Health Service: Come to the office any time we are open. One of the nurses will talk to you and provide the medication. Like all our services, this is a confidential visit. It is a violation of federal privacy laws to release any of your private health information without your written consent. There is a small charge for EC that can be paid at the time of the visit, or the charge can be put on your tuition bill if you request.
• If you are not able to come to our office (for instance, you are off campus the whole day), you may call and speak to one of the nurses and after talking to you they can give it to our medication pick up area for a friend to pick up. As is the case whenever someone picks up any medication for you, you will need to give the friend your ID and a note authorizing them to pick up your medication. You will also need to arrange for payment.
• Getting EC at a pharmacy: In Massachusetts, EC is available without a prescription for anyone age 17 or over. You need to request it from the pharmacist at the pharmacy's prescription window. It is not on the open shelves. The cost is set by the pharmacy.

How much do you charge for EC?
There is a nominal charge for EC, that can change from year to year as the wholesale price changes. For the 2011-2012 year, the cost is $15.

What happens at an annual GYN examination?
An annual gynecologic examination should be performed yearly in all women starting in adolescence. The examination is a time to discuss each woman's general health, to discuss health risks, and to perform both a general and a breast examination. Testing is performed for sexually transmitted infections (STI) and other health screenings are done following national guidelines. Based on a woman's health history, her age, and other risk factors, a pap smear may or may not be performed at this visit. If a pap smear is not needed, the STI testing can be done on a urine sample.

How often should I have a Pap smear? When should I first have one?
The "Pap smear" is a test that scrapes some cells off the surface of the cervix (the opening of the uterus), and looks for signs of pre-cancerous changes. It is one of the best and most useful cancer screening tests. It is one of the tests done during an annual gynecologic examination, but it is not the only test. Until recently, a Pap smear was recommended yearly for all women from age 18 on. Recent research has indicated that pap smears do not need to be done so frequently, and new guidelines were developed in 2009. A first pap smear does not need to be done until a woman is 21 years of age, or older if she is not yet sexually active. Between ages 21-29 most women should have a pap smear every two years, and women 30 and over can sometimes go three years between pap smears. However, all women should continue to have a gynecologic examination every year to review other health issues, have a breast examination, get regular STI testing depending on age and risk history, and other routine health screening procedures according to national guidelines.

Does Health Service administer the HPV vaccine?
Yes, Health Service carries Gardasil, one of two vaccines currently licensed for use against Human Papilloma Virus (HPV). Gardasil is licensed for use in men and women ages 9 through 26, and we administer it to both men and women. It is most effective if given before becoming sexually active. It provides protection against 4 strains of HPV: two strains that most commonly cause cancer of the cervix, and two strains that most frequently cause genital warts. It is a three shot series, given over a 6 to 12 month period. The vaccine does not treat HPV; it can only help prevent it. There are dozens of strains of HPV, so those who are immunized need to be aware that they can still catch HPV—vaccination just decreases the likelihood. Even those who are vaccinated should follow standard recommendations to reduce their chance of all sexually transmitted infections: consistent use of barriers (condoms, oral dams), and limiting the number of partners. For information on cost, see "What does it cost" page.

For more information about contraception and women's health:
Visit the Planned Parenthood League of MA website.