The nurse practitioners at the Henry Wise Wellness Center are committed to providing quality health care for the women attending Bowie State University.

Li-Lin Chiu, CRNP-A, CRNP-OB/GYN, MSN

On this page:

Services

Services available on site at Henry Wise Wellness Center with nurse practitioners include:

  • Pap smear and annual pelvic exams (with pap smear education classes prior to examinations)
  • Breast exams
  • Pregnancy testing
  • Care and support for women with menstrual problems
  • Treatment of vaginitis
  • Treatment of urinary tract infection
  • Sexually transmitted infections screening and treatment
    • Chlamydia
    • Gonorrhea
    • Syphilis
    • Herpes culture, if lesions present and if clinically indicated
    • HIV testing

Referral to Community Resources for:

  • HIV testing
  • Contraceptive services
  • Emergency contraception
  • Obstetrical care
  • Specialized gynecologic procedures

Counseling Services

  • Support and information for negotiating safer sex and choosing abstinence
  • Assistance in choosing a contraceptive method
  • Pregnancy testing and options counseling and referrals
  • Pap smear education
  • General health concerns

First-Time Visits

A first-time appointment for an annual exam will be 45 minutes long. The first 15 minutes will include pap smear education followed by a medical history form, pertinent information, and brochures. When you arrive for a pelvic exam, the nurse practitioner will review your medical history form. Be sure to mention any specific symptoms you have and ask questions about any special concerns. If you are not sexually active, this is an opportunity for you to become well informed before having to make decisions. Information will be offered regarding all methods of contraception. If you are concerned about sexually transmitted diseases, you can ask the practitioner to discuss your concerns. She will take your blood pressure and examine the breasts and abdomen. The pelvic exam will follow.

Confidentiality

Any information regarding services and appointments is kept strictly confidential. This information is not available to family, friends, or administration without your written authorization.

STI Testing

The following sexually transmitted infections screening is available at Henry Wise Wellness Center:

  • Syphilis (blood sample)
  • Chlamydia (urethral for males or cervical swab for females)
  • HIV (blood sample collected by the Prince George’s County Health Department)
  • Gonorrhea (urethral or urine sample for males or cervical swab for females)
  • Genital warts (HPV) (Visual inspection and pap smear)
  • Herpes Simplex (if lesions present and patient symptomatic)

Condoms

A WORD OF CAUTION: Condoms are an imperfect prevention for herpes and genital warts. A large number of individuals will have lesions in the genital area in areas not protected by a condom from exposure. Oral sex without protection is another way of transmitting herpes.

Pap Smears

Guidelines 

A.   Initiation of Screening

  1. Start screening at age 21 years regardless of the age of first sexual intercourse.

B.   Frequency of Screening

  1. Age 21-29:  every 2 years.
  2. Age 30 and older: every 3 years, if the person has had 3 consecutive cervical cytology results that are negative.
  3. Exceptions that may require more frequent screening:
  • Women who are infected with HIV

              Recommendation:  twice in the first year after diagnosis; annually thereafter

  • Women who are immunosuppressed (ex: transplant patients)
  • Women who were exposed to diethylstilbestrol in utero
  • Women previously treated for CIN2 , CIN3, or cancer

             Recommendation: Annually for at least 20 years after treatment

 

Source: Clinical management guidelines for obstetrician-gynecologist: Cervical cytology screening. ACOG practice Bulletin, December 2009. No.109

If you have any questions or concerns, please do not hesitate to call our office at 301-860-4170.

Emergency Contraception

Emergency contraceptive pills are not available in the Wellness Center.

The pill can be purchased over the counter at the pharmacy without a prescription. This service is available through the Healthy Teen Center at 301-324-5141. Although recommended to be given within 72 hours, recent published literature indicates that EC (emergency contraception) is effective even up to five days post-incident. The sooner it is given, the better. The number 1-888-not-2-late is a toll-free number that gives ECP options and resources.

When is emergency contraception appropriate?
No contraceptive method is 100% effective, and few couples can use their method perfectly every time they have intercourse. Emergency contraception provides an important safety net when:
  • A condom breaks
  • No contraceptive is used
  • A woman misses two or more contraceptive pills in a row or starts a new pack two or more days late
  • A diaphragm or cervical cap slips out of place
  • A woman is more than two weeks late for a contraceptive injection
  • Intercourse occurs unexpectedly and without contraceptive protection
  • A woman is raped
Emergency Contraception is not a substitute for regular contraceptive use. It is less effective than regular contraception (used correctly) and provides no protection from HIV or sexually transmitted infections (STIs). However, in emergency situations, it can play an important role as a backup for other methods. It is second-chance contraception.
What is my risk of pregnancy from unprotected intercourse?
The risk of pregnancy is virtually zero during the first three days of the cycle (day 1 of the cycle is the first day of bleeding). The risk begins to rise steadily thereafter, reaching 9% on about day 13, begins to decline slowly thereafter to about 1% on day 25, and remains at about 1% as late as day 40 and beyond. (Average cycle length is 29 days, but it is normal to have cycles that last anywhere from 20 days or less to 40 days or more.) However, it is important to note that these figures are averages and that the risk for an individual woman may be higher or lower. The important point is that almost any act of unprotected intercourse entails some risk of pregnancy and that EC can reduce this risk substantially.
How long after unprotected sex can emergency contraceptive pills be taken?
The current treatment schedule is one dose within 72 hours after unprotected intercourse and a second dose 12 hours after the first dose. ECP should be taken as soon after unprotected intercourse as is practical.
As of October 15, 2003, the Maryland State Family Planning Clinical Guidelines have broadened their recommendations. "Published studies have demonstrated: (1) That the 72-hour limit for giving emergency contraception is too restrictive and that any of the accepted dosages of emergency contraception are effective up to 120 hours (5 days) after unprotected sexual intercourse and (2) that a single 1.5 mg dose of levonorgestrel is equally as effective as two 0.75 mg doses of levonorgestrel taken 12 hours apart."
How effective is emergency contraception?
On average, if 100 women have unprotected intercourse once during the second or third week of their cycle, eight will become pregnant. Following treatment with combined ECP, two will become pregnant (a 75% reduction in the risk of pregnancy). Following treatment with progestin-only ECP, one will become pregnant (a 85% reduction in the risk of pregnancy). Even when used perfectly, ECP is not as effective as other methods of ongoing contraception when it is used correctly.
What are the side effects of ECP?
Almost all women can safely use ECP. The only absolute contraindication to the use of ECP is confirmed pregnancy, simply because ECP will not work if a woman is pregnant. There are no long-term or serious side effects from using ECP. About 50% of women who take combined ECP experience nausea and 20% experience vomiting. If vomiting occurs within one hour after taking a dose, some clinicians recommend repeating that dose. The non-prescription, anti-nausea medicine meclizine reduces the risk of nausea by 27% and vomiting by 64% when two 25 mg tablets are taken one hour before combined ECP, but the risk of drowsiness is doubled (to about 30%). The risk of nausea and vomiting with progestin-only (no estrogen) PLAN B ECP is far lower than the risk with combined ECP. Other side effects of ECP include fatigue, headache, dizziness, and breast tenderness.
How do I take emergency contraception?
Swallow the first dose as soon as possible. ECP is more effective the sooner after unprotected sex they are taken. Take the second dose 12 hours later. As noted above, recent published guidelines indicate that the two doses of levonorgestrel (0.75mg) can be taken at the same time.
Do not swallow any extra ECP. More pills will probably not decrease the risk of pregnancy any further. More pills will increase the risk of nausea and vomiting.
If you have nausea, it is usually mild and should stop in a day or so. If you vomit within one hour after taking a dose, call your clinician. You may need to repeat a dose. You may need some anti-nausea medicine.
What is Plan B®?
Plan B® is the first progestin-only emergency contraceptive approved by the United States Food and Drug Administration (FDA). Although oral contraceptive pills containing progestin have been in use for routine contraception for many years, Plan B® contains the first progestin-only tablet specifically developed for post coital contraception. Plan B® is safe for most women and is highly effective. Each Plan B® packet includes a single course of treatment and consists of two tablets, each containing 0.75 mg levonorgestrel, a totally synthetic progestogen. Inactive ingredients include colloidal silicon dioxide, potato starch, gelatin, magnesium stearate, talc, cornstarch, and lactose monohydrate. The first tablet should be taken as soon as possible within 72 hours (3 days) of unprotected intercourse. The second tablet is taken 12 hours later. As noted above recent published studies indicate that the two doses can be taken at the same time and that it can be taken up to five days post-event.
How is Plan B® different from other emergency contraception regimens?
Most significantly, the new levonorgestrel-only regimen is better tolerated. In a large multi-center double blind clinical trial of 1,998 women, Plan B® reduced the average risk of pregnancy among users from about 8% to about 1%. After a single act of unprotected intercourse, correct use of Plan B® thus reduced the risk of pregnancy by 89%. Plan B® demonstrated a superior safety profile with respect to nausea and vomiting. The incidence of nausea in women taking Plan B® was reduced from 50.5% with ECPs containing estrogen to 23.1% with the Plan B, and the incidence of vomiting was reduced from 18.8% to 5.6%.
How does Plan B work?
Mechanism of Action: The exact mechanism of action of Plan B® is unknown. Levonorgestrel is believed to act as an emergency contraceptive principally by preventing ovulation or interfering with fertilization (by altering the tubal transport of sperm and/or ova). In addition, it may inhibit implantation by altering the endometrium. Plan B® is not effective once implantation has begun. Once pregnancy is established, Plan B® cannot interrupt the pregnancy or cause an abortion.
How safe is Plan B?
No serious complications have been associated with Plan B® treatment. Used as directed, Plan B® is safe for most women. A physical examination is not required prior to prescribing Plan B®.
What happens if they fail?
If emergency contraceptive pills fail, you may have counseling, education, and referral options, just as would any other woman diagnosed with an unintended pregnancy. There is no evidence that emergency contraceptive pills pose danger to a woman's fetus.

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