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What
is Contraception?
Contraception, also known as birth control, is the prevention of pregnancy conception by natural or artificial methods. The ideal contraceptive would be 100% safe, 100% effective, convenient and doesn't interfere with the act of sex or hamper future efforts to reproduce. So far, no method yet developed meets all of these conditions. There are, however, an increasing number of ways to practice contraception, some natural, some artificial or mechanical, some temporary and some permanent. Some contraceptive methods also reduce the spread of sexually transmitted disease, while others pose some known and unknown risks to users, mainly women. The greater the choices, the greater the chance a couple will find a contraceptive choice they are comfortable with to use regularly. You can get pregnant:
Non-penetrative sex involves couples being sexual without inserting the penis into the vagina. In terms of HIV/AIDS, STD's and contraception, it is sex which does not involve any exchange of body fluids between partners. Non-penetrative activities include:
Advantages: Non-penetrative sex is free and easy to do. It can enhance a relationship and communication between couples. It is the safest way to have sex-there is no risk of pregnancy or STD's. Disadvantages: Communication plays an important part in non-penetrative sex and people who have difficulty talking about sex may not find this method of contraceptive desirable. Natural methods of contraception are based on the woman understanding her body well enough to avoid intercourse at her most fertile times during the month. The temperature, rhythm and ovulation (or Billing's) methods are the most common methods, however, none are very effective and they require more motivation and discipline than other forms of contraception. The temperature method relies on a woman taking her oral, rectal, or vaginal temperature each morning before getting up and before eating or drinking anything. Around the time of ovulation the temperature rises by about 0.3 degrees Celsius or .05 degrees Fahrenheit and remains there for about 14 days of the cycle. There is no warning of ovulation with this method, so it is often difficult to be sure of the fertile time. Intercourse must be avoided until the temperature has been elevated for 3 days. The ovulation or Billing's method is based on the variation of vaginal mucus during the menstrual cycle parallel with hormonal changes. As ovulation approaches in most women, the cervix produces a slippery, wet mucus much like the raw white of an egg. This lubricative mucus allows the sperm to move more freely and increases the sperm survival rate. On the last day, when the mucus is clear and stretchy, fertility is at its peak. In the Billing's guidelines, only half of the days in the cycle are not available for intercourse. Abstinence is required during menstruation and for 7 to 10 days mid cycle. The rhythm method is an out-dated method. It should not be used in isolation. The rhythm method can be combined with the temperature method and the ovulation or Billing's method. The rhythm method works on the fact that ovulation occurs on a single day, 10 to 16 days before mentruation and sperm can live for at least three days and possibly longer in fertile mucus. Even women with consistent menstrual cycles suffer from fluctuations in their cycle and so this method is quite risky. Where to go: Counseling by a doctor, a BEBASHI Prevention Specialist, or at a Family Planning Clinic is recommended as all of these methods require a high level of motivation, commitment and good communication between partners. Side effects: There are no chemical side effects to natural contraception methods. Advantages: The advantage of natural methods is a better understanding of how a woman's body works. Natural methods cost nothing and are accessible. Disadvantages: Restrictions on or abstinence from intercourse may cause stress or anxiety in a relationship, although other activities, such as non-penetrative sex, are an alternative. Natural methods offer no protection from STD's. There is also an increased risk of pregnancy. One of the most commonly practiced methods of contraception is withdrawal or coitus interruptus. This is when a man takes his penis out of the vagina before he ejaculates. The success of the withdrawal depends on a couple of factors:
Side effects: There are no chemical side effects with the withdrawal method. Advantages: Withdrawal is an instant contraceptive, costing nothing. No medical advice is necessary to practice it. Disadvantages: The withdrawal method is unreliable, messy and risks pregnancy. It reduces the sexual experience for both partners. It also provides no protection from STD's. A condom is a fine rubber sheath, made from latex and worn on an erect penis. It prevents semen from entering another person's body and is used for contraception as well as for the prevention of STD's and HIV. Putting on a condom can be fun and can play a part in foreplay. Before using condoms, check the use-by date on the packet as latex deteriorates over time. The penis must be erect before a condom can be put on. Squeeze air out of the condom to allow space for semen and then gently roll down over the penis as far as it will go. Only water-based lubricants can be used. Oil-based lubricants can weaken the latex, leading to the condom splitting or tearing. After ejaculation, the penis must be withdrawn before the erection is lost. Holding on to the rim of the condom ensures no semen escapes before withdrawal. When removing the condom, care must be taken not to spill any of the semen. Never dispose of the condom in the toilet-throw it in a trash can. If used correctly, condoms are 99% effective. Where to go: Condoms are freely available at pharmacies, Family Planning Clinics, supermarkets, convenience stores, vending machines in pubs, clubs, cafes and discos, and by mail order. BEBASHI can also provide a limited number of free condoms at each visit. Side effects: There are no chemical side effects with condoms- some people may have an allergy to the latex or the lubricants, but this is rare. Advantages: The cost of the condom is low. Condoms allow the man to take responsibility for contraception and safer sex. They are a reliable method of contraception and provide protection from STD's. Disadvantages: There is a slight reduction in sensitivity experienced by a man when using a condom. Applying a condom can be an interruption to the spontaneity of sex. Tubal Ligation is a surgical procedure leading to sterilization in women. It involves either closing off the Fallopian tubes with clips or rings, cutting and tying, or burning and sealing the tubes to prevent sperm from reaching the egg. Where to go: Tubal Ligation is a relatively easy surgical procedure carried out under general anesthetic in a hospital on an outpatient basis. Side effects: There are no side effects except those associated with a general anesthetic. There are some myths associated with Tubal Ligation, such as loss of sex drive, early onset of menopause and heavier periods. These myths are unfounded. Advantages: Tubal Ligation is a permanent form of contraception. It is about 99.5% effective. Disadvantages: Tubal Ligation provides not protection from STD's. It is a permanent method of contraception and, although reversal is possible, it is not always successful. Spermicides are creams, foams, gels or vaginal tablets placed in the vagina before sex. Their success rate is highest when used in conjunction with either condoms, diaphrams or caps. A spermicide kills sperm before it reaches the egg. Some condoms come applied with spermicide and others require it to be applied. Where to go: Spermicides are readily available at pharmacies, or Family Planning Clinics. Side effects: There are no chemical side effects, however some men or women may be allergic to any of the constituents. Advantages: The use of Spermicides provides increased confidence in the reliability of condoms, diaphrams or caps. Disadvantages: Spermicides are only 50% effective when used on their own. They are messy to use and can reduce desirability of other sexual activities such as cunnilingus or oral sex. Diaphrams and caps are made from soft rubber. They are worn inside the vagina and provide a barrier method of contraception like condoms. Diaphrams and caps cover the cervix, the entrance to the uterus, and prevent sperm entering. There is some debate about the need to use a spermicide with a diaphram- if spermacide is used, only a small amount is necessary. If too much is applied, the diaphram may slip out of position. Where to go: Diaphrams and caps must be the correct size. They require fitting by a doctor and a woman must be instructed on how to insert and remove it. Side effects: There are no chemical side effects- some women have a rare allergy to rubber and some women can develop the bladder infection, cystitis. Advantages: Diaphrams and caps are effective contraceptives, though not as reliable as the pill or condoms. They are non-interruptive to foreplay or sex. Disadvantages: Diaphrams and caps are a little difficult to use. They provide limited protection from STD's. Depo Provera is a type of injectable synthetic hormone that prevents pregnancy by preventing ovulation. A dose of Depo Provera lasts for three months. Injectable synthetic hormones were first used in the 1960's for the treatment of endometriosis and miscarriages. Depo Provera is injected deep into the muscles of the back or buttocks. It works by stopping the release of an egg, by changing the cervical mucus to form a barrier to the sperm and by thinning the lining of the womb and preventing the growth of the fertilized egg. The hormone also acts on the Fallopian tubes to restrict sperm or the egg from traveling through them. Where to go: A full medical examination by a doctor is required prior to prescribing Depo Provera. Depo Provera has been used for more than 20 years. Side effects: In the early stages of Depo Provera use, there will be a change in the menstrual cycle. After two or three injections most women will have no periods at all. Some women may experience spotting, irregular bleeding or, occasionally, heavy bleeding. Weight gain or loss may occur. Other problems can include headaches, nervousness and, occasionally, depression and loss of libido. Advantages: Depo Provera is a very effective form of contraception. Each injection lasts for three months, so there is none of the risk- as with the Pill, for example- of forgetting to take it. It is as effective as the Pill and more effective than an IUD or barrier methods. Depo Provera can reduce the risk of thrush, pelvic inflammatory disease (PID) and cancer of the ovary and womb, as well as relieve the symptoms of endometriosis. Disadvantages: If side effects occur they generally last for the three month period of the injection's efficacy. When Depo Provera use is stopped, a delay in the return of normal periods and fertility may be experienced. It gives no protection from STD's and introduces chemicals into the body. There are two main types of oral contraceptive pill: the combined pill, and the mini-pill or progesterone- only pill. The combined pill contains two hormones. The hormones stop the ovaries from releasing an egg each month and change the mucus at the entrance to the womb and cervix. The combined pill also acts to thin the lining of the womb. The mini- pill or progesterone- only pill, has hormone and works by changing the mucus at the cervix so that sperm cannot pass through and fertilize the egg. As the pills contain hormones, most women experience what appears to be a period at the end of each cycle. By not taking the Pill for seven days each month, bleeding occurs. This menstruation- like bleeding is caused by hormone withdrawal. The blood is usually darker in color and has a much lighter flow. Where to go: A medical check- up is necessary for a prescription. The Pill is available at pharmacies or Family Planning Clinics. Side effects: While there are some good and some bad side effects to the Pill, many users have no bad side effects from it at all. Good side effects include: Regular periods that are shorter and lighter. Improvement of acne, improvement of absence of pre- menstral syndrome. Bad side effects include: Slight bleeding (called spotting) between periods. Weight gain or loss, brown patches on the face when in sunlight (though this is rare). Mood changes, enlargement and soreness of the breasts. Advantages: The combined pill is about 99.5% effective if used as directed. The mini- pill is about 96% effective, but must be taken at the same time each day. As the pill is a prescribed contraceptive, a woman must visit a medical practitioner to obtain repeat prescriptions, ensuring she maintains a regular health check regimen. The Pill is a very easy form of contraception to use. Disadvantages: One of the disadvantages with the Pill is that people sometimes dismiss the need for safe sex as the chance of pregnancy is decreased. But the Pill gives no protection against STD's. It should not be taken by women who are likely to develop severe vascular (or circulatory) disease, such as those who smoke or have had a vascular disease in the past. Blood is much more likely to clot while taking the Pill, so women with high blood pressure, blood clotting disorders, or liver problems should not be using it. The Pill introduces chemicals into the body. A vasectomy is a surgical procedure leading to sterilization of a man. It is a simple procedure involving cutting, tying and sealing both vas deferens, the tubes running from the testes to the urethra and penis. A man is still able to ejaculate, but there is no sperm in the semen. Sperm is still produced, but it does not reach the penis. Where to go: Vasectomy is a quick, easy surgical procedure carried out under local anesthetic in a doctor's office or at a Family Planning Clinic. Side effects: There are no side effects to a vasectomy except for a little tenderness or bruising following the procedure. Advantages: A vasectomy is a permanent form of contraception. It is about 99.8% effective. Vasectomies can be reversed, but the success rate is low- around 50%. A vasectomy allows the man to take responsibility for contraception. Disadvantages: Vasectomies provide no protection from STD's. It is not immediately effective- other forms ofcontraception are recommended for a period of about two months following the procedure. The female condom is a polyurethane sheath about 15cm in length. It is designed to loosely line the inside of the vagina to prevent semen from entering the body. At each end of the condom are two flexible rings. At the closed end, one of the flexible rings is inserted into the vagina to hold the female condom in place. A larger, fixed ring stays outside the vulva at the entrance to the vagina. This ring acts as a guide for penetration and stops the sheath from bunching up inside the vagina. Where to go: The female condom is available in the UK and the USA, but is not yet available in Australia. Side effects: There are no side effects to using the female condom. Advantages: Polyurethane transmits heat, unlike latex used in condoms, so the female condom is the same temperature as the body. Oil-based lubricants do not damage the polyurethane. The female condom can be an effective method of contraception and it reduces the risk of STD's, but its reliability as a contraceptive has not yet been established. Using a female condom gives a woman a contraceptive option that also ensures safe sex. The outer ring can increase sexual pleasure as it rubs against the clitoris. The female condom can be inserted any time before intercourse so that the spontaneity of sex is not interrupted. Disadvantages: Female condoms are more expensive than male condoms. There may be a slight reduction in sensitivity and they can be a little noisy. Some people may be put off by their appearance. The female condom may be difficult to insert at first, and the inner ring can cause a little discomfort. It is important for the women to guide the penis into the female condom as it can slip into the vagina outside the condom. Extra lubrication may be necessary to make intercourse easier and more enjoyable. The morning- after pill is a short course of special- dose oral contraceptive pills taken after unprotected intercouse to prevent pregnancy. To ensure success, the first dose must be taken within 72 hours of intercourse. Depending on the stage of the cycle at which intercourse occurred, the morning- after pill either delays ovulation or prevents a fertilized egg from implanting in the womb. However, it is only 95% effective in preventing pregnancy after unprotected intercourse. Where to go: The morning- after pill is easily prescribed after a medical check. It is available from doctors and Family Planning clinics. Side effects: The morning- after pill can cause nausea or vomiting. Some women experience sore breasts. Advantages: The morning- after pill, by reducing the risk of pregnancy following unprotected intercourse, reduces the need for abortion or going through with a pregnancy. Disadvantages: The morning- after pill can disrupt the menstrual cycle. It reduces the risk of pregnancy, therefore encouraging the idea of unprotected sex. The morning- after pill introduces chemicals into the body. It provides no protection from STD's. The intra uterine device, or IUD is a small plastic and copper object inserted by a doctor into the uterus. No one knows exactly how these devices work, but their main actions include: Stopping the sperm from reaching the egg. Affecting the movement of the egg down the Fallopian tubes. Changing the lining of the uterus and preventing the fertilized egg from settling in the uterus. Where to go: IUD's must be inserted and removed by a doctor. Side effects: Some women experience heavier periods, which usually settles down after a couple of months, cramps with periods and spotting (or slight bleeding between periods) with an IUD. Advantages: IUD's are a reliable method of contraception. Modern IUD's are 98-99% effective. They are relatively cheap, lasting five years or longer depending on the type of IUD. After removal, fertility returns immediately. Disadvantages: The disadvantages of IUD's include: Some pain on insertion. The IUD can be expelled during heavy periods or cramps. Increased risk of infection in the Fallopian tubes, which occurs more quickly than if not using an IUD. No protection from STD's. IUD's are not recommended for women under 25 or women who have not had children. A NOTE ON SMOKING AND CONTRACEPTION: There are many dangers associated with smoking, including ways in which it can affect your uterine health. Smoking affects every phase of contraception. Women who smoke have a greater risk of not ovulating (releasing eggs from the ovaries). Smoking can also interfere with a fertilized egg implanting in the uterus. Nicotine can interfere with the function of the Fallopian tube, the route that a fertilized egg travels to the uterus. This can lead to ectopic or tubal pregnancy, both of which are life-threatening conditions. Smoking can also increase your risk of cervical and rectal cancer. Young women who smoke are six times more likely to develop rectal cancer. Smoking can hurt your unborn child. Carbon monoxide, a byproduct of smoking, can poison the fetus (or unborn baby) and fetal tissue seems to be more susceptible than adult tissue. Smoking also:
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