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Your body and you

Contraception – Timing Methods

Preventing pregnancy is a concern for most sexually active adults. Most of the methods of contraception available today fall under the control of women, but that does not mean that men should not be interested and knowledgeable about such things. In fact, I think it is in everyone’s best interest that they know what options are available, how they function, and what their failure rate is so they and their partner can make the best decision for themselves.

In this installment I will review methods whereby timing and control are significant issues.

Withdrawl – In this contraceptive method, the man withdraws his penis from a woman’s vagina before ejaculation. Both partners must be in agreement on this method, and must be prepared to deal with an unplanned pregnancy. It provides no protection against sexually transmitted infections.

Effectiveness – Pregnancy occurs in 1 out 5 users.

Issues – This method isn’t very effective because there may be sperm in the pre-ejaculate, which can lead to pregnancy. It also requires a lot of self-control and practice. However, it is better than nothing. Unless you are prepared to deal with the possibility of pregnancy, it is highly recommended that you put off intercourse until some other form of contraception can be obtained.

Fertility Awareness – A woman can keep track of her monthly cycle by taking her temperature, by checking the thickness of her vaginal mucus, or by tracking the time of her periods on a calendar. Once she has determined the pattern of her cycle, she can predict when she’s most likely to be fertile. During this fertile period, she stays away from sex, or uses another form of contraception.

Effectiveness – 20% of women become pregnant within the first year of using this method.

Issues – This method helps women understand their bodies and cycles, and can eventually be used to plan a pregnancy. Fertility awareness is not a very effective form of contraception, especially in teens and premenopausal women who have an irregular cycle, and it offers no protection against sexually transmitted infections (STIs). Women need to make sure that their partner will cooperate with them.

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Contraception – Barrier Methods

Contraceptive Sponge - A disposable sponge containing spermicide that is placed at the cervix to absorb and kill sperm. Provides 12-hour protection, and you do not have to change the sponge if sex is repeated during this time. It cannot be re-used after being removed.Contraceptive Sponge

When used in combination with the male condom, the failure rate is only 2%.

The sponge can be purchased without a prescription at local drugstores (they are being re-introduced to the American market this fall, but have been available for some time in Canada and other parts of the world). It is not recommended as a stand alone contraceptive. It should always be used in combination with another form of birth control such as a male condom.

Some women find it difficult to remove the sponge, or forget to take it out all together. Some may also be allergic to the spermicide. By itself, the sponge will not protect against sexually transmitted infections (STIs).

Diaphragm – A latex cap that covers the cervix and prevents sperm from swimming inside.

The diaphragm should always be used in combination with a foam spermicide, placed inside the diaphragm, to offer protection from pregnancy.Diaphragm Women can insert it before sex and it must be kept in place for at least 6 hours after last intercourse. It can be left in up to 24 hours, but not longer.

If used perfectly, the failure rate is 4-8%. In other words, if 100 women use it correctly for one year, four to eight of them will become pregnant.

You must make an appointment with your doctor to have a diaphragm fitted properly to your body. You will need to be refitted if you gain or lose a significant amount of weight or if you have been pregnant. A diaphragm will last for at least 2 years with proper care (washed with mild soap and warm water, rinsed and dried carefully, put back into its container away from light, etc…).

Some women find diaphragms difficult to insert at first, and others find that it doesn’t fit them right and that it can become dislodged. There is also a chance of developing a urinary tract infection while using it. It does not protect against sexually transmitted infections (STIs).

Cervical Cap - A deep latex cap that fits against the cervix and prevents sperm and bacteria from entering. It can be inserted before sex.Cervical Cap

When used perfectly, the probable rate of failure is about 10-13% per year, which means that if 100 women were to use it perfectly for one year, 10 to 13 would likely become pregnant. The failure rate may be higher for women who have already had a baby.

It doesn’t protect against sexually transmitted infections (STIs), and it must be used with spermicide, which kills sperm. A poor fit or latex allergy will prevent some women from using the cap. However, there are now some silicone versions available depending on your location.

Lea Contraceptive – A soft, silicone device is inserted into the vag

Lea Contraceptive

ina in front of the cervix to prevent sperm from entering. It is a reusable option that can be inserted hours before sex and offers 8 hours of protection. To increase effectiveness, it should be used with a spermicide – failure rates increase to 12.9% from 8.7% when used alone.

It doesn’t protect against sexually transmitted infections (STIs), and it is not overly effective if used without spermicide. Some women may also find it difficult to insert at first and it should be noted that if the male partner feels the Lea during sex it is not inserted properly.

Female Condom - A polyurethane sheath shaped Female Condomlike a round, upside-down baggie worn by women during sex. It holds in the sperm, preventing it from entering the vagina. It is the only contraceptive controlled by females that protects them from both pregnancy and sexually transmitted infections (STIs). Used perfectly, the female condom has a failure rate of 5%.

Some women may have trouble inserting it correctly, and they can be expensive as compared to male condoms or other forms of contraception – around $3 each.

Male Condom - A latex sheath that is rolled over a man’s penis to prevent secretions (including semen) from entering the vagina. Condoms are a 97% effective contraceptive when used properly and consistently, and protect against most STIs. They are 88% effective with typical use.

Some men complain about lack of sensitivity. The condom may slip off during sex. Rough handling may cause the condom to break. Some men and women may be allergic to latex.

If a condom breaks or slips off during sex, you should contact your doctor or a clinic for emergency contraception as soon as possible.

Spermicide - Note: This is not a barrier contraceptive but I wanted to include it with this article as it is mentioned as a partner to many of the barrier methods listed.Spermicide

Spermicide is a chemical called nonoxynol-9 comes in the form of cream, gel, foam, film, or suppository (only for use with diaphragms and other cup like contraceptives). By inserting spermicide in front of the cervix in the vagina, it destroys sperm on contact. Spermicides should be used along with another method of contraception, such as a condom, because they are not highly effective alone.

Along with protecting against pregnancy, spermicide also protects against bacterial infections and pelvic inflammatory disease. It can also be used as an emergency method, if inserted immediately after you have an accident with your primary contraception. It offers some protection against STIs, like chlamydia.

Spermicide can be messy. You have to insert spermicide right before sex, because it’s usually only effective for one hour. It may irritate the entrance of the vagina or the tip of the penis. Using a spermicide alone can increase your risk of HIV transmission, so only use it with a steady partner.

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