Contraception
The ovulation testing
pack
is a completely new method of natural family
planning that allows you to enjoy making love
without using any contraceptives on most days of
your cycle. The pack includes a personal monitor
that checks your urine samples and analyses
them to indicate the days of the month on which
you are likely to get pregnant. You should use
contraceptives if you wish to make love on those
days. The pack is 93-95 per cent reliable and
very easy to use.
Natural family planning,
by contrast, requires meticulous record keeping
and iron self-discipline. It involves charting your
temperature day by day throughout the menstrual
cycle to discover the period of ovulation, during
which you must abstain from sex. Any
unpredictable irregularity in the cycle can carry
the risk of pregnancy.
The Pill is up to 99 per
cent reliable. It allows for
completely spontaneous lovemaking. The
freedom it gives is of enormous psychological
benefit in any relationship. The Pill also regulates
the menstrual cycle and reduces period pain and
heavy bleeding in many women. Mild side effects
occur in some women who take the Pill, but they
usually disappear after a few months. They may
include nausea, headaches, and depression,
weight gain and some bleeding between periods.
If side effects persist, the doctor or clinic will
usually recommend a change of contraception.
Before your doctor prescribes the Pill, he or she
will ask for your medical history, including
incidence of thrombosis in your family. The health
risks involved in taking the Pill are slight when
compared to the risks of pregnancy and
childbirth.
The combined Pill contains
synthetic forms of the sex hormones estrogen
and progesterone, which interfere with the
woman's regular 28day menstrual cycle. In a
woman who is not taking the Pill, production of
the sex hormones fluctuates during the cycle,
and it is this fluctuation that triggers ovulation.
When the Pill keeps the hormone level artificially
constant, the signal to ovulate is cancelled out.
The same happens during pregnancy, which is
why overlapping pregnancies do not occur.
Anyone who smokes heavily may be at risk of
thrombosis, smokers and those who are over 35
are often advised not to take the combined Pill.
The progestogen - only
Pill is not, as sometimes assumed, a low
dose Pill, but one containing a single hormone,
progestogen. It has the effect of thickening the
secretions in the cervix, which makes it difficult
for sperm to pass. It can be taken by breast
feeding mothers, unlike the combined Pill, which
suppresses lactation.
The condom is 85-98 per cent
effective as a method of contraception. Condoms
work by preventing the sperm from getting to its
destination, and they do not interfere with the
body's chemistry. The condom is also the key to
safe sex as it protects against all sexually
transmitted diseases. For more details about
condoms and how to use them, see page 128.
Caps and diaphragms act
as a contraceptive by forming a barrier across the
neck of the womb (cervix), which prevents the
sperm from reaching and fertilizing the egg. A
good fit is crucial. You need to be examined by
your doctor or family planning clinic so that the
right-sized cap or diaphragm can be chosen, and
you can be shown how to insert it. A cap or
diaphragm should always be used with a
spermicide. This combination has been found to
be a 95 per cent safe contraceptive. Smear a
little spermicide on to the diaphragm and around
the rim, to facilitate insertion. Squeeze the
diaphragm into a boat shape and insert it as you
would a sanitary tampon, opening the lips of the
vagina with one hand. When the rim rests behind
the pubic bone at the front and the dome covers
the cervix at the back, it is in place. Doctors
recommend that you should not leave the
diaphragm or cap in place for longer than 24
hours, but you should wait for at least six hours
after intercourse before removing it. Remember
that spermicide will be effective only for about
three hours, so you will need to put more into the
vagina if you have intercourse after the
diaphragm or cap has been in place for that
length of time. When you remove the diaphragm
or cap, wash it carefully in warm soapy water and
allow it to dry in a warm place, or pat gently with
a towel.
The female condom is as
effective as other barrier methods. It lines the
vagina and has an inner ring that sits over the
cervix and an outer ring that lies flat against the
labia. The female condom is made of colorless
odorless polyurethane. The woman pushes the
condom up inside her vagina before intercourse,
and afterwards removes it and disposes of it. Like
the male condom, the female condom is not
reusable. It comes ready lubricated for easy
insertion and no spermicide is necessary. Female
condoms are made in one size only and will fit all
women. During intercourse, it is a good idea for
the woman to guide the man's penis into the
condom to make sure it does not enter the vagina
outside the condom. As the female condom is
loose fitting, it will move during sex, but you will
still be protected, because the penis stays inside
the condom. To remove the condom after sex,
simply twist the outer ring to keep the semen
inside, and pull the condom out gently.
The I U D (intra-uterine device) or coil is a
small plastic and copper device that is inserted
into the womb to prevent conception. Only a
doctor trained in family planning can do this. The
IUD comes compressed in a thin tube, which is
slid through the cervical canal into the uterus and
then withdrawn, leaving the IUD to spring into
shape. Thin threads hang from the IUD about
3cm/ 1 inch into the vagina, and these can be felt
with the fingers to make sure that the device is
still in place. To remove an IUD, the doctor pulls
the strings with a specially designed instrument.
Depending on type, IUDs are usually replaced
about every five years. The IUD is reckoned to be
96-99 per cent effective as a contraceptive,
although it is not clear exactly how it works. Many
women like it because it allows both partners to
be spontaneous in their lovemaking. However, it
does not suit everyone. Some women experience
discomfort and bleeding for a few hours or days
after the IUD is inserted, and one in four women
have to have it removed because of acute pain
and heavy bleeding. Sometimes an IUD may fall
out; this is more likely to happen during a period
than at any other time, and this is why it is
important to check regularly that the thin strings
are still inside the vagina.
Contraceptive injections may be
given with a drug that contains hormones of the
progestogen type. An injection is needed every
8-12 weeks and is a virtually 100 per cent reliable
contraceptive. However, it often has a disruptive
effect on a woman's menstrual cycle, making
periods more frequent or even disappear
altogether. Return of regular periods may be
delayed for up to a year after the last injection.
Contraceptive implants release a
hormone into the bloodstream. The implants are
small, stick-like and pliable, and are inserted
under the skin of the inner upper arm by your
doctor or clinic in a simple, almost pain free
procedure. They cannot be seen. The effects will
last for up to five years, and although the
implants can be removed at any time, the body
will not be free of the hormone for a short time
afterwards. Implants are more than 99 per cent
reliable, although they may make periods less
regular or disappear altogether. These side
effects may settle down after several months.
Emergency contraception is also
called the 'morning-after Pill'. This last-resort
method can be used if intercourse has taken
place without contraception or if the usual
method has failed, say in the event of a burst
condom. It may also be prescribed to a woman
after a sexual assault. It can be given up to 72
hours after intercourse and is 96-99 per cent
effective.I
The danger of AIDS, young people often had sex with a new partner without a condom, particularly if they had been drinking. It is
important to remember that AIDS is much more dangerous to your health than pregnancy, and unlike pregnancy, there is no way that the disease can be terminated.
The message is clear: anyone who
engages in casual sex or is having sex with a
new partner should use a condom even if
contraceptive protection is provided by the Pill.
Women as well as men are recommended to
carry condoms with them.
Clean bodies are generally more
appealing than dirty ones, though the smell of a
lover's sweat can have aphrodisiac qualities.
Bathing is not always practicable or desirable, but
you should always wash the genitals and anus
before sex, to protect against infection, to
increase the enjoyment of your partner and to
give self confidence. Soap and water are all that
is needed. Deodorants and perfumes kill the
body's delightful natural scents, and they also
taste unpleasant. Vaginal deodorants can be
positively harmful, destroying the
micro-organisms in the vagina that protect
against disease. Always wash anything that is
inserted in the anus, as anal sex carries the
highest risk of infection.