Contraceptives

Teens, Sex, and Contraception

Many teenagers are curious about sex but do not know the facts. Movies, television, magazines, even the Internet portray sex as fun, exciting, and adult but rarely mention the consequences: unwanted pregnancy and sexually transmitted disease (STD). Nearly 1 million teenagers become pregnant every year in the United States; most don’t intend for it to happen. About 3 million teens get an STD every year. Proper use of contraception and latex condoms can help prevent these consequences.

The most effective way to avoid getting pregnant or infected with an STD is to not have sex (abstinence). If you choose to have sex, however, you should use an effective method of birth control and protect yourself against STD infection by using a latex condom.
Choosing the Right Birth Control

Oral contraceptives (the pill) and condoms are the methods that most sexually active teens use. Injectable contraception is the next most popular. Some methods of birth control also have non contraceptive benefits that are especially important to teens, such as clearing up acne or making menstrual periods less painful (fewer cramps) and more regular. Whatever method a teen chooses, it should be used correctly and consistently— every time he or she has sex. Even if teens use a hormonal method, latex condom use is essential to decrease the risk of STDs.

Common Methods Teens Might Choose

• Birth control pill: Oral contraceptives are an effective method for preventing pregnancy. Correct use requires that a pill be taken every day. Pill use also offers a number of health benefits. Teenagers and women who take the pill usually have less pain and fewer cramps with their periods. Most users also have lighter periods that last fewer days and occur more regularly. In addition, most teens find that their acne improves when using oral contraceptives. Most women who take the pill do not experience a change in weight. Birth control pills require a visit to a clinician and a prescription.

To read all about the side effects, precautions and use see Alesse, Desogen, Mircette, Ortho Tricyclen, Levlen and Ovral

• Male condom: Condoms are less effective than many other methods at preventing pregnancy. However, male latex condoms are the only method that has been shown to help prevent all types of STDs. Used correctly and at every act of intercourse, they provide the best protection currently available against infection.

If your partner refuses to use a male latex condom, you may wish to use a female condom to help protect yourself or say “no” to sex. Male and female condoms are available over the counter in drugstores, supermarkets, and convenience stores. You do not need to see a clinician or talk to a pharmacist to get condoms.

• Injectable: Birth control shots are highly effective at preventing pregnancy. The main side effects with the 3-month shot are menstrual changes (which can include irregular cycles, bleeding between periods, and, occasionally, heavier bleeding) and weight gain. Another change over time may be no bleeding at all.
The once-a-month birth control shot has effects similar to oral contraceptive pills. The monthly shot is more likely to cause regular, lighter periods. Injectables require a visit to a clinician’s office once every 28 days or 3 months to get another shot.
• Barrier methods: In addition to male and female condoms, barrier methods include the diaphragm, the cervical cap, and spermicides. Barrier methods must be used correctly during every act of intercourse. On average, these methods are the least effective forms of birth control—all have typical-use failure rates of about 20% or higher.
Diaphragms and cervical caps require fitting by a clinician and a prescription. Barrier methods have few side
effects, although some people may be allergic to latex or spermicides. (see post below re warning about using products containing N9)
• Emergency contraception: Emergency contraception is an option if you’ve forgotten to use your birth control method or if a method fails (for example, if a condom breaks). It can also be used after forced sex (if you’ve been assaulted). Although emergency contraception is often called the “morning after” pill, it actually can be used several days after sex, not just the next morning. The most common side effects are nausea and vomiting. Call your clinician to discuss emergency contraception as soon as possible after unprotected intercourse.

• Vaginal ring and a skin patch—are approved by the Food and Drug Administration but see my post on the strong warning about the patch. The FDA has recently changed the labelling on this product and I urge you to discuss it with your doctor if it appeals to you. With the ring, a woman inserts the round, flexible device into her vagina and leaves it in place for 3 weeks. She then removes the ring for 1 week and gets her period. She inserts a new ring at the end of this week. With the patch, a woman applies one matchbook sized patch to her abdomen, arm, or buttock each week for 3 weeks, then gets her period during a patch-free week. Both the vaginal ring and patch are very effective at preventing pregnancy and may improve menstrual regularity much like the pill. When available, both methods will require a visit to a clinician and a prescription.
Speak with Your Clinician

Each type of birth control has advantages and disadvantages. If you’re a sexually active teen, speak with your clinician. He or she can help you decide which method is best for you. If you prefer to do your own ‘home schooling’ check out these teenage favourites for your Christmas reading :
S.E.X.: The All-You-Need-To-Know Progressive Sexuality Guide to Get You Through High School and College

The Teenage Body Book

For More Information
The following Web sites address issues in sexuality and reproductive health relevant to teens.

ARHP Patient Education Site
www.arhp.org/arhpframepated.htm
This patient-oriented site from the Association of Reproductive Health Professionals includes online brochures and information. Two interactive programs on the site can help you
test your “contraception IQ” and choose the right birth control method.
Center for Young Women’s Health www.youngwomenshealth.org Sponsored by Children’s Hospital in Boston, this site provides information about health issues that affect teenage girls and
young women.
Emergency Contraception Site
www.not-2-late.com
Operated by Princeton University, this site provides accurate
information about emergency contraception (the “morning
after” pill) and a directory of clinicians who provide it.

It’s Your (Sex) Life
www.itsyoursexlife.com
This site provides sexual health information for young adults.
The information also is useful for parents wanting to address
these issues with their teenagers.
Sex, Etc.
www.sxetc.org
This online teen newsletter examines love, sex, relationships,
and health.
Teenwire
www.teenwire.com
This teen site from Planned Parenthood® Federation of
America provides information and news about teen sexuality,
sexual health, and relationships

Source: Centers for Disease Control and Prevention and “The Contraception Report”

Latest Warning about Spermicidal and and Vaginal Contraceptives sold over the counter.

If you have been in the habit of relying solely on spermicides such as foams, gels, films or an insert that contains N9 for your sole method of birth control it is important that you heed the latest warning from the FDA- as you are playing Russian Roulette with the risk of being infected with an STD, especially if you have several sexual partners.

The U.S. Food and Drug Administration (FDA) issued a warning yesterday to all manufacturers of stand-alone, over the counter, vaginal contraceptive and spermicidal products containing the chemical ingredient nonoxynol 9 (N9) to include a statement in the pack warning that the chemical N9 does not provide protection against infection from the Aids virus or other sexually transmitted diseases (STDs).

N9 may actually facilitate transmission of the disease for those who are at risk for HIV/AIDS.

HOW? N9 can irritate the delicate tissues in the areas of the vagina and rectum, which the FDA says may increase the risk of contracting HIV/AIDS from an infected partner. In case you are saying to yourself, ” I have no irritation, so I must be OK”, know that this irritation often has no symptoms.
Apparently this final decision comes after a major clinical study conducted in Africa and Thailand (high incidences of Aids and STD’s) where one group of women used a contraceptive gel containing N9 and another group used used a ‘placebo’ gel, (not containing N9).

The women who used the contraceptive gel containing N9 were not protected against HIV and other STD’s and alarmingly, were also found to be at a higher risk of HIV infection than the women using the placebo gel.

To read the full labelling now required by manufacturers for products containg N9
visit the FDA News page HERE.

STOP using any of these above mentioned contraceptive products NOW if you have experienced a rash, burning sensation or itching of your vagina or if your partner has these symptoms on his penis. Go to the doctor, get checked out and and discuss future options.

Source: FDA News page

Go grab a latte, your partner and a quiet corner for half an hour of uninterruted time to talk contraceptives.

NOW- before the partying gets under way. If you don’t have a partner but are hoping to find one, (or several) all the more reason to make sure that YOU are prepared, after all, if ‘he’ can’t see how responsible you are being with your spare stash of condoms, then is he really the man for you?

PLAN to have a great time over Christmas enjoying sex but without the shadow of a pregnancy or an STI to mar the pleasure! I know you are thinking that spontaneous sex is part of the fun but it will be a lot more fun if the stress of an unwanted pregnancy or catching a sexually transmitted disease is a ‘no brainer’.
It only takes one little sperm to make it inside that egg and snuggle down into your womb to change your life forever.

Both you and your male partner share the responsibility if you become pregnant. Only you, as a woman, have the 9 months of pregnancy and labour to go through before possibly bringing up a child on your own.
Both you and your partner, equally, deserve to enjoy great sex together.

Put aside any awkwardness or inhibitions you may have to agree on which method of protection (s) you are both going to use, then when the excitement of the moment sweeps you away you will both be ready for a good time, relaxed in the knowledge that you are ’safe’ from an unwelcome surprise further down the track, when that magic moment is just a hazy memory (or worse, a huge mistake!)

Sadly, many men today still believe that it’s a woman’s responsible NOT to get pregnant- “You ARE on the pill, babe?’ Well, take a lead from the Netherlands guys and go ‘Double Dutch’ (the pill for the woman and the condom for the man). This practise keeps the teenage pregnancy rate low and enables sexually active young couples to grow up with a healthy, responsible attitude to sex - something wonderful to share. These young people are also educated in the role safe sex has to play as part of family planning. What a good foundation for managing their lives as future parents.

It’s about time we caught up and took our heads out of the sand, put the funding into sound sex education rather than ‘abstinence only’ programs. Don’t get me wrong here either, I would include a strong argument for abstinence within the sex education curriculum but hope that the content of the course was so relevant to today’s youth that it would empower them to make choices about sex that was right for them.
Granted, the introduction of the pill in the sixties brought a new sexual freedom for women and a 99.7% effectiveness rate against becoming pregnant. I am not going into the pros and cons of the pill here because this article is about BOTH partners taking responsibility for using contraceptives.

Contraceptive pills can cause side effects in some women so I am not saying that this is only answer, quite the opposite- talk to your doctor about what is best for you as IUD’s (intra uterine devices) may not be suitable for girls who have not yet had a baby. Some women prefer a contraceptive injection. Remember though, while these methods prevent pregnancy, none of these methods of contraception will stop you from getting an STI.

If you are starting a course of oral contraceptives for the first time, it will take a while for your body to adjust to the new hormone levels so reduce the anxiety of getting pregnant by using backup protection such as condoms /spermicide) for at least the first 3 months! Again, this article is about reducing anxiety and enjoying ‘festive’ sex without the ‘headaches’.

To protect against HIV/Aids and other STI’s - VITAL if you have several sexual partners over Christmas - you are best to use a barrier method that stops sperm from entering in the first place. Do you know how long sperm can survive once ejaculated? If not, check out this site a bit further down the page.

Male condoms are easily purchased from vending machines and pharmacies without prescription. Buy good quality brands made of latex and polyurethane. I think the best site for buying on line is this one.

If you prefer to use a female barrier method consider:

• the diaphragm
• cervical cap
• female condom
• contraceptive sponge

For these methods to be effective, they MUST be used/fitted correctly, which can be a bit tricky until you get the hang of it so have several trials prior to starting that round of parties!
WARNING. More teens fail with this method of birth control than adult women.

Humour goes a long way to breaking the ice for a chat with him on this topic girls but you’ll only have to do it once or twice before it becomes second nature to you . It’s in both your interests to talk about contraceptives before you feel pressured, compromised or conflicted and you’ll find that if he’s worth it, it will bring the stress down and the pleasure up.

Not every woman can use a hormonal contraceptive pill. For those of you who prefer or are obliged, to use a natural method of birth control, here is a simple online calendar that is easy to use. The calendar helps you with ‘fertile awareness’ ie. helps you to find out when, in your menstrual cycle, you are ovulating (releasing an egg) and thus, when you are most fertile.

Natural contraceptive methods are acceptable for couples who have religious concerns related to contraception or for women who physically cannot tolerate hormonal contraceptive pills and do not wish to use another method of birth control.

Natural birth control requires consistent and accurate record keeping and is more challenging for women with irregular cycles. It is effective when used correctly and consistently with an achievable 80% plus success rate. However, the average typical user of this method of contraception has a failure rate of 25%.

The obvious benefits:

• No side effects or health risks
• Immediate reversibility
• Inexpensive

Couples using this method of natural birth control need periods of abstinence or backup contraception for approximately 1/3 of each month.

Like the oral contraceptive pill, fertility awareness does NOT provide any protection against sexually transmitted diseases.

GO HERE for more information on Fertility Awareness/Natural Family Planning.

For those of you who do use oral contraceptives and whose diaries are rapidly filling with Christmas party dates, I shall have more information on emergency contraceptives soon.

We cannot ignore the real side effects that some women experience when taking oral contraceptives and if this is your preferred method of birth control, it may take a few ‘trials’ to find the right one to suit you. However, most women who take ‘the pill’ would argue that reliability and convenience far outweigh the possible risks. One third of women also take the contraceptive pill for non contraceptive reasons.

Dr. Judith Reichman, the TODAY show’s medical contributor on women’s health, has practiced obstetrics and gynecology for more than 20 years and has recently written an article to balance out the negative with a positive, factual report on findings from the latest studies on oral contraceptives.

The full article can be READ HERE but below are the main points to bring you quickly up to date.

6 benefits of using oral contraceptives:

1. protects against pregnancy - when used perfectly, failure rate only 3%
2. relieves PMS - decreases cramps by as much as 50%
3. regulates periods and decreases blood loss by 45% = lighter periods
4. use of the pill for more than 2 yrs. can DECREASE the risk of ovarian cancer by as much as 70% - combined oral contraceptives , containing estrogen and progestin, are the ONLY current method of preventing ovarian cancer. Studies have also shown that women whose mothers had breast cancer are not a higher risk of getting this disease if they continue to take the pill
5. decreases acne by 50%
6. higher dose pills have been shown to decrease the development of cysts in the ovaries and also fibroids in the uterus (though low dose pills may not be as effective)

A quote from DR. Reichman’s article.

“The CDC (Centers for Disease Control and Prevention) has stated that the current or past use of birth control among 35- to 64-year-old women didn’t increase their risk of breast cancer. They even checked women who are known to have a mutation in the genes related to breast and ovarian cancer (called the BRCA1 and BRCA2 genes) and found that a low-dose pill still didn’t increase their breast cancer risk. They have found, though, that COC use will decrease the risk of ovarian cancer in these women.”

I shall be presenting further articles on the topic of hormonal contraceptives and cancer so that you can read other views and statistics and make up your own mind as to whether you wish to use ‘the pill’.

Remember, doctors are busy people- it is a daunting task to keep up with the latest medical studies on EVERY disease and the results of EVERY drug study so if the information in the Dr. Reichman’s article triggers a concern about the oral contraceptive you are using, you know what to do- discuss it with your doctor.

Pills do not protect against STDs so if you want a reliable on line supplier of condoms and other goodies go here.

Do you know how long sperm can survive in fertile cervical fluid?

I know this site is about reviews of contraceptives BUT knowledge about the whole process is power, right? Even when you are trying to STOP those eager little beavers from getting to that egg of yours, the more you know about the habits of ‘the enemy’ the better to foil them, right?

I found this information (in quotes) at a good site for women who want to conceive and while www.fertilityfriend.com is not supplying information for prevention of pregnancy, the facts are empowering to us all, especially when read before watching the video on this site about ‘How you get Pregnant”.

“The longest that sperm can survive in fertile (eggwhite) cervical fluid is five days. All pregnancies can be attributed to intercourse that takes place within the five days before ovulation and the day of ovulation.

Sperm, however, do not typically survive for five days, even in fertile cervical fluid. A life span of 2-3 days is much more typical for sperm, even in fertile cervical fluid- less if there is no fertile cervical fluid.”

In a normal menstrual cycle

“Cervical fluid is produced by your cervix as you approach ovulation due to increased estrogen. It flows from the cervix into the vagina where it can easily be observed. Your cervical fluid changes throughout your cycle, increasing in quantity and becoming more clear and stretchy as you get closer to ovulation. Noticing and recording these changes will help you better time intercourse and recognize your own fertility pattern.

In the most common pattern, cervical fluid starts out dry after your period and then gets sticky, then creamy, then wet and watery, becoming most like eggwhite as you get closer to ovulation. You may get different types of cervical fluid on the same day.”

Hopefully this will help you to understand why oral contraceptives are effective in slowing down sperm -they THICKEN this cervical fluid, the sperm take longer to swim through this ‘glue’, few make it through to reach the egg or die of exhaustion in the process!

OK- Now you know all this- make sure you have ‘back up’ from this guy too.