Contraceptives

If you are not taking your low dose birth control pill correctly, you risk being one of the 12 women who get pregant each year while using this popular method of birth control. Why?  Because you are missing too many pills.  Apparently, while we may not admit it,  30-50% of us miss taking 3 or more low dose birth control pills per month!

Today, those of us using low dose birth control pills can avoid many of the significant side effects that the 60’s contraceptive pill inflicted on us but one leading expert,

Professor James Trussell of Princeton University in America is warning us now that even the low dose birth control pill may be ‘outdated’. Are you taking a low dose birth control pill ‘by default’ because your doctor did not offer you other options of reversible birth control (maybe because he /she is not adept at fitting IUDs or inserting implants)?

What can you use instead that will give you reliable and effective protection against pregnancy yet at the same time give you the same benefits (reduced side effects) as your low dose birth control pill?

The methods of birth control advocated by Professor Trussell, at a British Pregnancy Advisory Service conference in London, are either implants or intra - uterine devices (IUD) -  these also last longer and can be ‘fitted and forgotten’. Of course, like the low dose birth control pills, neither of these methods of contraception will protect against STDs.  Paragard is a non hormonal IUD that is safe if you smoke. IUDs can cost from $200-$500 dollars but protection lasts from 5 -10 years depending on type.  It can take up to one year to get pregnant after removing an IUD.  Watch this video on IUDs HERE and there’s more information on implants HERE.

Half of all pregnancies in America are unintended and are due to the failure/improper use of contraceptives.  It’s probably a similar situation in Australia and the UK.  If 7% of women currently using a low dose birth control pill swapped to an IUD or an implant, it’s estimated that 73,000 unintended pregnancies per year would be prevented in the UK. Let’s face it, with so much unprotected sex going on too, it’s unrealistic to think that every lass is going to rush off the next morning to get emergency contraception. If you decide on a home induced abortion and live anywhere other than the UK, you can take your first dose of the appropriate medication at a clinic then take the second at home 48 hours later. In the UK a woman has to go back to the clinic for her second dose.

GASP!

It turns out (see this chart Table 2) that low income, teenagers under the age of 20 who are living with their boyfriends and who are using the contraceptive pill have a failure rate of almost 50%.  48 of them will have a pregnancy within 12 months. 

The bottom line is:  NO type of contraceptive is reliable if you don’t strictly follow the instructions and use it as it has been designed.  Human error causes accidents!
In view of all of the above, we MUST improve the way we teach our children.  We must improve the ‘holistic’ sex education curriculum to focus on encouraging young people and singles to be much more responsible about their sexual behavior, more educated about rearing children and wiser about CHOOSING the person with whom they wish to raise a family.

Too much, too soon
Advertising and the media bombard young people with sexual imagery, encourage instant gratification while detracting from the real ‘love’ aspect of a union that creates a new life. Young people now live in a culture of “use and be used,” instead of “love and be loved.”  Whether the two parties are consenting to ‘using’ each other, doesn’t make it ok.

Source:  Jennifer Roback Morse, Ph.D., is the author of  Smart Sex: Finding Life-long Love In A Hook-up World. She blogs at jennifer-roback-morse.blogspot.com

There are 17 (seventeen) different types of birth control on the market, apart from the emergency contraceptive pill-  which one is the best for you? For a really quick reference this free, handy  FDA BIRTH CONTROL GUIDE gives you an overview of the various types of birth control available today, their success rates, risks involved with each and how to use them .  Consider using more than one type of birth control, particularly if you have multiple partners, as most types of birth control do NOT protect you against HIV/AIDS or any other sexually transmitted disease?

Of course, your initial consultation should always be with a health care provider or family planning
professional but this handy chart will at least place you in a powerful position to begin discussing the
options that are best suited to you and your circumstances.

If You Choose a Contraceptive Pill

You may find that once you have your prescription, particularly if it is for an oral contraceptive pill such as Alesse or Ortho Tri Cyclen, that ordering your contraceptive on line is the most convenient way of purchasing. Repeat Ordering on line reduces the risk of running out of pills at the end of the month (most dangerous time to miss a pill!)  and ordering several months supply at once will save you money.

It’s easy to settle into an ordering routine once you find a contraceptive pill that ‘agrees’ with you and
has few or no side effects but it is also a good idea to review your medication with your doctor at least
once a year when you go for your Pap smear.

If the first prescription does not suit you, it may be that you have AN INTOLERANCE TO ESTROGEN, an active ingredient contained in the combined contraceptive pills and need to trial a ‘progestin’ only pill (often called the ‘mini pill’). Trial a different type of oral contraceptive for a few months and hopefully you’ll find one that is acceptable- if not, your doctor will advise you of alternate methods of birth control that will be appropriate for your age and medical history.

Talk with your Partner about Types of Birth Control

Get rid of the stress, get rid of the anxiety over becoming pregnant, especially if you are a sexually active teenager. I am aware that on this site, even though I try to cater for the guys too, so much information on types of birth control seems to be targetted at ‘females only’.  I realise that there is still a very limited range of birth control options for guys but PLEASE, talk to your sexual partner(s)  about the types of birth control that you are both happy to use. It is the 21st century! Leaving all the responsibility for contraception up to women alone is just ‘not on’ anymore.

I believe that everyone deserves a joyful and healthy sex life, free from the anxiety of unwanted panic attacks (”OMG I’m pregnant!” or “OMG I’ve got an STD!”) and the facing the dilemma of abortion.I also believe that both partners should ‘want’ a child only when the time is right and let’s face it, that may be never so long term options for birth control may be the ‘go’ for some. It follows then that both
partners should be responsible for discussing, planning and managing an appropriate ‘contraceptive career’ together until that time comes around……..and with the right person.  Go get that free GUIDE now.

Low Dose Birth Control Pills Minimize Side Effects

Today’s oral contraceptive pills,  called ‘new generation contraceptives’,  contain much lower doses of synthetic hormones than in the 1960’s when ‘The PILL’  (with 50 micrograms of estrogen) first went onto the market. “So how does that benefit me?”, you may be saying to yourself - here’s some information about low dose oral contraceptive pills that may help you to talk to your doctor if you’re not happy with the oral contraceptive that you are currently taking.

Trial and error with different pill types is likely to be ahead of you -bearing in mind that oral contraceptives are still not the perfect method of birth control for everyone. If you are on the ‘right pill’ to suit your body, you should feel exactly the same way as you do normally, if not a little better. Some women cannot tolerate the estrogen in combined oral contraceptive pills so are prescribed progestin only pills.  Estrogen seemed to be the main culprit where side effects were to blame so low dose  birth control pills were developed to minimise these.

Changing hormone levels within your body can result in side effects which vary for every individual. Keeping hormones at  a consistent level in your body is the job of an oral contraceptive so that you do not ovulate, your uterine lining thins and your cervical mucous thickens. These three events work together to prevent pregnancy.

Pills such as ALESSE and MIRCETTE are called ultra low dose birth control pills as they contain only 20mcg of estrogen. These oral contraceptives are effective at preventing pregnancy but some women find that they have more spotting and breakthrough bleeding with them than with pills containing 30 or 35 micrograms (considered the norm today) of estrogen. Spotting and breakthrough bleeding often disappear after a few months on a low dose birth control pill.

Women who prefer ALESSE and MIRCETTE say they reduce headaches, mood swings, breast tenderness and bloating. These two brands also may be better for ‘first timer pill users’ as a ‘low estrogen start’ to introducing synthetic hormones into their bodies.

Progestin only pills or ‘mini pills’

These oral contraceptives are 90-95% effective at preventing pregnancy compared to the 99% efficacy rate of combination pills.  However,  they do not cause the common side effects of estrogen pills such as nausea, breast tenderness and cramps. The risk of developing deep vein thrombosis and cardiovascular disease is lower with progestin only pills. Nursing mothers can use progestin only pills a few weeks after giving birth as progestin does not affect milk supply like estrogen does. ‘Mini pills’ must be taken every day at the same time with no break.  If you miss just one pill or take it more than three hours past the regular time, you need to use a backup method of birth control for 48 hours after taking the late pill.

Disadvantage of the ‘mini pill’ - apart from irregular spotting and breakthrough bleeding, is that it can increase the risk of ovarian cysts and ectopic pregnancy.

Latest Update

Low-dose birth control pills may increase risk for heart attack or stroke, especially in women who suffer from polycystic ovary syndrome (PCOS) or metabolic disorder. However, this risk disappears when you stop taking the pill (according to a Virginia Commonwealth University study published in the July issue of the Journal of Clinical Endocrinology and Metabolism).

PCOS is a condition that can affect a woman’s menstrual cycle, fertility, hormones, insulin production, heart, blood vessels and appearance.

“Despite the doubling of risk associated with the pill, the absolute risk for a cardiovascular event in an individual woman taking the pill is low - Women using the pill are not going to automatically have a heart attack,” states John Nestler, M.D., professor and chair of the Division of Endocrinology and Metabolism in the VCU School of Medicine. “However, our findings do raise the issue of whether oral contraceptives are optimal therapy for certain groups of women who are at baseline risk or who are taking the pill for a longer time, such as women with PCOS.”   Source: http://www.medicalnewstoday.com

So if you don’t have PCOS and you think a low dose birth control pill may suit you better, read more about Alesse and Mircette before asking your doctor which brand would ’suit’ your own medical history. Don’t forget to tell him/her which other medications you are also taking. The suppliers I have recommended on line are accredited and also offer the best prices.

Sources: Centers for Disease Control and Prevention, Dr. Elizabeth Silverman,  obstetrician-gynecologist at Scripps Memorial Hospital in La Jolla. Dr. Pamela Deak, obstetrician-gynecologist at the University of California San Diego Medical Center.

This post follows on from an earlier one with more information about contraceptive IUD’s (intra uterine devices). An IUD is highly effective at preventing pregnancy and works by preventing fertilisation. Once inserted you can ‘forget it’ and your fertility status can easily be reversed by removing it.

IUD’s are recommended for cost effective, long term contraception and can be used by most women unless they have a history of cervical infections or genital cancer.

The newest form of IUD or IUS (intra uterine system) releases a progesterone like hormone called Levonorgestrel and is sold under the name Mirena (introduced in 2000 and believed to be more than 99% effective) Protection lasts for 5 years- maybe even longer and, unlike the copper IUD, this type of IUD does not have the potential to cause anaemia. The original copper IUD- known by the names: TCu-380A (most widely used) the Multiload ML375, and Nova-T380- is also highly effective and is preferred by some women as it does not contain hormones and therefore does not interfere with a woman’s natural hormone levels. Protection lasts for 5-10 years depending on type.

Questions first

You will be thoroughly checked by a doctor to make sure that you are a suitable ‘candidate’ for the insertion of an IUD and you should use this opportunity to ask lots of questions yourself, however silly they may appear. IUD’s do not travel around the body or interfere with your heart. IUD’s do not cause pelvic inflammatory disease (PID) if you don’t already have one.

If you have gonorrhea, chlamydia or purulent cervicitis it is not advisable to have an IUD inserted as you may be at risk of developing a PID within the first 20 days after insertion.

Insertion-takes 5- 10 minutes

Your doctor will insert your IUD into the top of your uterus through your vagina during the first 12 days of your menstrual cycle or at any time when he is certain that you are not pregnant. Some mild cramping may occur after insertion. To see a diagram of where the IUD is placed go here.

Careful insertion reduces the chances of the uterus contracting and expelling the IUD and also avoids perforation of the uterine muscle wall. If perforation does happen (rate fewer than 2 per 1000) it is usually obvious and the IUD is removed at once without serious damage occurring.

Can the IUD come out on its own?

Unlikely if it is inserted correctly -but 2-8 women per 100 expel their IUD’s in the first year and usually within 3 months of insertion. Some studies show that young women, aged 20-25 and women who have not had children account for several cases within this range.

Side effects

There is a slight chance of infection if the IUD is not inserted carefully/correctly. Serious complications with IUD’s are very rare.

Copper IUD -The main reason that stopped some women using the copper IUD was increased bleeding and cramping, in some cases up to 50% above ‘normal’ levels prior to IUD use. The new copper IUD’s only ‘moderately increase’ blood flow. Increased blood loss can lead to a decrease in iron levels and subsequently lead to anaemia in women who are already low in iron.

Hormone IUD -can eventually decrease bleeding due to the thinning of the uterine lining caused by the progestin hormone. After a year of having an IUD inserted 20- 35% of women have no bleeding at all. Side effects of hormone IUD’s occur in fewer than 5% of women, (hormone is released in the uterus and is not processed by the liver) are similar to those experienced with oral contraceptives such as acne or other skin problems, back pain, breast tenderness, headache, mood changes and nausea.

What if I get pregnant when I have an IUD fitted?

The chance of you getting pregnant with an IUD insertion is rare. If you do conceive you risk severe complications such as miscarriage so go to your doctor immediately if you suspect that you may be pregnant and if confirmed, he will remove the IUD.

Are there any cancer risks with IUD’s?

IUDs may reduce the risk of cancer of the uterus but read this report for yourself.

A final reminder: IUD’s do not protect against HIV/STD’s.

Sources: Salem, R. “New Attention
to the IUD:Expanding Women’s Contraceptive
Options To Meet Their Needs.” Population
Reports, Series B, No. 7. Baltimore, Johns
Hopkins Bloomberg School of Public
Health,The INFO Project, February 2006.

This second post on contraceptive implants is packed with information so it’s a bit long but it IS timely, given the decision by the Department of Health in the UK to introduce a national campaign that aims to make young people more aware of contraceptive options. ‘Doctors will be told to advise young women they should not automatically opt for oral contraceptives and instead think about using newer methods that last between three months and five years.’ reports the Daily Telegraph. Women will be told to consider injections and implants instead of the Pill, in an attempt to reduce the number of unwanted pregnancies.

Regardless of country, every women has the right to be offered and counselled on ALL methods of contraception, with no bias implied unless individual medical history prevents some types of contraceptive from being safely prescribed. In Britain, it seems that for 3/4 of women, this does not happen (APPG survey).  Surely, for a public campaign, the focus should be on educating and empowering everyone to make their OWN informed choice according to their own circumstances, not steering them to ‘long term’ contraception with contraceptive implants and injections?

SO, to inform and empower you, here are a few FAQ’s and answers to some common misunderstandings about the ‘new generation’ contraceptive implants :
(read the earlier post on the effectiveness of contraceptive implants and how they work)

If you have a specific question, do a quick scroll down to find the answer.

Do I have to undergo any pelvic or breast exam before I use an implant? NO
Do I need a blood test? NO
How long do the new implants work?
Jadelle is currently labelled for up to 5 years of continuous use
Sino-Implant (11) is labelled for up to 4 years of continuous use
Implanon is labelled for up to 3 years of continuous use

Does it hurt to have a contraceptive implant inserted and removed?  A local anaesthetic is given first and most women say it doesn’t hurt as much as they expected though removal may hurt a bit more than insertion.
Will I have a scar? Possibly a tiny one after some bruising but the implant is inserted with a hollow needle in the doctor’s clinic then bandaged, no major surgery is needed.
Will the implant be visible? NO, not unless you are VERY thin but you can feel it under the skin.

How soon am I protected? After 24 hours but remember that unless you use a condom aswell, you are NOT protected from STD’s.
Do I need a follow up visit to my doctor? NO, not unless you have any concerns.
Will an implant make me infertile? NO, fertility resumes with normal bleeding patterns after removal of the device.
Can the implant move around my body? NO. Very rarely a rod may start to come out because it was not inserted correctly or infection has occurred (in the first 4 months). Go straight to the doctor.
Do implants interrupt a current pregnancy? NO and they will not harm a fetus if you get pregnant during use.
Do contraceptive implants cause cancer? NO, studies have not shown increased risk but if you have or have had breast cancer implants are not for you.
Will an implant make me ‘moody’? Generally NO, some women complain of this side effect but the majority don’t- some even report an improvement in mood changes and sex drive.

Will a contraceptive implant change my sex drive? There is no evidence for this.
I am breastfeeding-will a contraceptive implant affect my baby? Wait for 6 weeks after the birth then an implant will be permitted and is deemed to be safe.

I am overweight - can I use a contraceptive implant? YES but you may need to have it replaced earlier than its recommended ‘life span’, depending on the brand.
I have HIV, can I use a contraceptive implant? YES but use a condom also
I have abnormal vaginal bleeding- does this mean I can’t use implants at all? NO, not necessarily but get a proper diagnosis and treatment first then ask to be re-evaluated for an implant.
I have a liver disease- can I use a contraceptive implants? NO, hormonal contraceptives are not for you.
I’m a heavy smoker and I’m over 35 years old- can I use an implant? YES. Contraceptive implants contain a progestin hormone, not estrogen which increases the risk of blood clots. However, if you suffer from serious clotting in your legs or lungs, contraceptive implants are not suitable for you.
Can I go back to work after having a contraceptive implant inserted? YES, providing you do not bump the insertion site or get it wet.
Can an implant be left in my arm permanently? It will not do you any harm but beyond its effective lifespan it will no longer be releasing its hormone and providing you with protection so this is not recommended. You will be given a reminder card with the type of implant on it and the dateby which it should beremoved.

WARNING: If you are taking ANY medications for seizures, tuberculosis or other illnesses they may reduce the effectiveness of a hormone -delivering, contraceptive implant so make sure you discuss contraceptive alternatives with your doctor.

That was a lot of information to get through but I hope you found it valuable. If you want a brief handout to take with you to the doctor’s GO HERE.

Sources: Ramchandran, D. andUpadhyay, U. D. “Implants: The Next Generation.”Population Reports, Series K, No. 7. Baltimore,INFO Project, Johns Hopkins Bloomberg School of Public Health, October 2007

‘Family Planning- a Global Handbook for Providers’.

Are you taking an oral contraceptive ?

Are your teenage hormones raging?

Hormones are chemicals that send information between cells and organs to control our body’s processes. The sex hormones that cause such a ruckus in puberty are crucial to the reproduction process in men and women. The contraceptive pill plays its monthly role in this relay system by tricking the body into thinking it’s pregnant.

Contraceptive pills are one of the most popular types of female contraceptive in use today but do you know HOW and WHY they work? No, I don’t just mean “oral contraceptives stop ovulation” or “they thicken the cervical mucous”, I mean WHAT HAPPENS in various parts of your body, including your pituitary gland, when you swallow a synthetic hormone (present in the contraceptive pill) and HOW does that actually change your body’s normal functions each month to significantly ‘reduce’ the chances of you getting pregnant.

In my hunt to discover a simple explanation to this question that I could pass onto you, I feared a medically ‘high brow’ (and boring!) answer. However, I found this excellent little animated film that does the job nicely.

If you are interested in really knowing what is going on inside you when you take an oral contraceptive pill, then I think you will find the film below easy to understand. To watch it you will need Flash5 plug in though, which you can get HERE for free if it’s not already installed on your pc.

The information you will discover will also make sense of those side effects that sometimes sneakily accompany the contraceptive perk- not that this makes them any less acceptable but at least you’ll be a ‘know -it-all’ when you next talk to your doctor about birth control! Who knows, you may even find another contraceptive pill suits you better after you’ve been able to ‘take charge’ of the discussion? I cannot emphasize strongly enough though, the need to have a good back up stock of condoms, especially if you have multiple partners, this site is reliable and has quality stock if you wish buy on line.

HOW THE PILL WORKS - The film window is a bit small but there is a zoom button and the option of watching another film on how the female reproductive cycle works too. Just click on the picture when you get to the site.

For detailed information on use and side effects of oral contraceptive pills, here are some popular brands :

ALESSE, DESOGEN, LEVLEN, MIRCETTE, OVRAL and ORTHO TRI-CYCLEN

The very mention of the Dalkon shield contraceptive device sent shudders through the women of America in the 1970’s. At that time, 12 deaths occurred as a result of miscarriage related infections associated with the use of this female contraceptive. Consequently this particular contraceptive was taken off the market in 1975.

Today, that model of contraceptive is widely acknowledged to have had a flawed design, being a multifilament string that served as a channel for infection to a woman’s uterus. Infection could lead to diseases of the pelvic area, infertility and in the worst cases, to the septic miscarriages that first sparked panic.

What is an IUD? An Intra Uterine Device or IUD is a small, plastic or metal/copper device inserted into the uterus that provides years of protection against pregnancy, primarily by interfering with sperm and eggs. For types, use, pros and cons see this easy to follow Handout

Today’s IUDs are one of the most popular types of contraceptive in use and are effective from the time of insertion. Only three IUDs are available in the United States: —the Copper-T 380A (also known as the ParaGard), the Progestasert and a newer one called the Mirena (introduced in the United States in 2001) Effective for a full five years, the Mirena releases a tiny daily amount of levonorgestrel, a hormone similar to progesterone.
No women have died after an IUD ­related miscarriage since 1977 but if a woman has an STD, such as chlamydia, at the time of the insertion of the IUD or soon after, even with the today’s improved design she may be at a higher risk of miscarriage than a nonuser and she may also tend to get more vaginal infections and inflammation of the cervix (cervicitis) .

Neither copper nor hormonal IUDs will protect you against sexually transmitted diseases so please use a condom and spermicide as ‘backup’ if you have more than one sexual partner.

The scientific consensus is that an IUD is safe - even for single women and women who have never given birth (presuming they do not have an active STI at or near the time of insertion). Insertion for women who have never given birth can be a little more difficult though and sometimes the contraceptive device can be more easily expelled so extra vigilance is recommended. If you know that you will constantly be at risk of catching an STI you should NOT have this type of contraceptive fitted.

Use of this type of contraceptive should be discussed with your doctor . The life span (5-10 years ) alone is an important factor for young women to talk about if they wish to have a family at some future date - the IUD does not affect your ability to have children once it is removed- pelvic infections can lead to infertility. For women who have finished having children, this method of contraception may be the answer.
PS. If you are currently using a contraceptive IUD and you think you may be pregnant see your doctor as soon as possible to rule out an ectopic (outside the uterus) pregnancy and have the IUD removed to avoid any risk of a miscarriage.

Future posts on this type of contraceptive and its fitting/insertion will also review the differences between copper IUDs and hormonal IUDs.

Popularity Disparity: Attitudes About the IUD in Europe and the United States

Do you know how spermicides work?

Spermicides kill sperm. A spermicide is a chemical that can be used alone (high failure rate!) but is usually used with diaphragms, cervical caps and condoms. This type of chemical contraceptive can be used without involving a man as it is placed high up inside the vagina, near the cervix. No prescription is required. Spermicides are available over the counter at supermarkets, pharmacies and convenience stores.

Continuing with the ‘How To’ series on the basics of using contraceptives, here is another doctor’s patient handout, this one contains tips for using spermicides. You will find facts about effectiveness, use, the different types of spermicides and information about side effects.
Please also read my earlier post about the warning related to Nonoxynol 9.

Using barrier contraceptives? Are you spinning your cap, girls? Yes, you need to do this to improve the seal but if you don’t know what this means read carefully through this simple fact sheet on How to use Contraceptives properly- this time we review the Cervical Cap.

Similar to the diaphragm, the cervical cap is also made of latex rubber and covers the cervix (neck of the womb). Like the diaphragm and the condom, this is a ‘barrier’ method of birth control which works by stopping those little swimmers from entering the vagina and swimming off in search of that egg. Spermicides are used with cervical caps - these are chemicals that kill sperm on contact. If you use Nonoxynol 9 please read this warning, you may wish to change brands!

No hormones so no side effects- this is one benefit of using this particular contraceptive, unless you are allergic to spermicides or latex as some people are. Women who cannot use a diaphragm (those with uterine prolapse or vaginal relaxation) often find the cervical cap does the job nicely.

You do need to be fitted for a cervical cap as they come in four different sizes and then refitted again if you have a baby. If used correctly and consistently, this type of barrier contraceptive is effective though the success rate is not as high as hormonal contraceptives.

The handout shows clear diagrams for insertion of the cap and correct placement over the cervix. Risks and benefits are included alongside care and storage tips so if you are using this type of contraceptive or considering an option to your diaphragm please make sure you read through the details HERE.

Some contraceptives can be downright frustrating to use, others can bring on an attack of the giggles -you’ll know what I mean if your diaphragm has ever flipped itself across the room! I have discovered some very clear sets of instructions on ‘How To” use various types of contraceptives so I thought I’d start the year by going back to basics and featuring them on my site. The tips may be useful to ‘first timers’ and may save a lot of fumbling about for those of you who still have trouble.
The link to the instructions is below (they were prepared for handing out to patients by doctors) but here are a few pros and cons on the first type- the diaphragm- to give you a good basis for further discussion with your doctor.

Contraceptive Type- The Diaphragm

Advantages:

• reasonably effective (if used perfectly, approx. 6 out of 100 women get pregnant each year using a diaphragm)
• does not contain hormones so no hormonal side effects
• it can be put in several hours before any sexual activity
• the woman is in charge of birth control
• your partner can put it in as part of your lovemaking
• his penis can stay inside you after ejaculation
• intercourse during your period is less messy as the diaphragm holds the blood

Disadvantages:

• you must be fitted for a diaphragm by your doctor initially
• you must wash your hands with soap and water before inserting your diaphragm
• you MUST also use a spermicide
• if not put in prior to sex, insertion may interrupt sex
• you increase the risk of getting a urinary tract infection
• some women find a diaphragm unattractive and difficult to put in correctly
• a diaphragm must NOT be left in for more than 48 hrs or there is a slight risk of toxic shock
• a diaphragm must be left in place for 6hrs after the last intercourse
• the diaphragm may slip during various sexual positions so you make sure your cervix is still covered
• you may need a fitting for a different size after having a baby, an abortion, miscarrying or gaining more than 15 pounds

Diaphragms are used with spermicides for extra protection - spermicides kill sperm but read the warnings about Nonoxynol 9 before buying this one.
GO HERE for diagrams and instructions on How To Use a Diaphragm- they also explain what a diaphragm is, how to store it and how it works to prevent pregnancy.

Sources: www.contraceptiononline.org

Emory Department of Gynecology & Obstetrics