Contraceptives

Following on from the last post on choosing the right doctor for your contraceptive ‘affair’, here are some ’starter’ questions on contraceptive options to take with you to the consult. Don’t be embarrassed, put off or rushed through a short consult when you talk to your doctor about choosing the right contraceptive for you - pay for a long consult if need be but DO empower yourself with knowledge before rushing off to the pharmacy with your script.

Even if you use the convenience of buying your oral contraceptives on line, discussing all aspects of birth control with a medical practitioner is essential when it comes to understanding and taking charge of your body’s health in regard to managing birth control- especially if you take oral contraceptives which affect your body’s hormone levels.

The doctor will know your medical history but maybe not know what type of lifestyle you lead so explain a bit about this first. Remember, this is your body, your future safety and happiness that’s at stake and you are about to make one of the most responsible and important decisions of your life, your partner’s life and the lives of your unborn children.

If you ask these questions and you don’t understand the answer you get back, be a little terrier and keep asking until you do.

1. Given my age and state of health/lifestyle, which method of contraception do you suggest for me?

2. Out of all the hormone based types of contraceptives, which is the most effective and are there any I cannot take due to my medical history or the medications I’m taking?

3. If I don’t opt for a hormone based contraceptive, what other alternatives are most effective?

4. Is an IUD an option for me and can it cause problems if I want to become pregnant later on?

5. How will ‘the pill’ affect my fertility and what do I watch out for re side effects?

6. Which form of contraceptive carries the greatest health risk?

7. If I ever want to get pregnant when should I stop taking the pill?

8. What should I do if I fail to use contraceptives during intercourse?

9. How and where can I get the ‘morning after’ pill?

10. I’m breastfeeding, what do I do about contraception?

11. Do you have information about natural birth control?

12. I don’t want kids for YEARS yet, is an implant a good option for me now?

13. Are there any other resources in my community where I can get help and advice on contraceptives?

14. We have enough children now, I need information on tubal ligation and vasectomy and whether or not these methods are reversible.

Here are a couple of books that I recommend, vastly different in price but both excellent.

The Contraception Sourcebook: From oral contraceptives and intrauterine devices to periodic abstinence and male contraception to the latest developments in the field, every form of birth control is covered in this book. Thought provoking and pragmatic, here at last is a comprehensive, intelligent guide to contraception.

Family Planning SourceBook: Family planning covers a wide range of issues related to pregnancy and contraception as well as how best to plan and prepare for having a family. The basic, straightforward information presented in this Sourcebook can help men and women deal with such concerns as methods of contraception and avoiding unwanted pregnancy. It also provides guidance on factors to consider when planning a family, why you should plan, and how to prepare for pregnancy.

Using contraceptives for the first time can be daunting and stressful. Before you rush out for those contraceptives ask yourself “Am I really ready for sex?” You only lose your virginity once.
Running through these few questions with a simple YES or NO answer may help you to be really sure:

• Is someone putting the hard word on you to have sex, especially your boyfriend?

• Do you want to have sex before marriage or before living with someone?

• Are you forcing the sex issue with your partner?

• Do you know the person you are considering having sex with really, really well?

• Are you absolutely certain that your intended sex partner doesn’t have (or has never had) a sexually transmitted disease (STD), or even HIV/AIDS? No it won’t just ‘go away’.

• Are you sure that YOU don’t have an STD that you could pass on? Almost 30% of sexually active teens contracted a new STD within a mere six months, even among condom users (Archives of Pediatrics and Adolescent Medicine, Sept 1995)

• If this relationship does not last, will I be glad that I had sex with this person?

• If I do get pregnant, (it only takes one sperm!) am I ready to be a single parent and can I afford it on my own?

• If I can’t face becoming pregnant right now, can I go through with an abortion or give my baby up for adoption?

Any ‘NO’s in there? Or maybe you have doubts about continuing to be sexually active? If so, stand tall and take charge of your life at this point. It is responsible and sensible to wait till the timing is better for YOU. Just because ‘you’ve done it a few times already’ doesn’t mean you can’t stop for a while now (hopefully you aren’t pregnant yet and you don’t have an STD)

If you have been sexually active, just pop into a clinic and get checked out. There are plenty of places and people to talk to these days if you are confused about your relationship or sexual habits.

Trust your intuition- if it doesn’t feel right- it ISN”T- you don’t have to know why in your head.

Abstinence is practised by some young people so the use of contraceptives is not an issue for them yet ( if you want to try it- make it easier for yourself by avoiding situations where your hormones are at an unfair disadvantage, like the back seat of a car or a bedroom at a friend’s party!)

“But we don’t go all the way”

If you are having oral sex you can catch an STD.
If you are engaging in mutual masturbation, sperm from hands can get into the vagina then they swim like hell so you CAN get preggers this way AND the little devils can get through clothing too,
that’s why condoms are made of non porous, non woven material!
If you think anal sex is safe- guess what? Those little spermies can spill over into your vagina then off they swim in search of your egg. These and other similar practices mean you ARE having sex so don’t kid yourself that you’re abstaining! You are also still at risk of pregnancy and/or sexually transmitted diseases.

If he is ‘putting it in’ halfway, pulling out before ejaculating or even if you are letting him ‘put it in’ for a second- you are having sex and you can get pregnant or catch a disease that, if untreated, could cause permanent damage to your reproductive system or even death in severe cases.

If you are absolutely determined to have sex, then find out all you can about birth control options and please BE SMART - not reckless with your sexual habits.
Dying of AIDS can be agonising and bringing up a child alone is a huge responsibility.

If you wish to use an oral contraceptive pill (such as Alesse, Desogen, Levlen, Mircette, Ortho Tricyclen or Ovral) as well as condoms, (because if it’s not on, ‘it’s not on!’ right?) then please read the information about the various types and their side effects (see sidebar headings on the RHS of this site) before discussing what’s best for YOU with your doctor.

Knowledge is power- ASK QUESTIONS and don’t be intimidated, it’s your body and you’re the one who will have to cop the consequences of your decisions, possibly for the rest of your life.

When the time is right- enjoying a great sex life with a great partner is wonderful but…you are a goddess- be smart, be safe and be choosy! Here are 3 easy to read books for more help.

If you are looking for a fascinating bedtime read with a difference, check out Andrea Tone’s book, Devices and Desires: A History of Contraceptives in America and you’ll be riveted by some amazing facts on early types of contraceptives and their use.

Did you know, for instance that:

• condoms were first invented by a down-and-out sausage-casing worker who turned surplus animal intestines into a million-dollar condom enterprise?
• inventors fashioned cervical caps out of watch springs
• a mother of six kissed photographs of the inventor of the Pill

The book begins with the criminalization of the birth control business and ends with today’s contraceptives, (including Depo-Provera and Norplant). Andrea looks at the benefits of chemical prophylaxes kits for World War I soldiers, the Lysol antiseptic douche and the disastrous 1973 Dalkon Shield.

I found this interesting review for Devices and Desires: A History of Contraceptives in America

Andrea Tone provides valuable new insights into what it was like to make, sell, buy, and use contraceptives in a period when contraception developed from an illicit trade to a big business. Her account challenges the conventional view that contraceptive history is a tale of progress in which bad, over-the-counter, contraceptives were replaced by good, medically prescribed methods.”
–Carole R. McCann, author of Birth Control Politics in the United States, 1916-1945
With a few surprises tucked in here and there, the book is fun to read and takes us on a journey from an illicit trade located in basement workshops and pornography outlets to one of the most successful legitimate businesses in American history.

Author
Andrea Tone, an associate professor of history at the Georgia Institute of Technology, is the author of The Business of Benevolence and the editor of Controlling Reproduction: An American History.

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”

Teenage sex is always a hot topic and more so now with the decision to dispense contraceptives to middle school students in the USA. If you are a teenager you may not feel comfortable talking to your parents about how you feel about sex. (At least, girls, carry a packet of condoms in your purse) If you are a parent you may wish to broach the subject but may not know how to go about it. Take heart, there’s a few modern books I found on Amazon that will come to the rescue- or at least ‘break the ice’ and provide accurate information that will do the job with or without the ‘awkward moments’.

With Christmas coming up, perhaps you could start with a gaily wrapped stocking filler?

The ones listed below are voted favourites with teenagers and parents alike. All the books cost less than $20 and I recommend that you browse through all the reviews first because you’ll probably want to buy more than just one. By the way, I’ve added a ‘rogue’ one at the bottom just in case!

Happy reading, happy chatting and happy adolescence!

The Teenage Body Book

The Underground Guide to Teenage Sexuality, 2nd Edition

Everything You Never Wanted Your Kids to Know About Sex (But Were Afraid They’d Ask): The Secrets to Surviving Your Child’s Sexual Development from Birth to the Teens

S.E.X.: The All-You-Need-To-Know Progressive Sexuality Guide to Get You Through High School and College

Ten Talks Parents Must Have with Their Children About Sex and Character

Dilemmas of Desire: Teenage Girls Talk about Sexuality

Young, Poor, and Pregnant: The Psychology of Teenage Motherhood