Contraception

Menstuff® has compiled information on the issue of Contraction.


Your Contraceptive Choices
A Couple’s Guide to What’s New In Birth Control
What's New in Birth Control: Here is an Easy-to-Follow Guide About New Choices
Continuous Abstinence
Outercourse
Sterilization
Norplant
Depo-Provera
The IUD (Intrauterine Device)
The Pill
The Condom
Nuva Ring
Filshie clip
Saran Wrap - A Warning
Withdrawal
The Diaphragm or Cervical Cap
The Female Condom or Spermicide
Periodic Abstinence or FAMs (Fertility Awareness Methods)
Contraceptive Effectiveness
You May Want Emergency Contraception
Ideal Success Rates of Various Forms of Birth Control
Newsbytes

Resources
Related issues: Talking With Kids About Tough Issues, AIDS, Bacterial Vaginosis, Blue Balls, Chancroid, Chlamydia, Condoms, Contraception, Crabs, Genital Herpes, Genital Warts, Gonorrhea, Hepatitis A, B, C, D, E, Impotency, Nongonococcal Urethritis, Pelvic Inflammatory Disease, Reproduction, STDS, Syphilis, Trichomoniasis, Yeast Infection

Your Contraceptive Choices

There are a number of contraceptive choices which may change throughout your life. To decide which method to use now, consider how well each one will work for you:

Here is some information to help you decide...

Continuous Abstinence

Women & Men: This means no sex play. This will keep sperm from joining the egg.

Effectiveness

Advantages

Possible Problems

Cost

Outercourse

Women & Men: This is sex play without vaginal, anal or oral intercourse. This will keep sperm from joining the egg.

Effectiveness

Advantages

Possible Problems

Cost

None

Sterilization

Women & Men: An operation to keep sperm from joining the egg.

Effectiveness

Advantages

Possible Problems

Tubal sterilization:

Vasectomy:

Cost

 

Norplant

Women: A clinician will put six small capsules under the skin of a woman's upper arm. Capsules constantly release small amounts of hormone that:

Removal can be done at any time but must be done by a clinician.

Effectiveness

Advantages

Possible Problems

Cost

Depo-Provera

Women: Your clinician will give you a hormone shot in your arm or buttock every 12 weeks to:

Effectiveness

Advantages

Possible Problems

Cost

Intrauterine Device (IUD)

Women: Your clinician will put a small plastic device in the woman's uterus. The IUD contains copper or hormones that:

Effectiveness

Advantages

Possible Problems

Cost

$150-$300 for exam, insertion, and follow-up visit. Some family planning clinics charge according to income.

The Pill

Women: The clinician will prescribe the right pill. Take one pill once a day. Complete one pill-pack every month. Combination pills contain estrogen and progestin. Mini-pills contain only progestin. Pills contain hormones that work in different ways.

Effectiveness

Advantages

#pillrisks Possible Problems

Cost

The Condom

Women & Men: Covering the penis with a sheath before intercourse to keep sperm from joining egg.

Effectiveness

Increase your protection:

Advantages

Possible Problems

Cost

Nuva Ring

Nearly fulfilling the persistent dream that is consequences-free sex, the FDA has approved a contraceptive vaginal ring that is 99% effective. Called Nuva Ring, it's better than playing with the 95% effectiveness of the Pill and 97% of condoms. FHM, 5/02

The only thing that the NuvaRing has in common with the diaphragm is that it sits in the vagina. They are not remotely similar forms of birth control.

Here is a site regarding the disaphragm: www.fwhc.org/birth-control/diaphram.htm This page describes how the NuvaRing works: www.nuvaring.com/Consumer/whatIsNuvaRing/index_flash.asp

Withdrawal

Women & Men: When the man pulls his penis out of the vagina before he "comes" to keep sperm from joining the egg.

Effectiveness

Advantages

Possible Problems

Cost

Diaphragm or Cervical Cap

Women: The clinician will fit you with a shallow latex cup (diaphragm) or a thimble-shaped latex cap (cervical cap). Clinician also will show you how to coat diaphragm or cap with Spermicide and put it in your vagina to keep sperm from joining the egg

Effectiveness

Advantages

Possible Problems

Diaphragm:

Cervical Cap:

Cost

Female Condom or Spermicide

Women:

Effectiveness

Advantages

Possible Problems

Cost


Periodic Abstinence or Fertility Awareness Methods (FAMs)

Women: A professional will teach you how to chart your menstrual cycle and to detect certain physical signs to help you predict "unsafe" days. Abstain from intercourse (periodic abstinence) or use condoms, diaphragm, cervical cap, or Spermicide (FAMs) during 9 or more "unsafe" days.

Includes:

Effectiveness

Advantages

Possible Problems

Cost


RU-486

Women:

Effectiveness

Advantages

Possible Problems

Cost


You May Want Emergency Contraception

Women:

Emergency Contraception

...is designed to prevent pregnancy after unprotected vaginal intercourse.
...is provided in two ways:

Don't use emergency hormonal contraception if you:

Consult your clinician about taking emergency hormonal contraception if you are:

Source: www.plannedparenthood.org/bc/CONTRACHOICES.HTM © Planned Parenthood® Federation of America, Inc.

Sarah Wrap - A Warning

Saran Wrap has often been recommended versus a dental dam for use in cunnilingus for its flexibility. However, it is recommended never to use Saran Classic or any other similar product which is designed for microwave use. It is said to be porous for possible transference of an STD.

Newsbytes


California Supreme Court Rules on Contraceptive Coverage

The California Supreme Court ruled on March 1st that Catholic Charities must provide its employees in California with medical coverage for birth control in spite of the organization’s religious objections to contraception. California state law requires employers - except "religious employers" - to insure their workers for contraceptives if they provide coverage for other prescription drugs. The court ruled that Catholic Charities does not count as a "religious employer" because it offers a range of secular services (such as counseling, housing and immigration services) to people of all faiths without directly preaching Catholic values.

Of the 20 states that mandate comprehensive coverage of contraceptives by all health insurers that cover prescription drugs, 12 have incorporated some form of religious exemption. Most allow "religious employers," variously defined, to opt out where the coverage would conflict with the employer's bona fide religious tenets.

Male Hormonal Contraceptive For U.S. Market

Pharmaceutical companies Schering AG and Organon said Thursday they aim to produce a marketable hormone contraceptive for men in five to seven years - a goal that has stumped researchers for decades.
Source: www.intelihealth.com/IH/ihtIH/EMIHC000/333/333/358327.html

Planned Parenthood Counseling Patients About Voluntary Recall of the Once-a-Month Injectable Hormonal Contraceptive Lunelle

Planned Parenthood is working with Pharmacia to quickly reach out to Lunelle users, instruct them to use a barrier method like condoms, and counsel them on other contraceptive options. Continue:
www.plannedparenthood.org/about/pr/021010_lunelle.html

Morning After Pills Covered In California

Gov. Gray Davis has ordered HMOs to pay for women's "morning-after" contraceptives, making California the first state in the nation to cover the pills.
Source: www.intelihealth.com/IH/ihtIH/WSIHW000/8799/22002/347923.html

Spermicide Promotes HIV

A common spermicide gel -- once thought to protect against HIV -- might actually increase the risk of HIV infection.

Several studies show that the ingredient nonoxynol-9 -- when used frequently in anal sex -- apparently can cause lesions that increase the body's exposure to HIV.

It's an issue that more than 85 health organizations and public health researchers have collectively become concerned about, says Lori Heise, director of the Global Campaign for Microbicides, the group spearheading the "Call to Discontinue N-9 for Rectal Use."

Forty-two percent of all condoms sold commercially in the U.S. are lubricated with N-9. In fact, N-9 has been used as a contraceptive for over 50 years, and manufacturers began adding it to condoms and lubricants in the mid-1980s when early research suggested it might offer some protection against HIV.

New research has proved that to be false.

"Too many consumers still have the belief that condoms with N-9 are actually offering them protection against STDs and HIV, when it may be increasing their risk when they use the condoms rectally," Heise said in a press teleconference.

The problem: Even the very small amounts of N-9 on condoms "has been shown to cause sloughing of the cell lining of the rectum, which creates portals of entry for the virus, increasing risk of STD and HIV infection for people who practice rectal sex," said Heise.

In fact, last fall the World Health Organization issued a strong cautionary statement against using N-9 products rectally. "They provided a clear, definitive statement that N-9 does not protect against STD and HIV transmission and should not be used for that," she added. "We're specifically asking manufacturers of sexual lubricants and contraceptives to discontinue adding N-9 to products. We're also asking retail outlets to discontinue stocking N-9 products."

For every product that contains N-9, manufacturers also provide another version of that brand with lubrication that doesn't contain N-9, she pointed out.

"This is extremely important for public health," said Heise.

Since last June, a number of companies have agreed to take N-9 out of products, including Mayer Laboratories. Johnson & Johnson does not produce condoms in the U.S., but the company's facility in Brazil has agreed to discontinue production of N-9 condoms, says Heise. Also, a Johnson & Johnson subsidiary makes a very popular line of KY lubricants -- KY-Plus -- that contain N-9. In July, Johnson & Johnson took action to stop production.

However, three of the largest condom manufacturers -- including the maker of Trojan brand condoms --have no plans to remove N-9 from their products, she added.

"Condoms are still the best way that sexually active individuals can prevent disease and pregnancy," says Vanessa Cullins, medical director of Planned Parenthood. "It's so important that the public understands that condoms are still the best protection against pregnancy and STDs. The issue is not condoms, it's N-9."

Should people throw out those at home -- or still use them -- if they do not practice anal intercourse? "People do not need to throw away their N-9 condoms as long as they are low-risk and as long as they are utilizing those condoms for pregnancy prevention," says Cullins.

"However, if that person is using them during anal intercourse -- or has sex multiple times during the day, or bought them to prevent STDs -- they should not use the N-9 condoms they have stored," Cullins adds. "That specific individual is at risk of increased transmission of disease."

In fact, the small amount of N-9 on a condom is insufficient as a contraceptive, says Heise. "It gets rubbed off as the condom enters the woman. There's a higher dosage in the type used with diaphragms, and you're putting it right against the cervix."

The FDA regulates both condoms and lubricants, and it is in FDA jurisdiction to remove the products from the market if necessary. "But as we know, the FDA doesn't often move quickly," said Heise. "Lubricants have been loosely regulated anyway, because they're viewed as cosmetic products."

"Because we saw the urgency, we wanted to work collaboratively with manufacturers, and not necessarily have to get the government regulators involved," she added. "If we're not able to achieve goals through voluntary action, we'll look at other schemes."
Source: By Jeanie Davis my.webmd.com/content/article/1689.53865

Ideal Success Rates of Various Forms of Birth Control
Perfect Use
Failure Rate/Typical Use*

General Methods

.

.

Abstinence **
100%
60-88%

Chastity belt
100%
99%*

No Protection
10-20
80-90

Withdrawal
96
25

Rhythm Method
90
15-25

Outercourse
100%
*

Medical Methods

.

.

The Pill (female) ****
99.5-99.9
7.5

Emergency Contraception (female)
99
3-5

Gels and Foams
95
15

Genital Devices

.

.

Male Condom
98
14

Female Condom
97
10-15

Cervical Caps and Diaphragms (female)
98
10-15

IUD - Mirena
99+
4

IUD - Paragard
99
4

Shot - Depo Provera
99+
NA

Patch - Ortho Evra
99
NA

Ring - Nuva
99
NA

The Sponge (female)
95
15-20

Surgery-Sterilization

.

.

Vasectomy (male) ***
99+
0.15

Tubal Litigation (female)
99.5
0.05

Filshie Clip (female)
99+

 

* Recognizes that 100% proper application and use is not always attained. In order to achieve the Ideal Success Rate, the method must be used on 100% of all occasions. The belt only requires a good locksmith.
** Higher failure rate than all other forms of birth control with the possible exception of no protection at all.
*** Note: We expect that castration would show similar results.
**** Depending on formulation. Sources: Perfect use--Hatcher, RA, et al., Contraceptive Technology, 17th ed., 1998, page 216. Typical use--AGI, Fulfilling the Promise: Public Policy and U.S. Family Planning Clinics, 2000, page 44.
Source of most of the information: www.guttmacher.org/pubs/spib_SE.pdf  

*    *    *

Condoms are easier to change than diapers and fail less often that abstinence.

Contraceptives should be used on every conceivable occasion. - Spike Milligan

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