MALE CONTRACEPTIVE OVERVIEW
EXCERPTS FROM MODERN BIRTH CONTROL – Above options and Permanent Options including Tubal ligation & Vasectomy
The condom is a thin sheath worn on the penis during sexual intercourse to prevent semen from entering the vagina and to protect against sexually transmitted diseases. They are single use only, made from numerous materials and are available broadly. Condoms are safe and effective if used correctly. Each one is individually packaged, ready to roll onto a firm penis. There is a reservoir on the tip to collect expelled semen. The rim should be on the outside. Be sure to have the correct side out. – After sex, remove the condom carefully, keeping semen inside to discard. Instructions on use and safe removal can be found at: www.plannedparenthood.org Cost ~$1.
Unfortunately, there are no birth control pills for men and none likely in the near future. An injectable product used to block the duct carrying sperm from the testes to the penis is being researched. It is not expected to be available for a couple of years. To reverse the blockage requires a second procedure.
The days a woman is fertile and capable of becoming pregnant are predictable if the woman’s menstrual periods are regular. Using the calendar rhythm method has some value, along with measuring a woman’s body temperature. These procedures are commonly used when a couple is trying to become pregnant. However, if you absolutely want to avoid pregnancy, this method is risky.
Withdrawal of the penis before ejaculation sounds like an efficient method of contraception, but 4% of women will become pregnant/year even if done correctly. It is difficult to know the exact moment before ejaculation. Because of this difficulty, the failure rate is closer to 25% per year. Fluid that can contain sperm may escape prior to ejaculation and result in pregnancy. Obviously, with this there is no protection against STDs.
National surveys report “natural contraception” as the least effective method of birth control.
* Forgotten pills – Be sure to follow instructions from your physician if you missed a pill and had unprotected intercourse.
* Breakage or slippage of condom/other barrier methods
* Taking a course of antibiotics blocks contraceptive effect of pill, patch and vaginal ring, putting you at risk for unplanned pregnancy unless an additional method is used throughout the month when antibiotics are taken. Check with doctor or pharmacist for guidance.
* Douching (washing out the vagina): By the time you do this, sperm are likely to have already entered the uterus.
* Use of creative condoms such as plastic wrap or a plastic bag
* Use spermicide without a barrier method
* Use lubricant that damages condom
* Positional changes: Do not prevent sperm from reaching the uterus
EMERGENCY CONTRACEPTION OVERVIEW
Emergency Contraception (EC) can be used to reduce pregnancy risk following unprotected intercourse or unexpected situations such as a broken condom. To be effective, EC must be used soon after intercourse and will not be effective if pregnancy has already occurred.
If you are raped Emergency Contraception is recommended. (See: Sexual Assault)
An emergency contraceptive prevents pregnancy. It does not cause an abortion (pregnancy termination).
This so-called “Morning After Pill” has many forms. For example Plan B, One-Step, My Way and others. They are available over the counter, without prescription. There are no point of sale restrictions.
This hormone stops or delays ovulation and is best taken within three days of unprotected intercourse. It will not end a pregnancy. Talk with a pharmacist for information and side effects. Cost: ~$40.
This prescription medication delays or prevents ovulation. It can be taken up to 5 days after unprotected intercourse. (It is thought to be more effective than either progestin-only or the combination hormone pill containing both estrogen and progestin.) Cost: ~$40-$60.
These pills contain both estrogen + progestin. It is taken in two doses and results in delayed ovulation. For dosage consult with physician or pharmacist. Information may be found at www.not-2-late.com a Princeton University web site. Cost ~$30
If you are overweight or obese effectiveness of EC pills is reduced. Insertion of a Copper IUD is effective. Must be inserted by a health practitioner. (Review more information above: Copper IUD) Cost: variable. May be free at Planned Parenthood clinics. Provides contraception for ten years.
First trimester abortion, ending a pregnancy during the first twelve weeks after conception, is a legal right.
After the advent of birth control pills, improved education, and more options for contraception, pregnancy rates fell, as did the number of abortions. There are still times when women decide to end a pregnancy and they have that right, but some people disagree even when she is the victim of violent rape or incest.
Prior to abortion legalization under Roe v. Wade in 1973, women were forced to go to untrained abortionists, or aborted themselves using all sorts of objects including knitting needles and rug hooks. Often, they died of infection and hemorrhage.
Safe abortion is legal, now, and doesn’t usually require a surgical procedure. In 2000, the Federal Drug Administration (FDA) approved RU-486, the first oral medication to induce abortion. A newer, lower dose drug, Mifeprex (mifepristone), is now available. The FDA recently lengthened the duration of time it can be used to 70 days (10 weeks) of gestation. This is measured from the first day of the woman’s last menstrual period.
Mifepristone blocks progesterone cell receptors, a hormone important in maintaining pregnancy. The drug is used in combination with misoprostol to complete the abortion.
Misoprostol is given after mifepristone to induce uterine contractions, soften and dilate the cervix. There will be significant cramping and bleeding when the abortion occurs and a follow-up visit with a practitioner is necessary.
* Patient receives counseling, signs an agreement form, and is given a copy of the FDA Mifeprex Medication Guide.
* A certified healthcare provider dispenses the medications.
* Mifepristone, 200 mg, is taken by mouth.
* 24-48 hours later, misoprostol, 800 mcg, is taken as directed.
This method is 98% effective. If the abortion is incomplete, a surgical procedure may be necessary. See www.fda.gov/drugs/ for more information.
Surgical sterilization procedures are very effective and convenient for permanent long term contraception. Both tubal ligation in women and vasectomy in men have been reversed, but this is uncommon and may not be successful.
If you are considering a sterilization procedure, consultation, discussion of other options, and firm conviction it is the right procedure for you, are all important. Sometimes surgical sterilization is an easy decision, for example, when an individual carries a serious or harmful genetic trait he or she does not wish to pass on to children. Other times, possibly for a woman’s health, when medical problems make pregnancy problematic or life-threatening.
If you have thoroughly considered your options, and proceed to permanent sterilization, you should have no remorse. However, even though surgical sterilization is effective, it is important to always use a condom if you are not in a long term monogamous (one person) relationship with someone who you trust to be free of STDs.
Tubal ligation (“tying” the fallopian tubes) – This is typically a same-day surgical procedure and is effective immediately. Tubes are usually cut and tied, preventing sperm access to an egg.
Trans-cervical Sterilization – This is a non-surgical method to produce permanent sterilization by blocking the tubes. A device is threaded through the cervix and into each fallopian tube where it lodges and stimulates scar formation that prevents sperm from reaching an egg. It takes about three months for tissue to grow and close the tube. Then, an additional test must be done to determine if the tubes are fully blocked.
Vasectomy is an outpatient surgical procedure that cuts the tube that carries semen and sperm (the vas deferens), connecting the testes to the penis.
Ejaculation remains normal, but it takes about 12 weeks for semen to be free of sperm. Another form of contraception must be used until the follow-up sperm count is zero. A condom is still recommended to prevent sexually transmitted diseases.
There will be two more blogs with book excerpts. The next one on Sexually Transmitted Infections, STIs. This section is particularly important. Some of these diseases can cause sterilization due to Fallopian tube scaring or death as with hepatitis and HIV. Most are treatable and curable, but there are some drug resistant forms. It is essential to be quickly treated and a followup culture done to assure the cure.
Betty and Bev, The Lipstick Logic Sisters