Contraception

During intercourse, if the man’s spermatozoid enters the woman’s ovum, conception takes place. Contraception means “against conception”, therefore contraception means stopping the spermatozoid from penetrating the ovum in order to avoid pregnancy. During intercourse, one must also be protected from sexually transmitted infections (STI), which were called sexually transmitted diseases (STD) in the past.

The use of a double contraception method is assuredly the most efficient. For example, using a condom, the best protection against STI, combined with a second method to avoid undesired pregnancy, results in a very efficient contraceptive method.

There are many contraceptive methods. Choosing the one better suited to your needs is important. Here is a brief survey of the most frequently used methods.

Condom for men

This condom is a latex or polyurethane sheath preventing the man’s fluids, specifically the sperms, to be in contact with the vagina. During intercourse, it is the best protection against an undesired pregnancy and STI. The use of a lubricated condom or a water-based lubricant (saliva, KY gel) is recommended. The use of a spermicide is also recommended to achieve better protection. Maximum protection requires a good application technique. Costing very little, condoms for men are easy to find; they are sold by many retailers (pharmacies, convenience stores, grocery stores, etc.). Be cautious though: some people are allergic to latex; in this case, polyurethane condoms are proving to be a good alternative.

Condom for women

The woman’s condom, a cylindrical polyurethane sheath, is inserted in the vagina as long as eight hours before intercourse. It holds the sperm, preventing its penetration in the vagina. It is the only method entirely controlled by the woman which protects her against undesired pregnancy and STI. Since some women experience problems in inserting it correctly, it is important to remind users that maximum protection requires a good application technique. Also note that a certain rustle can be heard during intercourse. Like in the case of men’s condoms, the polyurethane condom can be used by people allergic to latex.

Intrauterine contraceptive device

The IUD is a small T-shaped device inserted inside the uterus and requires a prescription and a visit to the physician who will insert it. Its protection can last as long as five years. Contrarily to what is generally thought, it can be used by women who never had children and does not increase the risk of infertility. It is recommended to breast-feeding women, women facing a very low risk of contracting STI or who cannot use hormonal contraception (containing an oestrogen and a progestin). It is a good protection against undesired pregnancy, but not against any STI; the combined use of a condom is therefore necessary.

Intrauterine hormonal device (Minera®)

This device is in fact an intrauterine contraceptive device liberating progestin into the uterus, in order to prevent undesired pregnancy for a period up to 5 years. For some women, the presence of the progestin may diminish menstrual pains and bleeding. Just like the IUD, it can be used by women who never had children and it does not increase the risk of infertility. It is expensive and requires a prescription and must be inserted by a physician. It offers no protection against STI, therefore it must be combined with the use of a condom. Due to the presence of the progestin, there may be undesirable side effects: irregular bleeding, “spotting”, absence of menstrual periods, etc.

Hormonal contraceptives

Hormonal contraceptives contain either oestrogen and progestin, or progestin only. They prevent ovulation and/or make it more difficult for the fertilized ovum to attach to the uterus. They allow for a more regular menstrual cycle, reduce bleeding, decrease acne and protect against some cancers. They offer the best protection against undesired pregnancy, but none against STI, therefore the combined use of a condom is necessary. They are easy to use, but require a prescription and an annual visit to the physician. They can cause some undesirable side effects such as irregular bleedings, an increase in breast sensitivity, weight gain, headaches, nausea and vomiting. These symptoms generally disappear with time. Side effects that persist over three months may signal an inappropriate concentration or combination of hormones. Then, it is recommended to consult the physician or the pharmacist. Hormonal contraceptives are offered in various forms: tablets, injections, patches, rings, etc. Talk to your doctor or pharmacist about the advantages and disadvantages of each.

When these methods are not suitable, there are other alternatives:

• contraceptive sponge
• diaphragm
• cervical cap
• Lea contraceptive
• Ligature of the uterine
• tubes/vasectomy
• withdrawal method
• calendar method
• use of spermicidal agent

Talk to your physician or pharmacist about these methods.

Emergency oral contraception : OOOPS!

EOC is a contraception method to be used after a sexual relation putting you at risk of a pregnancy. It is the last chance to avoid an undesired pregnancy. EOC must be taken within 5 days following the sexual relation, but preferably as soon as possible, since its efficacy is higher during the first three days. Unpleasant side effects can develop such as nausea and vomiting. It is important to mention that EOC is not a birth control method. It is a buoy, an ultimate solution. The most know is the Plan B brand.

• EOC is indicated if:
• you have had unprotected sex;
• you have been forced to have unprotected sex or woke up to the realization that you had sexual intercourse;
• your partner did not withdraw himself in time;
• the contraception method used failed (e.g.: the condom broke or slipped);
• you have forgotten to take your pill during at least 2 days following intercourse or have started a new cycle with a delay of 2 days.

You can purchase the EOC from a physician, in a walk-in clinic, a CLSC or from a pharmacist.

The Website www.sexualityandu.ca is an excellent source of information.

The health information contained herein is provided for educational purposes only and is not intended to replace discussions with a healthcare provider. All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient. Links to other sites are provided as a convenience to the viewer. PROXIM accepts no responsibility for the content of linked sites.