The male condom
Be careful about buying condoms in shops and from vending machines,
where they are often stored in unhygenic environments and conditions.
Vending machines selling condoms in the UK and Ireland are especially
problematic, as they are often on the walls of bars and toilets,
where temperatures and conditions are unsuitable and detrimental.
Buying online is a convenient and safe way to buy condoms.
The male condom can offer
effective contraception and some protection against sexually transmitted
diseases, including HIV infection. It is always advisable
to use condoms, to help prevent the spread of stds and avoid the
risk of unwanted pregnancy. Don't ever have sex with a stranger
without using a condom. Also be sure to use a condom if you suspect
that your partner might be abusing intravenous drugs.
The male condom is made of thin but strong rubber and is designed
to fit over the man's erect penis. The condom needs to be carefully
used because, if it splits or breaks, sperm can enter the vagina
or anus and possibly lead to stds or unwanted pregnancy.
If you have an accident with a condom see your doctor as soon
as possible. The doctor can examine for any signs of
stds and prescribe the morning after pill to help prevent pregnancy,
if applicable.
The condom is up to 98%
effective in preventing pregnancy. Effectiveness is higher with
careful use and if spermicide is used.
This is sold in pharmacies and online under the name Femidom. It is one
of the newest types of contraceptive, to be used by women. It can
be put in place before sex and is inserted in the vagina until a small
ring at one end reaches the neck of the womb. Using
a spermicide as well increases effectiveness.
One of the disadvantages is that it is relatively expensive. Also
if used incorrectly the penis can slip between the condom and the
vaginal wall, leaving you unprotected.
The Pill
The pill is one of the most widely used contraceptives among women, as
it is easy to take and is highly effective. It is available only on
prescription from a GP or doctor at either the family planning clinic
or maternity hospital. The pill comes in two different types:
The combined pill
This combined pill is 97%-99% effective. It contains two hormones,
oestrogen and progesterone, which will act to prevent an unwanted
pregnancy. Even with long-term use, your ability to have a baby
later on will not be affected. It can also help in regulating periods,
making them less heavy and can reduce pre-menstrual syndrome symptoms,
in some patients.
Your doctor should take a full medical history before prescribing
the pill because in rare cases it can increase a person's chance
of blood clotting. Also it may not be suitable for women with
certain medical conditions or those who smoke and are over 35 years
of age.
Patients take one pill every day over 21 days, with a seven
day break when they don't take any. It's necessary that its
taken at the same time each day as it's not reliable if
taken more than 12 hours late.
If you miss a pill or experience vomiting or diarrhoea, it is important to use extra protection such as a condom. Consult the leaflet that comes with your box of pills or discuss with your chemist or doctor if you are unsure what to do.
The prescription is renewed every six months when your blood pressure, breasts and urine are checked.
The Progesterone-only pill
This pill is also called the mini pill. It contains only one hormone,
progestogen. It is suitable for women who cannot take the combined
pill, those aged over 40, smokers and breast feeding mothers.
You take the pill every day with no break between courses.
Used carefully it is up to 99% effective. However, if you miss
a pill or have vomiting or diarrhoea, it is important to use extra
protection such as a condom. Consult the leaflet that comes with
your box of pills or discuss with your chemist or doctor if you
are unsure what to do.
Injectable contraception
The hormone progesterone is given by injection every 12 weeks. It is
over 99% effective. It is most suitable for women whose priority is
an effective, simple to use method. However, after the last injection
there may be a delay in the return of regular periods and your fertility.
Latest developments
Implants - these are small tubes placed under the skin which release the hormone
progesterone into the bloodstream. It can last for up to five
years. It is inserted by a GP or family planning clinic. Periods may
become irregular or heavy and removal of the implant may be difficult.
It is reported to be highly reliable. These are still not available
in many countries however there are plans to introduce them in the
UK and Ireland.
Emergency contraception
It is still possible to prevent pregnancy after unprotected sex. The
emergency pill or the morning after pill
as it is more commonly known can be taken up to 72
hours after intercourse and it is over 95% reliable. Side
effects may include nausea. It can be obtained from a GP or family
planning clinic.
Diaphragms and caps
Many women opt for one of these two types of contraception because they can be
used only when needed. Both the diaphragm and the cervical cap are
made of soft rubber. They work by providing a barrier at the entrance
to the womb and can be inserted before sex but should not be removed
for at least six hours afterwards.
You must be fitted for a diaphragm/cap by a doctor or nurse
who will show you how to put it in. It should feel comfortable
when in place. You will also be given a spermicide to use. Not all
doctors are trained in fitting diaphragms/caps and so you may need
to be referred to one who is.
The diaphragm should be checked if your weight goes up or down by about 7lbs or after a pregnancy.
It is 95% effective when used carefully and with a spermicide.
Spermicide
Spermicide is a chemical which destroys sperm. It is available as a cream, jelly,
foam or pessary. Spermicide is not effective as a contraceptive
method on its own. Some male condoms are lubricated
with spermicide, but it is strongly recommended that you use extra
spermicide as well as the condom.
Spermicide gives extra protection against pregnancy and some sexually
transmitted diseases. However the use of certain spermicides such
as nonoxynol are not recommended for anal sex, as they can irritate
the internal lining, and increase the susceptibility to HIV
infection.
Spermicide is applied as near as possible to the cervix before intercourse. Pessaries are inserted with your finger, while jelly, cream and foam are inserted with an applicator.
The IUD (COIL)
The IUD or coil is a small plastic device which is fitted inside the womb
by a doctor and lasts for about five years. It is most suitable
for women who have had children. It is not recommended as the
first choice for young women. It is not suitable for women who
have a history of pelvic infection, previous ectopic pregnancy (outside
the womb) or abnormalities of the uterus. It may also be inadvisable
for women with multiple partners or whose partner has multiple partners.
It is very effective but can occasionally become misplaced. The doctor will show you how to feel the threads attached to the IUD to make sure it is still in place.
Some women get heavier, more painful periods while using an IUD. It is possible to become pregnant while the IUD is in place, so if you miss a period you should have a pregnancy test. If you are pregnant the IUD should be removed as if it remains in place there is a risk of miscarriage.
Not all doctors are trained to fit IUDs so you may have to be referred to another doctor or family planning clinic. It is 95%99% effective and again spermicide improves efficiency.
Sponge
This is a polyurethane foam sponge which contains spermicide. It is inserted
into the vagina, covering the entrance to the womb and is effective
for 24 hours. It must be left in place for 6 hours after intercourse.
It has a high failure rate and some women may
be allergic to the spermicide. It must be removed after
30 hours.
Female sterilisation
This is becoming more widespread as a form of contraception in the UK and Ireland,
particularly for couples over 40. It is a permanent form of contraception
and is for people who are sure they do not want any more children.
Careful consideration should be given before a decision is
taken.
Sterilisation involves a woman's Fallopian tubes being cut
or sealed. It is virtually 100% effective but there are very
occasional failures when the tubes rejoin.
Male sterilisation - vasectomy
Male sterilisation, known as vasectomy is a minor operation in which the two
vas deferens (one on each side ) which carry the sperm from the
testicles to the penis are cut and blocked.
Again it is virtually 100% effective but there are very occasional failures when the tubes rejoin. As with female sterilisation the operation is regarded as final and careful consideration should be given before a decision is taken to opt for a vasectomy.
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