Sexuality - Birth control

Birth control has had a dual purpose in recent times, specifically where condoms are concerned. Preventing an unwanted pregnancy goes hand in hand with preventing the spread of sexually transmitted diseases, including HIV. There are many forms of birth control, or contraception, available but none offer 100 percent protection against STDs, including condoms. Ideally, both partners should be tested for HIV and STDs before engaging in a sexual relationship so that their options for birth control widen and are not limited to the condom.

Condoms

A condom is a sheath that fits snugly over the penis. The reservoir at the tip of the condom collects the semen that is ejaculated, thus preventing it from entering the vagina. Condoms are the easiest, safest, and most commonly used form of birth control. Latex condoms that are spermicidally lubricated are the most effective. Spermicidal lubricant, such as Nonoxynol-9, kills any sperm that might leak out of a condom. Some people have latex allergies; for those individuals, condoms are available in other compositions; however, they are not as effective in preventing pregnancy or the transmission of STDs as latex condoms.

Condoms are widely available, at drug and convenience stores and even supermarkets. Both sexes can purchase them; this helps both partners share responsibility for birth control. Condoms are a good way to ensure that one is always prepared (in terms of birth control) for a sexual encounter.

It is a myth that condoms lessen sexual pleasure. If one or both partners are uncomfortable using condoms, each should be tested for STDs, including HIV, and then discuss other birthcontrol options with a counselor or physician.

The female condom, which is similar to traditional condoms, is also available. It is placed inside a woman and it lines her vagina and blocks her cervix.

The Pill

Another common form of contraception is the birth-control pill. There are several types of birth-control pills, available by a physician's prescription only. Most common is the combination pill (which employs a combination of different

hormones). This type of birth-control pill works by inhibiting the development of the egg in a woman's ovary. In other words, the ovaries remain somewhat inactive, which is similar to how a woman's body behaves when she is pregnant.

Birth-control pills are the most effective form of birth control (aside from abstinence) and are used by millions and millions of women throughout the world. However, the pill does not offer protection against sexually transmitted diseases (STDs), which leaves many women at risk for HIV and other diseases like herpes. Furthermore, the dangers of taking the pill (such as heart attack, stroke, or embolism—a sudden obstruction in a blood vessel) can be intensified by family and personal health histories and lifestyle. (It is advised that smokers over the age of thirty-five should not take the pill.) Always discuss possible side effects with a doctor. Most experts agree, however, that the possible dangers involved with an actual pregnancy and delivery outweigh the possible dangers presented by the pill. For most people, in consultation with a doctor, the pill is considered safe.

Some women have other issues with the pill, including nausea from the increased hormones, weight gain, irritability, migraines, depression, and a reduced sexual desire. These side effects usually decrease after a few monthly cycles of taking the pill. As with any prescription product, some have a great deal of difficulty with the pill while others experience no difficulty at all.

There are many pros and cons to taking birth-control pills, and these should be weighed carefully against a woman's lifestyle and health before deciding to use them.

Diaphragm

A diaphragm is a soft, round, rubber cup that fits over the cervix. It works by keeping the sperm out of the uterus. A doctor must measure a woman's cervix and prescribe the proper size diaphragm for her.

Diaphragms are used in conjunction with spermicidal jelly and are inserted thirty minutes prior to intercourse. The diaphragm must be left in place for several hours afterward. Many women enjoy diaphragms as they offer the freedom that is similar to pill usage. However, some women find diaphragms to be messy (because of the spermicide) and difficult to insert. Furthermore, the effectiveness rate is not as high as that of the pill and, unlike the condom, diaphragms offer no protection against STDs and HIV.

Cervical Cap

A cervical cap looks like a thimble with a rim. It fits over the cervix just like a thimble fits over a finger. It comes in four different sizes, and must be fitted to the user by a doctor. The cervical cap works as a diaphragm does, blocking the cervix.

Drawbacks to the cap are that it does not allow free flow of cervical fluid, which can lead to odor and infection in certain wearers. Also, like the diaphragm, the cervical cap can be difficult to insert and remove and it offers no protection against STDs, including HIV.

Intrauterine Device

Intrauterine devices (IUDs) are small devices placed in the uterus to prevent pregnancy. Though it is not known how IUDs work precisely, it is believed that they prevent fertilization. Usually comprised of plastic (copper IUDs are no longer common), most contain a synthetic hormone, often progesterone, that helps prevent pregnancy if the IUD exists in the body at a constant rate throughout a woman's entire cycle. IUDs are decreasing in popularity and are controversial as they have been known to affect fertility (the ability to become pregnant) and cause other health problems, such as rejection of the device by the body and damage to the uterus. Another drawback to IUDs is that they must be implanted and removed by a physician. Furthermore, IUDs offer no protection against STDs and HIV.

Norplant

Norplant is a contraceptive device that involves a set of thin, match-size capsules containing hormones that are implanted just under the skin of a woman's upper arm. Effective for approximately five years, Norplant has a high success rate in preventing pregnancy. Since it is implanted in the woman's arm, the woman is protected twenty-four hours a day and there is no chance of forgetting birth control (as with the pill, condoms, or the diaphragm). However, it offers no protection against HIV and other STDs; further, Norplant has many risks associated with its use, including irregular menstruation, headaches, weight gain or loss, benign (noncancerous) ovarian cysts, depression, and acne. Smokers or women with a history of certain health problems should not use it. Finally, Norplant is a very costly method of birth control (it can cost hundreds of dollars for insertion and removal is also expensive).