Female and Male Contraception (Birth Control)

There are basically two different kinds of birth control, and I will demonstrate all of them to you in a little bit. The first type I will talk about is hormone-containing birth control. And so far, we only have options for women. There are some options for men that I think will be ready in the future, there’s a lot of research going on in this area, but right now we only have hormonal birth control or contraception for women. In general, these hormonal methods prevent the release of an egg from the ovary. It’s called ovulation. So ovulation is prevented with these types of birth control. And another way that they work is they make the uterus an “unfriendly” environment for the sperm. All of them are 99% effective; however, it’s important to emphasize that they do not protect against HIV or other Sexually Transmitted Infections (STIs). And then the other type that I will be talking about after that is barrier methods, and you will see those demonstrated.

The hormone patch

Let me start out with the patch. This is the hormone patch, it’s about this big. The woman puts it on her skin – she needs a prescription, and the health provider who prescribes it for her will show her where to put it and how to apply it. It’s applied for one week at a time for three weeks in a row, and then for one week, week number four, she will not use the patch and that is the time when she will have her period. If she wants to get pregnant, it usually takes a few cycles after she has stopped using the patch before she can get pregnant. And again I do want to emphasize that it does not protect against HIV and Sexually Transmitted Infections (STIs).

Birth control pills

The other option that I think most people know is birth control pills. Basically, you take one pill pretty much at the same time every day, and the first three weeks are the white pills, and then week number four are the pills that have no hormone in them, and this is when you have your period. I do want to mention that there are a lot of different types of these pills available, in all kinds of combinations with different hormones and different dosages. And sometimes women experience some side effects with using the pills, that maybe their interest in sex is reduced. If that happens to you, let your health provider know because maybe you will have to switch to a different type. You can’t tell in advance, this is simply something that you have to try out, but if the pill is bothering you for any reason just let your health provider know and you can try another type. So again, you need a prescription, and again they also do not protect against HIV and STIs.

Injections

You can also get injections – shots – with hormones. And again it’s 99% effective, and you can either get a shot every month or every three months, and it’s a health provider, of course, who has to do that, you need a prescription. And it’s a very good method for younger women who do not want to get pregnant right away. It can sometimes take up to a year after you’ve been on these injections to get pregnant. They also, of course, do not protect against HIV and STIs.

The intrauterine device

Now the intrauterine device – unfortunately, I don’t have a sample that I can show you, but I made this little drawing for you that you hope will be able to see. This is the uterus. The intrauterine device, also called IUD, is fairly small – it’s really half of a Q-tip, that’s about the size. It’s a little “T” and the arms up here are flexible, and there’s a little string hanging out so that the health provider can pull it out when you’re ready to have it removed. So a health provider has to insert it and also remove it, and it doesn’t hurt much – it’s just a small, almost crampy feeling when it’s inserted. It’s very quickly inserted and sometimes women find that after they have it inserted their period might be a little bit heavier for a while – but that’s something that usually resolves fairly quickly. The way that the IUD works is it creates an unfriendly environment for the sperm and the egg to implant, and it prevents pregnancy this way. There are two types available right now in the United States. One contains hormones and usually that can be left in up to five years. The other type contains copper, and that can be left in for about ten years. And so they’re not cheap – they’re several hundred dollars – but if you look at the time frame, where you do not need any other birth control, many women choose this option. And I think it’s a very good option for women who maybe have had all of the babies that they wanted, but they are not quite ready to have their tubes tied yet. So it’s certainly an option that you can look into if you are in that category of women. And again, of course, they do not protect against HIV and other Sexually Transmitted Infections (STIs).

The vaginal ring

The next option is the vaginal ring. It is also 99% effective, and it releases hormones. This ring is inserted once a month and it’s left in for three weeks. So then it is placed all the way up in the vagina, around the cervix, and again your health provider will show you – you need a prescription for this and they will show you how to put it in and how to get it out again. So you leave it in for three weeks, and then for one week you do not use the ring at all. This will also protect you from becoming pregnant. And again, it does not prevent STIs and HIV.

Now if someone has had unprotected intercourse – for instance, has used a condom and it broke or has been raped, you can get emergency contraception. And in the United States, it’s called Plan B. There are two pills in here – you need a prescription – and you can take the first pill up to 72 hours after you’ve had unprotected intercourse, and when you take the second pill 12 hours after that. And what this will do is it will prevent the pregnancy from happening after you have had intercourse. This is called emergency contraception – it’s only to be used if you’ve had a case of unprotected intercourse that was not planned, and it shouldn’t be used as a usual method. It should be considered emergency contraception.

The barrier methods

Now let’s talk about the other methods – the barrier methods. All of the ones that I just mentioned have hormones in them, and that’s how they work and how they are effective. All of the other methods that I’m going to talk about now are the so-called “barrier methods” – these work in different ways; first of all, by providing a barrier against the sperm – the sperm won’t be able to get the egg. And also some of them interfere with sperm movement – they stop the sperm. And again, some of them create an unfriendly environment for the sperm.

The male condom

So let’s look at the first one, which is the male condom. And that’s really one of the only options we have so far for men. Most of you know there are lots and lots of condoms available – they come in all kinds of sizes, colors, textures, and they are easy to buy over the counter. Let me just demonstrate how you use a condom. First of all, you want to know which side is up and which side is down, and then you want to hold it and press the air out of the top. I’m just going to demonstrate this vibrator. You hold it on and then roll down the condom all the way to the base of the penis. So this has to happen on an erect penis. Some people don’t like that it interferes with their sex play, but you can actually make it a fun part of your love play, and you can have your partner put it on. And I always tell women, don’t count on your boyfriend bringing the condom along – have some on your own, be sure to have some condoms yourself. Condoms – very important – do prevent HIV and other Sexually Transmitted Infections, so it’s very important to use condoms, and many, many people combine condoms with other birth control methods as well.

Female condom

There also is a female condom, and the type that is out here in the United States comes with a nice brochure on how to use it, but I would like to show it to you since a lot of people are not familiar with the female condom. This is basically how it looks – there are two rings, and the smaller ring is inserted – you simply insert it into your vagina, and the larger ring stays on the outside. You can insert this up to 8 hours before you are having intercourse. The penis goes in here, and this part stays on the outside and it protects you from becoming pregnant. It also, just like the other condom, the male condom, will protect from Sexually Transmitted Infections and HIV unless it, for some reason, breaks or slips out – it will work just as well.

Dental dams

Now, if you like to have oral sex with your girlfriend, you can use dental dams. They come in packages with instructions. You basically hold this on the clitoris, the clitoral area, wherever you want to stimulate orally, and you can suck and lick and whatever you like to do with this dental dam. The reason it’s called dental dam is that it was originally used in dental offices. It’s very good for oral sex if you want to make sure that you use safer sex methods. So those are dental dams.

Spermicides

Then I would like you to see spermicides. Those are just 94% effective, and a lot of people use them in connection with other methods. They actually come in a variety of forms – there’s foams, jellies, creams. This sample here is vaginal suppositories, so basically you just take one of these – your finger goes on here – and you can insert it into your vagina and it will dissolve and it will kill the sperm. That’s why it’s called spermicide. But usually, it’s best to combine these with some of the other methods as well. And again they do not protect against HIV and other STIs. And you shouldn’t insert them too early – just shortly before you have intercourse.

The diaphragm

The diaphragm – I brought in a couple of sizes – they come in a lot of different sizes, and you actually need to see your health provider who needs to write a prescription and will fit you. They will try different rings because each woman is different. And actually, after you have had a baby you will have to be refitted because the cervix changes. And again, spermicide cream is put on the inside and on the outside. It’s easy to insert these, and then it goes around the cervix pretty much and provides a barrier and makes it unable for the sperm to enter the cervix. So this is called a diaphragm.

The cervical cap

And then the last option is the cervical cap. It’s almost like the diaphragm but it’s a little bit smaller. It’s pretty much used in the same way. It’s not quite as effective – if you’ve had a child it’s only 84% effective, and it’s 91% effective if you have not had a child, and the reason is that the cervix changes a lot after you’ve gone through delivery. And again, I’m repeating myself here, but I do want to emphasize that it does not protect against HIV and other Sexually Transmitted Infections. Really the condom is the only method we have the does protect against HIV and STIs, so it’s a good choice always to bring a condom along.

Finally, if the person, man or woman, has made up their mind that they don’t want to have any more children, they can have surgery. It’s called sterilization, and that option is more than 99% effective. For women it’s called having their tubes tied – it’s also called tubal ligation. Basically what the surgeon does is he ties the tubes that go from the uterus to the ovaries – they are tied off so that the egg can no longer be transported into the uterus and the sperm cannot get up to meet the egg. For men it’s called vasectomy, where the vas deferens is cut and the sperm can no longer be transported either. This is a permanent and irreversible technique, so you really have to give it a lot of thought ahead of time whether you want to do this or not. And this a lot of times is individuals who have had all of the children that they want to have – it’s a good method for those people, and it’s something that you should definitely discuss with your husband or wife.

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