Contraception
What are the various methods of contraception and their effectiveness rates?
% of women experiencing an accidental pregnancy in
the first year of use
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Lowest Lowest
Method Expected Typical Reported
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Chance 85 85 43.1
Spermicides 3 21 0.0
Periodic abstinence 20
Calender 9 14.4
Ovulation Method 3 10.5
Symptothermal 2 12.6
Postovulation 1 2.0
Withdrawal 4 18 6.7
Cervical Cap 6 18 8.0
Sponge
Parous women 9 28 27.7
Nulliparous women 6 18 13.9
Diaphragm 6 18 2.1
Condom 2 12 4.2
IUD
Progestasert 2.0 3 1.9
Copper T 380A 0.8 3 0.5
Pill
Combined 0.1 3 0.1
Progestogen only 0.5 3 1.1
Injectable progestogen
DMPA 0.3 0.3 0.0
NET 0.4 0.4 0.0
Implants
NORPLANT (6 capsules) 0.04 0.04 0.0
NORPLANT (2 rods) 0.03 0.03 0.0
Female sterilization 0.2 0.4 0.0
Male sterilization 0.1 0.15 0.0
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Associated Risk statistics with Contraception
Activity Chance of Death in a Year
Risks for men and women of all ages who participate in:
Motorcycling 1 in 1,000
Automobile driving 1 in 6,000
Power boating 1 in 6,000
Rock climbing 1 in 7,500
Playing football 1 in 25,000
Canoeing 1 in 100,000
Risks for women aged 15 to 44 years:
Using Tampons 1 in 350,000
Having sexual intercourse (PID) 1 in 50,000
Preventing pregnancy:
Using birth control pills
nonsmoker 1 in 63,000
smoker 1 in 16,000
Using IUDs 1 in 100,000
Using diaphragm, condom or spermicide NONE
Using fertility awareness methods NONE
Undergoing sterilization:
Laparoscopic tubal ligation 1 in 67,000
Hysterectomy 1 in 1,600
Vasectomy 1 in 300,000
Continuing pregnancy 1 in 14,300
Terminating Pregnancy:
Illegal abortion 1 in 3,000
Legal abortion
Before 9 weeks 1 in 500,000
Between 9-12 weeks 1 in 67,000
Between 13-15 weeks 1 in 23,000
After 15 weeks 1 in 8,700
The source is the 1990-1992, 15th Revised Edition of Contraceptive
Technology. Authored by too many doctors to cite. However, this book is used
by millions of doctors around theworld as an authority on contraception. Its
authors gather their sources from data published by several different
statistic gathering organizations (such as the Centres for Disease Control)
and then compile and interpret it in their book. Happy Reading.
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Common Methods of Contraception
Diaphragm
Has a failure rate of 2% (i.e. out of 100 women who primarily use the
diaphragm, two become pregnant in any year). Always use spermicide; both
partners must learn how to place it properly. It has few associated risks;
it cannot become 'lost' because the vagina is only a few inches long. Can
'slip' and press against the rectum; this can be uncomfortable. Also, some
men can feel the diaphragm during intercourse. Some women have recurrent
yeast infections when using the diaphragm.
The average diaphragm costs about 20-30 dollars, but it must first be sized
and fitted by a gynecologist, so there is the cost of a doctor's fee. Must
be replaced every two years to ensure correct fit and product lifespan. A
tube of Gynol II costs around 11 dollars and is good for 24 doses of
spermicide.
The major disadvantage to the diaphragm is that it must be used one of two
ways; either it is inserted before any sort of sexual play, in which case
the taste of spermicide can become an issue if the couple wishes to engage
in oral sex, or is inserted after oral sex but before intercourse, which can
be considered a major interruption of play and may lead to not using it all.
(SOURCE: "The New Our Bodies, Ourselves" The Boston Women's Health Book
Collective, 1984. Pgs 225-228.)
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Reality, The Female Condom
[IMAGE]
The female condom is a soft, loose-fitting plastic pouch made of
polyurethane (not latex) that lines the vagina. It has a semi-stiff plastic
ring at each end. The inner ring is used to insert the device inside the
vagina and hold it in place. The outer ring partly covers the labia area and
holds the condom open. The female condom is market in the United States by
Wisconson Pharmaceuticals under the name Reality. In the United Kingdom and
Canada it is marketed under the name Femidom. Market acceptance testing has
been going on for over a year, and on August 15, 1994, Wisconson
Pharmaceuticals began widespread marketing of Reality.
In theory, the polyurethane construction of the female condom makes it
viable to use with oil-based lubricants, and Wisconson Pharmaceutical's
hotline states that this is safe. The female condom is also the best viable
alternative available for those people who are allergic to latex. The female
condom should notbe used for anal sex-- the anus has no upper end and the
outer ring is not enough to prevent it from being pushed into the anus and
become lost.
Inserting the female condom.
[IMAGE]
The female condom can be inserted up to 8 hours before sex. However, most
women prefer to insert it between 2 and 20 minutes prior to sexual
intercourse. The condom should be removed immediately after sex.
Squeeze the inner ring with your thumb and middle finger, placing your index
finger down upon the plastic inside the inner ring. Still squeezing, spread
the labia apart. With your hand positioned with your palm towards you,
insert the female condom into the vagina. Push the inner ring and pouch the
rest of the way into the vagina until the inner ring is up past the pubic
bone. The outside ring should now lie against the vulva, covering the
opening of the vagina.
The female condom after insertion
[IMAGE]
During intercourse, the female condom may move or shift. It should not be
pushed into the vagina, and the outer ring is intended to prevent this.
However, it may happen. If so, stop intercourse, fix the ring, and apply
more lubricant to the penis or in the pouch.
After intercourse, the female condom should be disposed of in a trashcan. Do
not flush the female condom in the toilet.
Effectiveness
The pregnancy rate for the female condom under normal use is expected to be
comparable to that of the male condom (13%). However, because of a lack of
familiarity with the device, initial results have been discouraging, with
rates as high as double that (26%). The female condom requires the use of an
external, water-soluble lubricant. A package of Reality, the brand available
in the United States, comes with three female condoms and a small bottle of
lubricant (1/2 oz). The lubricant is comparable in quality to Astroglide.
The female condom requires practice to use properly. Be prepared to take
your time inserting it the first time. Those who have experience using a
diaphragm will find the process familiar.
The female condom has not been tested in its efficiency to prevent disease.
It is expected to be as effective as a male condom. However, the insertion
process calls for two steps: inserting the ring, where the hand is outside
the pouch and in contact with vaginal fluids, and then fitting the ring,
where the fingers are inside the pouch, thus spreading those fluids about
the pouch where the penis will go. While there are solutions to this problem
(have each partner do one of these steps, wear gloves for half the process,
or wash hands before the fitting stage), none of them are adequate for most
people. The female condom should not be considered a viable protection for
STDs in cases where the woman is suspected to have a mucosal infection such
as herpes or HPV.
In the United States, Reality has been available primarily through Planned
Parenthood. Wisconson Pharmaceuticals has started shipping to drug stores
and it should be available throughout the U.S. in the last quarter of 1994.
Reality is somewhat pricey-- three condoms and a small bottle of lubricant
cost approximately $7.00 US.
Personal observations.
My wife and I were part of a marketing test group for Reality. It's
expensive, difficult to learn how to use, and not very effective at
preventing STDs without extraordinary measures. However, I happen to like
it. Without enough lubricant, it will stick to the skin of the penis and act
just as a male condom. With enough lubricant it feels much better than a
male condom-- the penis responds mostly to friction, and that's what Reality
supplies. A friend of mine who is allergic to latex thinks they're a gift
from heaven. Some gay men have tried using Reality for anal sex, with mixed
but generally positive results. Wisconson Pharmaceutical has announced,
rather loudly, that they have no intention of making the modification
necessary to make Reality truly viable for anal sex.
Reality comes with an instruction booklet. The booklet is hilarious, mostly
because of the name of the product. For example:
* Use a new Reality with each and every sex act.
* Read instructions carefully before using Reality.
* The booklet explains how to use Reality.
* Don't tear Reality.
* Reality only works when you use it.
* Make sure Reality is not twisted after insertion.
* Reality should not be noisy during sex.
* Reality may shift during sex.
* Keep Reality out of the reach of children.
If you have the opportunity to purchase and try Reality, do so at least
once. Get three condoms and a bottle of lubricant and try them out. Any new
reproductive technology is worthwhile, and who knows-- you might like them.
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Condoms
This is a posting of information about types of condoms which are
significantly larger or smaller than average. I got it out of a book called
"The Condom Book" or something similarly imaginative.
One thing that was apparent from reading through the descriptions was that
advertising on size (or for that matter thickness or ribbing or whatever) is
often misleading. A brand which is claimed to be smaller than average
frequently isn't outside the normal variation. There may also be differences
in size based on variations in manufacturing and these figures were probably
based on single samples. Different size measurements for different styles of
the same brand may indicate such variations or be an attempt to provide some
size variation, in which case getting the precise style named is important.
All measurements are flat and don't take into account elasticity, which
might influence comfort when worn. Typical condom flat widths range from 2"
to 2-1/8" (meaning two and one eighth, not two minus an eight). All the
condoms listed here are both lubricated and reservoir ended. Company names
are listed in parentheses. Extra words which may appear in the name on some
packages are listed in square brackets. It is possible I've copied some
numbers wrong (and other disclaimer noises).
SLIMMER CONDOMS
Mentor (Mentor): 2" by 8", not smaller,
but has adhesive inside
Bikini (Barnetts): slightly less than 2" by
7-1/4", packaged in that
frustrating plastic
wrapper
[Sheik] Fetherlite (Schmid): 1-7/8" by 7-1/2"
Hugger (Circle): 1-7/8" by 7-1/8"
Slims (Circle): 1-7/8" by 7-3/4"
to prevent slippage,
rather expensive though
WIDER CONDOMS
Excita (Schmid): 2-1/4" by 8-1/4", Excita
Extra has spermicide
[Lifestyle] [Horizon] Nuda (Ansel): 2-5/8" head, 2-1/8"
shaft, by 8-1/8"
[Ramses] NuForm (Schmid): 2-1/2" upper, 2+" lower,
by 8-1/4, has benzocaine
anaesthetic
Rough Rider (Ansel): 2-1/2" by 8" thick but
doesn't block sensations,
raised studs
Sheik Ribbed (Schmid): 2-1/4", forgot to note
length
(Note wide variation in Sheik. Elite with spermicide and
Lubricated (with benzocaine?) are both 2-1/8". Fetherlite is
1-7/8".)
Trojan-Enz Lubricated (Carter-Wallace): 2-1/4" by 8"
LONGER CONDOMS
Man-form Lubricated (Protex): 2" by 8-3/4" long
packaged in that
frustrating plastic
wrapper
[Trojan] Naturalube (Carter-Wallace): 2" by 8-5/8"
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Elf Sternberg