Human Sexuality and Contraception

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Introduction Contraception is a deliberate prevention of pregnancy using any of several methods ranging from natural to scientific ones. There are a variety of methods available in accordance to its nature of use. Some methods provide short term birth control facility whereas some other provides permanent or long term birth control facility. The following paper discusses some of the most popular reversible and irreversible methods of contraception. Methods of contraception The choice of the method of contraception is a personal decision based on individual preferences for convenience and comfort, medical histories and the risks and benefits and side effects associated with each method. This calls for the personal involvement of the sexually active males and females to take the appropriate decisions keeping in mind the above stated factors. Further considerations become imperative when the contraception methods are implemented or long term. The issues like whether a couple intends to have children in future are of prime importance before opting for any specific method. Almost all the birth control methods are reversible. With the discontinued usage of the birth control technique men and women will be fertile to their normalcy and will still be able to reproduce. However in the case of surgical methods it becomes comparatively difficult to reverse the situation back to normalcy; which means that once the surgery is carried out, there are less chances for that male or female to reproduce. It is generally believed that no birth control method is 100 percent effective in the prevention of pregnancy; however it is found that some methods are found more effective then the rest. The pregnancy rates for birth control methods are known as failure rates and are generally expressed in percentage that represents the number of pregnancies expected in a group of 100 fertile women using the sole method for a period of one year. Researchers use two basic types of pregnancy rates while describing the effectiveness of a birth control method. Method effectiveness, or perfect use, is the chance of becoming pregnant when a particular method is used correctly and consistently with each act of sexual intercourse. User effectiveness, or typical use, is the percentage of pregnancies that result from average use of the method, which accounts for improper or inconsistent use. This paper provides an overview of birth control methods and provides typical use statistics. Barrier methods Barrier methods generally provide a physical barrier which help avoiding the sperms from entering the uterus. These methods generally include the male and the female condoms, the cervical cap and the diaphragm. The male condom, scientifically known as prophylactic, is made of thin sheath of latex or less commonly animal membrane that fits over an erect penis. The condom is easy to use and requires no medical prescription and has no known side effects. Further, it is inexpensive hence making it one of the most popular reversible techniques of contraception worldwide. In typical use, male condoms are 84 percent effective in preventing unwanted pregnancy. The female condom, a later invention to the male condom, is an elongated polyurethane sac with rings at each of its ends. One ring is inserted in the vagina while the other remains on the outside partially covering the female genital organs. The polyurethane sheath completely lines the interior vaginal mucosa and prevents the passage of sperms into the vagina. After the act of sexual intercourse it can be removed and discarded immediately. It has proved to be 79 percent effective in preventing pregnancy. In both the cases, male and female condoms are available without prescription and are meant for single use only. Another method is the use of diaphragm. It is a shallow molded cup made of thin rubber with a flexible rim. Before intercourse, the woman inserts the diaphragm into the vagina after applying spermicides in the insides of the cup and the rim. It is placed into the innermost part of the vagina covering the cervix. The vaginal muscles and the pubic bone help in holding the diaphragm in place where it prevents the passage of sperm from the vagina to uterus. The leftover sperms are killed by the spermicides. These diaphragms are available in various sizes to fit accordingly into the cervix. However, they are available only from the health care professionals who ensure that the device fits properly. In typical usage it is about 82 percent effective in prevention of unwanted pregnancy. The cervical cap is smaller than a diaphragm and fits directly onto the cervix where it is held in place by suction. Such diaphragms offer some advantages as it has low risk of complications and have almost zero side effects. Fertility is easily reversible with the removal of the diaphragm. However it needs to be replaced by a physician in case the woman loses or gains weight more than 10 pounds. It is also inconvenient to use it with each act of intercourse. Intrauterine devices The intrauterine device, also known as IUD, is a small plastic device placed in the uterus to prevent pregnancy. It might also contain partial copper covering or an insert with the hormone progesterone. Principally, it works by interfering in the activity of sperms fertilizing or by disallowing the fertilized eggs from implanting in the inner lining of the uterus. An IUD is always inserted and removed by a healthcare professional. Such devices have been highly popular on account of its high rate of effectiveness, long life up to 10 years and lesser side effects with total reversible procedure that can regain the fertility of a female. A woman can regularly check the position of the IUD with the help of a plastic string which hangs attached to the device and the other end hanging down through the cervix. A missing string can indicate the dislocation of the device. In typical use, the IUD is 96 percent effective in preventing pregnancy. In certain cases the device might cause some side effects like allergic reaction to copper, perforation of the uterus and the embedding of the device in uterus. It might also cause pelvic inflammatory disease (PID) and increased menstrual bleeding and cramping. Spermicides Spermicides are available in the forma of ointments, jellies, foams, suppositories, films or tablets that contain sperm killing agent lethal to sperms. They are available without the prescription of health care professional and can be optionally used in combination with the barrier devices. It is easy to use and an easily reversible process to gain fertility. When they are used alone, they must be inserted into the vagina before intercourse and the woman should not douche for six to eight hours after the act. The timing of application varies with the quality of spermicide used. Spermicides can also be used in backup with the pills during the early days. They can also be used as an immediate remedy for females who do not have frequent sexual intercourse. In typical cases, they are effective in preventing unwanted pregnancy in about 70 percent of cases. However, in certain cases it may cause the allergic reaction on vagina and penis. Vaginal sponge The vaginal sponge is a small, one size, polyurethane element that contains spermicides. The sponge is inserted in the vagina with the dimple side placed in front of the cervix as a barrier that keeps sperm from entering the uterus. The smooth side of the sponge has a woven loop of polyester fabric that provides easy removal of the sponge. Its typical use is around 91 percent effective. However if the sponge dislocates during the process of sexual intercourse, the chances of getting pregnant are higher and for the women who have experienced childbirths, this rate is higher. It is widely available without the prescription of a health professional. However wearing a sponge for more than 24 hours might cause adverse effects on health. Hormonal contraceptive Hormonal contraceptive is a method for the females in which the contraceptive delivers doses of hormones that interfere with the successful implantation of a fertilized egg in the inner lining of the uterus and also prevents ovulation thus preventing maturation and release of egg from the ovaries. The hormones can be administered with injection, through skin implants or with pills. Hormonal contraceptives are an extremely effective reversible contraceptive method when used properly and regularly. In typical use, the pill is 94 percent effective in preventing pregnancy. However some amount of side effects like headache, breakthrough bleeding and mood swings, hypertension etc. might be recorded. Another type of pills known as emergency contraceptive pills or morning after pills, prevent pregnancy after unprotected intercourse. These pills are similar to birth control pills but contain a higher dose of hormones. A woman takes the pills within 72 hours of unprotected intercourse. The pills will either inhibit or delay ovulation, or they may alter the uterine lining, preventing implantation of a fertilized egg. Such pills can prevent pregnancy 75 percent of the time. ] Surgical sterilization Surgical sterilization methods include vasectomy for men and tubal ligation for women. They are non reversible measures for birth control with almost 100 percent effective in preventing unwanted pregnancy. Vasectomy is comparatively simple surgery performed with local anesthesia whereas tubal ligation is more complicated process performed under general anesthesia. Vasectomy can be performed in a clinic and is relatively easy to perform. Two small incisions are made in the scrotum and the vasa deferentia, the ducts that carry sperm from the testes to the penis, are cut and the ends tied off to prevent sperm from reaching the penis. It has no known side effects and does not affect the performance of a sexually active male. However backup contraceptives must be used for first 15-20 ejaculations as during this time the leftover sperms in the vas might cause unwanted pregnancy. The failure rate of vasectomy is very low as 0.10 percent. Sexual activity can be resumed when an individual feels comfortable. Such failures might result from incomplete occlusion of the vas or on account of absence of backup contraceptive methods until all the sperm are cleared from the vas. Tubal ligation is a more complic

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