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Contraceptive Methods

Article examines various methods of birth control and contraceptive methods and devices used to to prevent unwanted pregnancy.

Contraceptive Tablets and Sponges

Spermicides are contraceptive tablets or suppositories that are placed in the vagina prior to intercourse. These substances are activated by vaginal secretions and kill sperm to prevent pregnancy. (Signs of being pregnant)

Used alone, spermicides are not an effective birth control method - the reason why they are usually combined with other barrier methods of contraception such as diaphragms, condoms, cervical caps and sponges.

"There is always the danger that the tablet will not dissolve completely and that contraception protection will thus be incomplete. This method is less preferred than others where the barrier to sperm attempting to enter the cervix is more certain. Purchasers should also make sure they are buying contraceptive tablets, not feminine hygiene suppositories, which are often displayed nearby," said Dr. Raphael Jewelewicz in "The Columbia University College of Physicians and Surgeons Complete Home Medical Guide."

The vaginal sponge is a disposable pillow-shaped device which looks like a tampon. It is packed with spermicide and absorbs seminal fluid when inserted in the vagina.

The earliest reference to sponges as a means of birth control was made in the Ebers Papyrus in 1500 B.C. This primitive sponge was made of lint and contained acacia and honey. So popular was this contraceptive that it was used for years. Modern sponges are made of a different material but work the same way. Aside from blocking and/or absorbing semen, they also kill sperm.

"The device works continuously releasing spermicide for up to 72 hours. Additional applications of spermicides are not necessary, even for multiple acts of intercourse. There are other advantages as well: the sponge is available without a prescription; unlike a diaphragm, the sponge does not have to be fitted; and the sponge can be inserted ahead of time, which allows greater spontaneity in sex. The sponge has been found to be 85 percent effective," according to the editors of Consumer Guide's "Family Health & Medical Guide."

Since the sponge comes in a size that fits all women, there is no need for professional fitting at a physician's office. Furthermore, a study of 4,162 women published in the American Journal of Public Health said sponges (and diaphragms) appear to offer more protection against two sexually transmitted diseases - gonorrhea and trichomoniasis.

Dr. Michael Rosenberg, professor of epidemiology and obstetrics and gynecology at the University of North Carolina, said the incidence of gonorrhea and trichomoniasis was 71 percent and 74 percent lower respectively in women who used these barrier methods compared to those who didn't use a contraceptive at all.

Rosenberg believes the sponge and diaphragm may be more effective in preventing sexually transmitted diseases than condoms. What's more, one can have worry-free sex for the next 24 hours after using the sponge.

What about side effects?

Like the diaphragm and spermicide, some women may experience an allergic reaction or irritation. Other complaints are difficulty in removing the sponge and a bad vaginal odor if the device is left for more than 18 hours. Most of these problems, however, are minor.

Cases of local irritation or allergic reaction have been reported; however, these have been mild and infrequent. There is also concern that the sponge could become a breeding ground for infection, especially if used improperly. You should consult your doctor about the contraceptive sponge and its proper use before trying this method of birth control," said the editors of Consumer Guide's "Family Health & Medical Guide."

To enjoy sex in your later years, keep fit, eat right and love life. That simple advice can go a long way in preserving your sex life.


The list of substances women have placed in the vagina to prevent pregnancy is endless. In the early days, it was common to douche the vagina with wine mixed with garlic and fennel, a plant with yellow flowers. This was done by means of instruments made from the horns of animals or the bills of birds. Others exposed the vagina to fumes or gases to stop pregnancy.

Various douching solutions were recommended after sex ranging from alum to green tea. Even today, some couples still believe they can prevent pregnancy by douching with vinegar or Coca-Cola. None of this, of course, has any scientific basis. In addition to being an unreliable means of contraception, douching can harm the vagina.

Fortunately, spermicides have replaced douching as a form of birth control. They are more effective and less likely to irritate the vagina. They are also applied immediately before intercourse - not after.

Spermicides are available in cream, foam, suppository or jelly. They are inserted in the vagina right in front of the cervix with the help of a small instrument called a plunger. This acts as a barrier against sperm and can be bought without a prescription.

Whether you use cream or jelly is a matter of personal preference. It's a good idea to stick to a brand you've already tried to avoid hassles in the future or an allergic reaction in the form of itching, burning or a rash. Price and complications are other factors to consider.

"Most brands contain similar, equally effective, ingredients. Creams tend to provide more lubrication than jellies. Most spermicides have a slight fragrance and a chemical flavor. Some have recently come on the market with fruit flavors and fragrances; others are now available without any flavor or fragrance," according to Dr. Raphael Jewelewicz in "The Columbia University College of Physicians and Surgeons Complete Home Medical Guide."

A contraceptive foam works the same way but can be used alone. It usually comes in a small aerosol can. The foam is applied near the cervix one to three hours before intercourse, but there is no way of knowing how long this protection will last.

Can you trust spermicides to prevent pregnancy?

Used alone, they are about 75 to 85 percent effective but some ingredients may fail to cover the cervix properly. To play safe, your best bet is to combine these products with a diaphragm or cervical cap. The effectiveness of spermicides, however, may be lower than believed since there are no studies to support this.

"There are no published human studies comparing the effectiveness of spermicides with other methods and no studies on whether gels or creams work better than foams or film. Researchers say the estimated failure rate for 'perfect' use (which is 3 percent) may be too low; it's based mostly on how effectively spermicidal kill sperm in a lab dish," said Deborah Franklin in Health magazine.

To maximize the spermicide's effectiveness, here are some tips from Franklin:

Wait the prescribed time after application to allow spermicide to disperse (for suppositories or film) and add more spermicide before additional intercourse if more than an hour has elapsed.

Use the recommended amount and shake the foam can vigorously (the more bubbles, the better the protection).

Use a condom or diaphragm, at least during the week mid-cycle when ovulation is likely. The first day of your period is day one of your cycle.

Barrier methods of contraception

The barrier methods of birth control work by preventing the sperm from reaching the egg. The idea of inserting something into the vagina to prevent pregnancy is not new. Such devices were called pessaries and they were used by the ancient Egyptians.

Pessaries were mentioned as early as 1850 B.C. in the Petri Papyrus. The formula then was a mixture of crocodile dung and honey which was placed in the vagina prior to intercourse.

"Interestingly, this mixture not only acted as a barrier to sperm, but had some broad spermicidal effects. If a convenient crocodile wasn't available, elephant dung could be used," said Dr. Niels Lauersen, a diplomate of the American Board of Obstetrics and Gynecology and Steven Whitney in "It's Your Body: A Woman's Guide to Gynecology."

Various formulas of pessaries were used throughout the world. Elephant dung and honey was the preferred combination in India and Africa. In Persia during the 10th century, pessaries were made of mixed rock salt and an oily material.

The most popular pessary, however, was invented by Walter Rendell, a London chemist who lived in the late 1800s. Seeing how many people suffered from the burden of having too many children, Rendell developed a pessary containing quinine which he distributed freely to customers at his pharmacy.

"The results of this new pessary exceeded his expectations. Requests were logged so rapidly that the pessary was marketed commercially in 1886. By the turn of the century, the product was a best seller throughout the world. In fact, until the 20th century, quinine was the only recognized spermicide which could be used with complete safety," Lauersen and Whitney added.

With the popularity of pessaries, new formulas were developed using less irritating substances. Today's barrier methods of contraception include the diaphragm, vaginal sponge, condom and cervical cap. These are often used together with chemical barriers such as creams, jellies, foams and suppositories. Let's examine them one by one.


The diaphragm is a molded rubber cap which blocks sperm as it covers the cervix and the back of the vagina. It must be inserted for each act of intercourse and left on for six to eight hours afterward.

A smaller version of the diaphragm is the cervical cap which covers only the cervix but works the same way. Unlike the diaphragm, however, this device must be fitted by a physician. Women may find it difficult to do the same because the cap must be inserted deep within the vagina.

The first real diaphragm was created by Aetius of Amida in the 6th century using the fruit of the pomegranate tree. After removing the seeds and pulp of that fruit, Aetius told women to insert the hollow end into the vagina before intercourse.

In 1883, Dr. Frederick Wilde, a German physician, described how a rubber cap could block sperm, but it was Dr. Wilhelm Mensinga, another German, who popularized the method.


Owing to the side effects experienced by some pill and IUD (intrauterine device) users, women turned to the diaphragm or cervical cap as a means of contraception. Unlike other birth control methods, these barrier devices have no serious side effects and may protect women against sexually transmitted diseases (STDs). In the presence of an STD, these devices reduce the likelihood that the disease will lead to pelvic infection.

But how effective are these barrier methods?

Experts say pregnancy can be prevented in 94 to 98.5 percent of the time provided they are used correctly in combination with a spermicide.

"Before intercourse, insert your diaphragm with about a teaspoon of spermicidal cream or jelly, spread around the edge and in the center of the device. After intercourse, wait at least six hours to remove the diaphragm. If you have intercourse again within the six hours, you must apply more spermicide," according to Dr. David E. Larson, editor-in-chief of the "Mayo Clinic Family Health Book."

If the woman fails to carefully follow these steps, the diaphragm loses its effectiveness and the failure rate may reach 18 percent. How can you avoid this? By making sure that the diaphragm or cap fits perfectly. One that doesn't is likely to cause trouble later.

A physician can help you choose the best one to avoid pregnancy. Be sure the device is properly inserted and apply the right amount of spermicide before using it. Also check the device every now and then for holes or thinning. If these occur, you need a new device. The same is true for those who lose or gain a large amount of weight. They may have to be fitted again for a different sized diaphragm or cap.

"Don't settle for a diaphragm or cap that doesn't fit properly. Not only are you less likely to use it if it pinches, rubs or causes cramping, but it's also more likely to prompt chronic urinary tract infections," said Deborah Franklin in Health magazine.

"Not every one is a good candidate for a cervical cap; your doctor can tell you if your cervix is the shape required for a proper fit. But most women who can wear the cap find it more comfortable than the diaphragm and more convenient. It can be inserted earlier and left in longer (for up to 72 hours), and requires only an initial dose of spermicide," Franklin added.

The most common problems reported by diaphragm users is that they either have trouble inserting it (which interrupts the spontaneity of the sex act) or the insertion is quite messy. Women who find it difficult to fit the device are advised not to use it.

Those under 30 who are allergic to spermicide, have sex more than four times a week or have a history of repeated urinary tract infections are poor candidates for these barrier methods of contraception.

How effective is the withdrawal method?

The withdrawal method, also known as coitus interruptus or onanism, is the oldest method of birth control. It got its name from Onan whose story is told in Genesis 38:8-10.

In that story, Judah told Onan to marry his brother's wife and have sex with her. Knowing that the child would not be his, Onan withdrew his penis just before he ejaculated and spilled his semen on the ground. This displeased the Lord who killed him.

This is one of the most widely used family planning methods. The reasons for its popularity are safety and convenience. The withdrawal method requires no preparation and can be used anytime.

Aside from this, it has no side effects since there is no need to take any medication or use any device. One study showed that this method is also popular among wives who are forced by drunken husbands to have sex.

But don't pin your hopes too high on this method. As a means of contraception, the withdrawal method is highly unreliable and frustrating to both sexes. The failure rate for coitus interruptus is 200 to 300 pregnancies per 1,000 women in a year. Some doctors, in fact, refer to it as the "Russian roulette" of birth control.

What makes the withdrawal the worst of the lot in family planning? First of all, it is difficult to enjoy sex if one is concerned about getting pregnant - which is what usually happens if the man fails to withdraw his penis on time.

Controlling ejaculation is difficult especially for younger men. Some men may not know when to withdraw while others may decide not to do so at all.

"The withdrawal method goes against human nature and the laws of physics. At the moment of greatest sexual excitement, it requires a cool head and a good aim. As far as physics is concerned, it compels the man to go backward when he wants to plunge forward, to stop when he wants to really get started, and to subtract when he wants to add," according to Dr. David Reuben, a noted California psychiatrist in "Everything You Always Wanted To Know About Sex (But Were Afraid to Ask)."

"It also makes the woman feel left out. At the moment of impending orgasm, she is jolted back to reality as five or six jets of hot semen are sprayed on her tummy. Not exactly ecstasy," Reuben added.

Can breastfeeding prevent pregnancy?

Thinking of using the withdrawal method as a means of birth control? Think again for this method is unreliable and risky as I pointed out in my previous article.

Even if the man withdraws on time, he must make sure that every drop of semen is far away from the vagina as possible. That's because a few drops of semen contain thousands of sperm. If one of them finds its way on the lips of the vagina, that could result in pregnancy.

Another point against the withdrawal method is that even if the man controls ejaculation, he may not feel the semen leaking out of his of penis prior to withdrawing. This is true especially when the sexual need is intense or sexual excitement is prolonged. Thus, pregnancy is a great possibility.

"Only about 50 percent of men ejaculate in one single burst; others expel semen sporadically or in a slow stream. Many men do not know exactly when they should withdraw, since there may have been a small ejaculation of semen prior to actual orgasm. Even a small ejaculation can contain millions of sperm, each one capable of fertilizing an ovum," said Dr. Niels Lauersen, a diplomate of the American Board of Obstetrics and Gynecology and Steven Whitney in "It's Your Body: A Woman's Guide to Gynecology."

What about breastfeeding? Can it really prevent pregnancy?

The benefits of breastfeeding are well-known. Aside from being highly superior to infant formula, breast milk requires no special preparation, can be done anytime, and protects the child from infectious diseases. It also strengthens the physiological bond between the mother and infant.

But there's more: Some women resort to breastfeeding as a means of birth control. This is true in countries where contraceptives are unavailable or in women whose religious beliefs prevent them from using pills or other family planning devices. Are these women on the right track? It all depends on how long they've been breastfeeding.

If breastfeeding is done regularly and frequently, it stops the release of a woman's eggs and delays ovulation and menstruation. This effect is produced when the baby suckles at the breast and nipple. The act of suckling stimulates nerves in the mother's breasts which interfere with ovulation. Therefore, the more you breastfeed, the less likely ovulation will occur.

"Regular breastfeeding does interfere with the release of a woman's eggs. The infant's stimulation of the nipple triggers increased production of prolactin, a chemical that suppresses the hormones necessary for menstruation and ovulation. No eggs, no pregnancy," explained the editors of In Health magazine.

"For the first six months after giving birth, if a breastfeeding mother hasn't resumed menstruation and the baby feeds often and only on mother's milk, breastfeeding can provide pregnancy protection that rivals accepted contraceptive methods - close to 99 percent, according to one study," In Health added.

There are, however, some problems associated with this method. If breastfeeding is prolonged or done for more than six months, ovulation could occur before menstruation starts. This means that a woman's missed period could actually be a sign of pregnancy. Pregnancy is also a possibility in those who supplement breastfeeding with an infant formula.

Then there are side effects to worry about. Frequent breastfeeding for a long time can lead to hair loss, skin changes and hot flashes. It also increases the demand for calcium, iron and protein in the mother.

To enjoy sex in your later years, keep fit, eat right and love life. That simple advice can go a long way in preserving your sex life. For extra help, take Fematril, a safe and natural female sexual enhancer that can stimulate your mind and body.

Also see How Birth Control Pills Work

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