Contraception


Condoms (sheaths, rubbers, johnnys, prophylactics)

A condom is a rubber sheath rolled over the erect penis before sexual intercourse. The condom stops the semen from entering the vagina. Sperm is often emitted before intercourse; therefore any close genital contact before foreplay may permit sperm to enter the vagina. For greater protection a woman should always use a spermicide since condoms and spermicide used together are at most 95% effective and they also increase protection against HIV.

How to use a condom confidently!

  • Use a new condom every time you have sex.
  • Check the use-by date on the packet.
  • Check for a minimum quality assurance, e.g. British standard kitemark.
  • Open the packet carefully to avoid tearing the condom.
  • Make sure the condom is the right way around.
  • Traces of sperm can be released before a man comes so make sure that the condom is put on before the penis gets near the vagina.
  • Wait until the penis is quite hard before putting on the condom, trying to put one on a flaccid penis is almost impossible.
  • Put the condom over the top of the penis, and gently pull it down a little. Then pinch the air out of the teat at the top of the condom.
  • With one hand holding the teat, gently roll down the condom. Be careful, condoms are strong but they can be broken by rings or sharp fingernails.
  • Roll the condom completely down to the base of the penis, otherwise it can ruck up during sex and come off inside the vagina or anus.
  • If you want to use additional lubrication make sure you use a water-based lubricant like KY jelly. Oil-based ones (e.g. Vaseline) can perish rubber within minutes.
  • Shortly after he comes and before the penis gets too soft, grasp the penis and the condom near the base and hold firmly whilst he pulls out.
  • Gently slide the condom off, being careful not to spill any semen. Remember sperm can live for up to eight hours outside the body, so dispose of it carefully.
Advantages:
  • Prevents the transmission of HIV and most STDs.
  • Easy to use.
  • Easily obtainable, no prescriptions needed. Can be bought in any chemist or can be obtained free in the SU shop in House 6.
  • No artificial substances remain in the system.
  • May protect women from cervical cancer.
Disadvantages
  • Some people find using a condom dulls the sensation for them.
  • May slip off or split if not used correctly.

The Female Condom

This is still relatively new, and so no major studies have been carried out on its effectiveness but it is believed to be as safe as the male condom. It consists of a polyurethane sheath with two rings that lies in the vagina during intercourse. Unlike the male condom it can be put in anytime before sex and oil-based products can be used with the female condom, as it is made of polyurethane. When using, it is important to ensure that the penis enters the condom, rather than slipping between the condom and the vagina.

The Pill

The contraceptive pill is the most reliable method of birth control known. The method consists of taking a small oral contraceptive pill for almost all of the month. Available only on prescription, the Pill is easy to take and involves the minimum of fuss and bother. Putting it simply, the Pill stops the ripening of the Women’s eggs by rearranging the balance of her hormones. Regardless of the controversy, the Pill is still a perfectly safe method of birth control for most women. If you are considering going on the Pill you should contact your doctor, the IFPA, the Well Woman Centre or the TCD Health Centre.

  • Ideally no woman taking the Pill should smoke.
  • Always remember the 7-day rule if you forget to take the Pill (this means that you will need another form of contraception for a week as well as taking the Pill)
  • The first and last pills in the packet are very important.
  • Have a check-up every six months.

The Pill is reliable, easy to use. It produces regular periods and can ease menstrual bleeding and discomfort, and it does not interrupt sex.

Disadvantages are that birth control pills do have some undesirable side effects: nausea, weight gain, breast tenderness, headaches, spotting between periods and irritability are among the more or less minor ones. However moving to a different brand of pill can solve these. The Pill offers NO protection against HIV or other sexually transmitted diseases.

Remember: Some antibiotics and other prescribed drugs may stop the Pill from working, so do ask your doctor about this before going on medication.

Injectible Contraception

Although it sounds new, this contraceptive was actually first manufactured thirty years ago but did not pass heath regulations (It was believed that the use of the injectible contraceptive Depo-Provera increased the risk of breast cancer in women. It was re-launched in the 80s once the previous claims were seen to be inaccurate and that the medication was in fact perfectly safe.

Once you are injected with a dose of Depo-Provera once every twelve weeks, you only run a very slight risk of becoming pregnant (.3%) A dose costs ¤12 approximately and must be administered by a doctor.

It does have some minor side effects similar to the Pill but it contains only progesterone therefore it is only safe in those where oestrogen is contraindicated.

You do not need to remember to take pills every day, there is very small risk of pregnancy, and periods are very light.

However, periods can be very irregular, there is no protection against STDs, and other side effects include weight gain (about 5 pounds), back pain, some headaches.

This injectible contraceptive costs €140 for the contraceptive and €50 to have it injected by the TCD doctor.

The Mini-Pill

Contains only one hormone - progesterone. It works by preventing the passage of sperm through the cervical mucus. It makes the lining of the uterus hostile to the implantation of the egg and may prevent ovulation.

  • It should be taken on the first day of your period.
  • It should be taken at the same time each day. If taken more than three hours later than the usual time it will not be effective.
  • The seven-day rule applies.
  • The Mini-Pill is not adequate protection for those under 30 years of age - therefore condoms would still be required.
  • It doesn’t control menstrual cycles as well as the combined pills, which contain both oestrogen and progesterone.
  • No protection against STDs.

Spermicides

These include creams, jellies, peccaries and jars of foam; they are placed in the vagina near the cervix, usually by a syringe-like applicator and function by killing the sperm when it enters the vagina. Used alone they are unreliable. However they do greatly increase the reliability of condoms and caps. Insertion can be messy and troublesome. They are available from the Well Woman Centres and the Irish Family Planning Clinic. Remember that spermicides provide no protection against STDs.

The Diaphragm or Cap

This is a dome-like rubber device, which the woman inserts over the entrance to the uterus, up to three hours before having sex. It must always be used in conjunction with a spermicide. If used carefully and correctly it is 95% effective. The device prevents sperm from entering the womb and the spermicide kills them. The diaphragm must be left in place for at least eight hours but not longer than 24 hours after intercourse. If you lose or gain more than 3.5kgs (7lbs) you need to get the diaphragm rechecked. After use, clean the cap by washing it in warm, soapy water. Rinse and dry thoroughly. Avoid disinfectants, detergents or strongly perfumed soap, as these spoil the rubber.

The I.U.D (The Inter-Uterine Device, Loop or Coil)

The coil is a small, semi-permanent device, made of either plastic or copper that is inserted in the woman’s uterus by a doctor. It prevents pregnancy by interfering with the complex chain of events that take place before the egg can become implanted in the wall of the uterus. The coil is left in place and only removed when a woman wants to become pregnant. A doctor can only remove it.

Whilst insertion is simple and reasonably effective, it is generally not suitable for young women with no children. It has many disadvantages, including increased menstrual flow and the danger of the device slipping out unnoticed. It provides no protection against STDs.

Sterilisation

For both sexes, this involves a minor operation and is generally irreversible.

For a man it is a simple operation that can be carried out under a local anaesthetic in surgery and need only take a few minutes. For a woman the most common method involves blocking the Fallopian tubes by tying, sealing or clipping them. It is carried out under general anaesthetic and can involve a short stay in hospital. Counselling is recommended for people considering sterilisation.

The Morning-After Pill

This works by altering the hormone balance, usually preventing pregnancy and involves two sets of pills that are taken twelve hours apart and must be taken within 72 hours of intercourse to be effective. This means you should see your doctor within 60 hours of intercourse, so that both pills can be taken within the time limit. The earlier the pills are taken, the more effective they are. You may be asked to sign a form clearing the doctor of responsibility if the pill fails to be effective.

Success rate: 5% risk of pregnancy midcycle, less than 1% risk at all other times. Time of next period varies depending on time of cycle when pills are taken.

You may feel or be sick, if this happens you might need to get more pills from your doctor. Not suitable for all women, your doctor will advise you. This special dose should only be used very rarely, in emergencies. The ‘Morning After’ Pill should not be used as a form of contraception.

The pill is available from the Student Health Centre in TCD at a cost of _6, the Well Woman Centres and the Irish Family Planning Clinics.

The Post-Coital I.U.D

The I.U.D is fitted within five days of intercourse or within five days of estimated date of ovulation. Clinics may very slightly on this. It works in the same way as the normal IUD though insertion can be quite painful.

The Post-Coital IUD is very effective.

It's not suitable for all women, your doctor will advise you. It can be painful to insert the device.

It's available from the Well Woman Centres and the Irish Family Planning Clinics.

Remember that the condom is the only from of contraception that offers protection from STDs and HIV. Unless you are in a single partner monogamous relationship, where both you and your partner know that you are both free from STIs and you are using another form of birth control, always use a condom.

© Trinity College Dublin Students' Union 2017