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Choosing a contraceptive may be one of the most important decisions we make during our childbearing years. Birth control - from the Pill, which requires a doctor's prescription, to condoms, which you can pick up at the drugstore - empowers us and gives us the freedom to be sexually active and to choose whether or not to bear children. What's more, many forms of birth control protect us from gonorrhea, chlamydia, AIDS and other sexually transmitted diseases (STDs). Although we have a number of contraception options, obviously something is not working. Shockingly, the United States has one of the highest rates of unplanned pregnancies (more than 3 million a year) and abortions (50 percent of unplanned pregnancies) of all industrialized nations, with the numbers highest among teenagers, the poor and women of color. New research has thrown another wrinkle into the birth-control picture. A study by the Alan Guttmacher Institute (which studies reproductive issues) shows that many types of contraceptives are much less effective than previously believed. If women use birth control incorrectly or inconsistently, note the researchers, unplanned pregnancies occur. Although there is no absolutely perfect birth-control option, no contraceptive can work effectively if you don't use it. We must take responsibility for our fertility and not leave pregnancy to chance. The guide below will help. Methods are listed in order of effectiveness. Which method to use is your own choice; the choice to use one and to use it correctly is your responsibility. STERILIZATION Effectiveness rate: 99.6 percent (see end of article). Pros: Reliable, permanent. Cons: Side effects and dangers connected with any operation, no protection against STDs, irreversible. Sterilization, the most commonly used means of contraception - and the most permanent - is effective for women who have completely finished with childbearing. Unfortunately, it has sometimes been forced upon women of color without their consent, especially in the South Also, recent studies have shown that sterilization regret is significant among women (25 percent). Vasectomy, male sterilization, is safe and also highly effective. Some men, however, are reluctant to undergo this procedure. THE PILL Effectiveness rate: 94 percent. Pros: Easy to use, Effectiveness, continuous protection. Cons: Minor side effects, links to serious illness, need a doctor's prescription, little or no protection against STDs. Oral contraceptives remain one of the most easy-to-use and effective birth-control methods. The Pill comes in two basic types and is generally taken daily. The most common type, the combined synthetic pill, works to suppress ovulation, while the newer "minipill" thickens the cervical mucus to keep the sperm from ever reaching the egg. Because hormones, even synthetic ones, can wreak havoc on the system, women who take oral contraceptives often complain of a number of side effects, including breast tenderness, weight gain, decreased libido, and moodiness. (The minipill, however, has a much lower dose of hormones and therefore, according to many women, fewer side effects.) Recently a "Pill scare" hit the media Studies have linked oral contraceptives with increased risk of breast cancer, but conflicting research claims that the Pill is safe and has a protective influence against some cancers. Until further, more conclusive, research is conducted, experts suggest that the Pill is safest for nonsmoking, nonobese women under 35 with no family history of breast cancer. INTRAUTERINE DEVICE (IUD) Effectiveness rate: 94 percent. Pros: Protection without continual insertion and removal Cons: Cramps, bleeding between periods, no protection against STDs, may encourage tubal infection, a doctor must insert. The IUD, once touted as the most carefree method of birth control (you put it in and forget about it) turned into a nightmare for thousands of women - and a disproportionate number of women of color - who suffered from complications caused by the poorly designed Dalkon Shield. Now. with American companies worried about lawsuits, only two IUDs are still on the market: the Progestasert and the ParaGard. They are both inserted into the uterus by a doctor and prevent egg fertilization. Along with side effects, the IUD may also allow bacteria to enter the reproductive system, causing infection and even sterility in extreme cases. These days the IUD is prescribed with care, mainly to women in stable monogamous relationships who have had all the children they want and who have no history of pelvic inflammatory disease. CONDOMS Effectiveness rate: 86 percent. Pros: Available over the counter, protection against STDs. Cons: Can break, sperm can spill into the vagina if not removed correctly, sometimes uncomfortable and disruptive to use. Condoms, thin latex sheaths, are placed over the penis prior to intercourse to block sperm from entering the uterus. They offer the best possible protection against STDs and are also highly effective (especially when used with a spermicide) and easy to buy. DIAPHRAGM Effectiveness rate: 84 percent. Pros: Fairly comfortable and easy to use, protection against STDs when used with spermicide that contains nonoxynol-9. Cons: Increased bladder infections, may become dislodged. The diaphragm, a soft rubber cup that is inserted into the vagina before intercourse and covers the cervix, doesn't hamper menstrual cycles or uterine walls. The device should be used with a spermicide to protect against pregnancy and STDs. NATURAL FAMILY PLANNING Effectiveness rate: 84 percent. Pros: Little or no equipment required, safe, free. Cons: Difficult to determine safe days. To prevent pregnancy women monitor their menstrual cycles by means of temperature, changes in their cervical mucus or a combination of these indexes in order to determine which days to abstrain from intercourse. The "rhythm method" works best for women with regular menstrual cycles. Your gynecologist can give you more information. THE CERVICAL CAP Effectiveness rate: 82 percent. Pros: Can't be felt during intercourse, protection against STDs when used with nonoxynol-9 spermicide, can be left in place for up to 48 hours. Cons: Can be difficult to insert, can cause abnormal Pap smears, requires a doctor's prescription, is not widely available. Another barrier method, the cap can be left in place longer than the diaphragm and without reapplying spermicide. It is also smaller and more comfortable. But the cap takes more practice to insert properly. It should only be used by women with normal Pap smears because of the possible adverse effect on cervical tissue. THE SPONGE Effectiveness rate: Pros: Available over the counter, works for 24 hours after insertion, protects against some STDs. Cons: Less effective for women who have had children, can be hard to remove, slightly increased risk of toxic shock syndrome. A cylinder of polyurethane infused with the spermicide nonoxynol-9, the sponge itself blocks sperm from entering the uterus, and the spermicide guards against a number of STDs as well as killing sperm. SPERMICIDES Effectiveness rate: 74 percent. Pros: Available over the counter, protection against STDs. Cons: Must be reapplied, can irritate genitals, low effectiveness. Spermicides are available in the form of foams, creams, suppositories, jellies and film. Even though they're messy, they are easy to buy and offer protection against STDs. Michele Kort is a staff writer for UCLA alumni publications. * Effectiveness rates are based on "Choosing a Contraceptive: Effectiveness, Safety, and Personal Considerations" by Elise Jones, Ph. D. and Jacqueline Forrest, Ph. D. Rates for sterilization, the IUD and the cervical cap are based on 1982 data. The "Choosing a Contraceptive" study categorizes the sponge as a spermicide for an effectiveness rate of 74 percent. Other, more detailed, studies have produced higher effectiveness rates. RU READY? Within two to five years - legally or illegally - the abortion pill will be available here. Developed by scientist Etienne Baulieu in 1982, it's called RU 486, after the French company Roussel-UCLAF. It was approved for use in France in 1988, and tens of thousands of French women have used it since then. Opponents of abortion are doing everything to stop this controversial drug. But Judy Norsigian of the Boston Women's Health Collective calls it "the most revolutionary new birth-control method available." When taken in the first five weeks after conception and in combination with an injection, RU 486 is 95 percent effective. In France, a woman must have a pregnancy test and a counseling session before she is given a dose of 600 milligrams. The drug causes the uterine lining to break down and expel the fertilized egg. Two days later she may return to the clinic for an injection to ensure that the abortion is complete. Although the process is considered very safe and avoids infection, it is not without discomfort from cramping.
COPYRIGHT 1990 Essence Communications, Inc. A complete guide to birth control for women and our menChoosing a contraceptive may be one of the most important decisions we make during our childbearing years. Birth control - from the Pill, which requires a doctor's prescription, to condoms, which you can pick up at the drugstore - empowers us and gives us the freedom to be sexually active and to choose whether or not to bear children. What's more, many forms of birth control protect us from gonorrhea, chlamydia, AIDS and other sexually transmitted diseases (STDs). Although we have a number of contraception options, obviously something is not working. Shockingly, the United States has one of the highest rates of unplanned pregnancies (more than 3 million a year) and abortions (50 percent of unplanned pregnancies) of all industrialized nations, with the numbers highest among teenagers, the poor and women of color. New research has thrown another wrinkle into the birth-control picture. A study by the Alan Guttmacher Institute (which studies reproductive issues) shows that many types of contraceptives are much less effective than previously believed. If women use birth control incorrectly or inconsistently, note the researchers, unplanned pregnancies occur. Although there is no absolutely perfect birth-control option, no contraceptive can work effectively if you don't use it. We must take responsibility for our fertility and not leave pregnancy to chance. The guide below will help. Methods are listed in order of effectiveness. Which method to use is your own choice; the choice to use one and to use it correctly is your responsibility. STERILIZATION Effectiveness rate: 99.6 percent (see end of article). Pros: Reliable, permanent. Cons: Side effects and dangers connected with any operation, no protection against STDs, irreversible. Sterilization, the most commonly used means of contraception - and the most permanent - is effective for women who have completely finished with childbearing. Unfortunately, it has sometimes been forced upon women of color without their consent, especially in the South Also, recent studies have shown that sterilization regret is significant among women (25 percent). Vasectomy, male sterilization, is safe and also highly effective. Some men, however, are reluctant to undergo this procedure. THE PILL Effectiveness rate: 94 percent. Pros: Easy to use, Effectiveness, continuous protection. Cons: Minor side effects, links to serious illness, need a doctor's prescription, little or no protection against STDs. Oral contraceptives remain one of the most easy-to-use and effective birth-control methods. The Pill comes in two basic types and is generally taken daily. The most common type, the combined synthetic pill, works to suppress ovulation, while the newer "minipill" thickens the cervical mucus to keep the sperm from ever reaching the egg. Because hormones, even synthetic ones, can wreak havoc on the system, women who take oral contraceptives often complain of a number of side effects, including breast tenderness, weight gain, decreased libido, and moodiness. (The minipill, however, has a much lower dose of hormones and therefore, according to many women, fewer side effects.) Recently a "Pill scare" hit the media Studies have linked oral contraceptives with increased risk of breast cancer, but conflicting research claims that the Pill is safe and has a protective influence against some cancers. Until further, more conclusive, research is conducted, experts suggest that the Pill is safest for nonsmoking, nonobese women under 35 with no family history of breast cancer. INTRAUTERINE DEVICE (IUD) Effectiveness rate: 94 percent. Pros: Protection without continual insertion and removal Cons: Cramps, bleeding between periods, no protection against STDs, may encourage tubal infection, a doctor must insert. The IUD, once touted as the most carefree method of birth control (you put it in and forget about it) turned into a nightmare for thousands of women - and a disproportionate number of women of color - who suffered from complications caused by the poorly designed Dalkon Shield. Now. with American companies worried about lawsuits, only two IUDs are still on the market: the Progestasert and the ParaGard. They are both inserted into the uterus by a doctor and prevent egg fertilization. Along with side effects, the IUD may also allow bacteria to enter the reproductive system, causing infection and even sterility in extreme cases. These days the IUD is prescribed with care, mainly to women in stable monogamous relationships who have had all the children they want and who have no history of pelvic inflammatory disease. CONDOMS Effectiveness rate: 86 percent. Pros: Available over the counter, protection against STDs. Cons: Can break, sperm can spill into the vagina if not removed correctly, sometimes uncomfortable and disruptive to use. Condoms, thin latex sheaths, are placed over the penis prior to intercourse to block sperm from entering the uterus. They offer the best possible protection against STDs and are also highly effective (especially when used with a spermicide) and easy to buy. DIAPHRAGM Effectiveness rate: 84 percent. Pros: Fairly comfortable and easy to use, protection against STDs when used with spermicide that contains nonoxynol-9. Cons: Increased bladder infections, may become dislodged. The diaphragm, a soft rubber cup that is inserted into the vagina before intercourse and covers the cervix, doesn't hamper menstrual cycles or uterine walls. The device should be used with a spermicide to protect against pregnancy and STDs. NATURAL FAMILY PLANNING Effectiveness rate: 84 percent. Pros: Little or no equipment required, safe, free. Cons: Difficult to determine safe days. To prevent pregnancy women monitor their menstrual cycles by means of temperature, changes in their cervical mucus or a combination of these indexes in order to determine which days to abstrain from intercourse. The "rhythm method" works best for women with regular menstrual cycles. Your gynecologist can give you more information. THE CERVICAL CAP Effectiveness rate: 82 percent. Pros: Can't be felt during intercourse, protection against STDs when used with nonoxynol-9 spermicide, can be left in place for up to 48 hours. Cons: Can be difficult to insert, can cause abnormal Pap smears, requires a doctor's prescription, is not widely available. Another barrier method, the cap can be left in place longer than the diaphragm and without reapplying spermicide. It is also smaller and more comfortable. But the cap takes more practice to insert properly. It should only be used by women with normal Pap smears because of the possible adverse effect on cervical tissue. THE SPONGE Effectiveness rate: Pros: Available over the counter, works for 24 hours after insertion, protects against some STDs. Cons: Less effective for women who have had children, can be hard to remove, slightly increased risk of toxic shock syndrome. A cylinder of polyurethane infused with the spermicide nonoxynol-9, the sponge itself blocks sperm from entering the uterus, and the spermicide guards against a number of STDs as well as killing sperm. SPERMICIDES Effectiveness rate: 74 percent. Pros: Available over the counter, protection against STDs. Cons: Must be reapplied, can irritate genitals, low effectiveness. Spermicides are available in the form of foams, creams, suppositories, jellies and film. Even though they're messy, they are easy to buy and offer protection against STDs. Michele Kort is a staff writer for UCLA alumni publications. * Effectiveness rates are based on "Choosing a Contraceptive: Effectiveness, Safety, and Personal Considerations" by Elise Jones, Ph. D. and Jacqueline Forrest, Ph. D. Rates for sterilization, the IUD and the cervical cap are based on 1982 data. The "Choosing a Contraceptive" study categorizes the sponge as a spermicide for an effectiveness rate of 74 percent. Other, more detailed, studies have produced higher effectiveness rates. RU READY? Within two to five years - legally or illegally - the abortion pill will be available here. Developed by scientist Etienne Baulieu in 1982, it's called RU 486, after the French company Roussel-UCLAF. It was approved for use in France in 1988, and tens of thousands of French women have used it since then. Opponents of abortion are doing everything to stop this controversial drug. But Judy Norsigian of the Boston Women's Health Collective calls it "the most revolutionary new birth-control method available." When taken in the first five weeks after conception and in combination with an injection, RU 486 is 95 percent effective. In France, a woman must have a pregnancy test and a counseling session before she is given a dose of 600 milligrams. The drug causes the uterine lining to break down and expel the fertilized egg. Two days later she may return to the clinic for an injection to ensure that the abortion is complete. Although the process is considered very safe and avoids infection, it is not without discomfort from cramping.
COPYRIGHT 1990 Essence Communications, Inc.             |
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