For those educating on sex and others, the rejoinder is agonizingly perceptible. Withdrawing prior to ejaculating, the so-dubbed ‘pullout’ technique is the final option that is to be employed solely when dearth of any other choices. Conversely, the efficacy of condoms is well established.

Hence, reproductive specialists were surprised by the report printed in Contraception publication, pronouncing that withdrawal had nearly similar efficacy as the male condoms – at least in regards to averting conception.

The authors have written that in case the man pulls out prior to ejaculating on every occasion the pair have vaginal sex, nearly four percent of pairs would conceive over the span of a year’s time.

Condoms usage when done correctly has a nearly two percent rate. However more significantly, the authors have mentioned are the rates of normal usage, as an individual could not always be able to use any birth control option flawlessly on every occasion. Typical usage of the withdrawal method leads to conception in eighteen percent of the cases, the authors have written; in case of normal use of condoms chances of pregnancy are seventeen percent.

Even with other techniques that have greater efficacy, Pills and patches have failure rate of eight percent, Depo-Provera shots have three percent failure rate whereas for diaphragm it is sixteen percent. Intrauterine device (IUD) has a failure rate of below one percent of the occasions.

The author helming the study, Rachel K. Jones from the Guttmacher Inst. that researches reproductive health issues states that she and her associates were not advocating the withdrawal method, instead were advocating speaking about it. Jones stated that withdrawal is a widely dismissed contraception method, though many women have used it at some stage in their lives. She stated that it did appear rational to contrast the withdrawal technique to condoms as health care experts have no issues promoting condoms despite them having certain flaws.

Worries ride high among sex educators and doctors that advocating this method would only fuel teens into engaging in unprotected sexual behaviours. However authors have pointed that disparate to a condom, pullout technique fails to safeguard from STDs or sexually transmitted diseases, a potent basis for encouraging condom usage.

Others say that withdrawal is preferable as it is a smell and chemical-free way of having sex. The study outcomes indicate that in correctly and consistently using withdrawal method could significantly lower chances of conception.

Some argue over the point that in regards to reliability any technique employed repeatedly is bound to have a high failure chances. Also in several circumstances, even well-meaning males could go off beam or some men were just not able to get it right despite having said so.

The nervous truth out there is that withdrawal method is better than no measure taken and is available at all times, though one needs to tread with caution in such grey areas.

Sergio Haimovich, researcher at the Hospital del Mar in Barcelona as well as author of the study that was printed in the European Journal Of Contraception And Reproduction Health Care, elucidated that the long-acting birth control means like the IUD, contraceptive injection or contraceptive implant are yet to be extensively used.

In European women subsequent to the male condom, the pill is the vastly accepted contraceptive means, whilst the intrauterine contraception (copper IUD or hormone-releasing IUS) is widely chosen as a long-lasting answer. From the more than eleven thousand women that were studied in fourteen European countries, long-term means were employed by 1,088 women – that was about ten percent of the sample.

The Spanish research, a branch of a broad-ranging study on the wide-ranging contraceptive outline of European women, assesses the usage of long-functioning reversible birth control means. Haimovich stated that those using them were thirty plus women who did not wish to bear more offspring and were exploring long-standing solutions. According to experts, girls in the younger age bracket employed diverse contraceptive methods.

Haimovich explicated that the reasons why particular birth control methods were chosen and how, were still unidentified. However, why was there a technical curiosity in the user report? He answered by saying that these queries could aid in formulating birth control recommendations that would be better modified to suit user needs.

Condom – A clear winner in Spain

The data takes into consideration the particular requirements of each country. Spain is one among the European countries where the condom is widely used by all age groups. But, a study revealed that hormonal methods like the pill or the ring are widely been employed.

The outcome of this study that garnered the award for the best work at the National Congress of Gynaecology during 25th September the current year, aids in elucidating what user’s wants are and enabling more apposite birth control means to be produced. Haimovich asserted that the scientist’s approach must perennially be to acclimatize their dissertation to that of the user’s needs and work in a way that makes them sentient to the user’s requirements.

For many years there have been soaring concerns regarding PID or Pelvic Inflammatory disease being associated to IUD, though it is unknown that IUD on its own doesn’t lead to PID. Rather, if one is suffering from a genital tract infection and goes in for an IUD insertion, the infection could spread into the uterus and fallopian tubes. If one is at risk of getting an STD, the doctor would examine and suggest appropriate treatment prior to getting an IUD.

Intrauterine devices lower the risk of getting pregnant inclusive of ectopic or tubal pregnancy. However, in the case of pregnancy in the presence of an IUD, there is a greater possibility of it being ectopic. Ectopic pregnancies need medications or surgical intervention in order to terminate the pregnancy. At times the fallopian tube related to the particular side would need to be taken out.

IUD usage could be a safe contraception choice in the following situations:

• Those women having a past of ectopic pregnancy for whom the duo choices of copper IUD and LNg IUD are apposite choices.
• Those with a past of erratic bleeding during periods and pain. The LNg IUD might be suitable for such women and in those with a bleeding disorder or those that are taking blood thinning medications (anticoagulants).
• Women with a risk of getting bacterial endocarditis. An antibiotics course would be administered during both the inserting and removal procedure.
• Diabetic women.
• Women that are breast feeding.
• The LNg IUD is an ideal option for those women with a past of endometriosis.

IUD might not be the right option for you when:

• Women that have never had a past pregnancy are more prone to having pain associated with IUD and have greater likelihood of the IUD being expelled following its insertion.
• Women presently having any kind of sexually transmitted disease or STD or have had an instance in the last three months.
• Women who are unwilling to use condoms in safeguarding themselves from STD’s.
• Those with an actively occurring infection in the vagina or cervix.
• Those having pelvic inflammatory disease or PID or with a lately occurred incidence of PID.
• Women with a bleeding disorder or having blood thinning medicines (anticoagulants). Though, the copper IUD cannot be used in such cases, in its place the LNg IUD could be used.
• Women with a problematic past with IUD.
• Women having anomalies in the uterus.
• Those women having uterine infection following delivery or a septic medical termination of pregnancy.
• Those with uterine bleeding of unclear basis.
• Those allergic to copper, hence the copper IUD would not be a feasible choice.

Those women that have one of the earlier plastic versions of IUDs like the Lippes Loop, must seek consultation regarding the replacement of the older IUD to a greatly effective copper or hormonal option.

Read more at: Intrauterine Device – IUD – The Effectual Birth Control Coil – Part V

An IUD is a miniature plastic device resembling the letter ‘T’, swathed in copper or could contain hormones. The insertion of the IUD is a procedure carried out by a doctor who inserts it into the uterus. The IUD has a plastic string that is attached to the IUD end that dangles down through the cervix into the vagina. The IUD could be checked for its correct placement by feeling for the presence of the string. This string is additionally employed by the doctor during the removal procedure of the IUD.

IUD Types

• LNg or Levonorgestrel IUD – This type of IUD is additionally known by the name ‘Mirena’ that works by releasing levonorgestrel – a type of progestin. The effectiveness of LNg IUD has been noted to being slightly more than copper IUD in the prevention of pregnancy. It might lower the chances of developing pelvic inflammatory disease or PID which is an added benefit not noted in other IUD’s. The LNg IUD has been found to be effectual for a span of five years.
• Copper IUD – The widely used IUD is the copper IUD (for e.g. Paragard). The T-shaped IUD has a copper wire wrapped around its stem portion. The copper IUD is known to stay in situ for a period of at least ten years and is quite an effective contraception means.

Working Principle

Both the kinds of IUD’s are known to hinder fertilization of the egg by having a marring effect on the sperm. The IUD additionally has an effect on the lining of the uterus which is the lodging and growing location for the fertilized egg.

• LNg IUD – The LNg IUD operates by thickening the mucus in the cervix that acts like a barrier for the sperms attempting to make an entry into the uterus, thus impeding fertilization. LNg IUD also avoids the endometrial lining of the uterus from becoming quite thick that in turn makes the endometrial lining an unfavourable place for implantation and growth of the fertilized egg. The hormones present in the LNg IUD also cause a reduction in monthly periods flow and associated discomfort due to cramps.
• Copper IUD – Copper has a lethal effect on the sperm. It causes the uterus and fallopian tubes to produce fluid rich in WBC or white blood cells, copper ions, enzymes and prostaglandins that have a fatal impact on the sperm.

Presently, the pill has been refined even further to be totally tailor-made to suit women’s needs by including the feature of lesser or no menstrual cycle along with no signs of pre-menstrual syndrome (PMS) and no nagging skin conditions. The birth control pill bandwagon comprising of Seasonale, Yaz, Yasmin, Lybrel and even Seasonique have made path-breaking changes in the field of birth control.

Christopher Estes, asst. professor of Obst. & Gynecology, University of Maimi School of Medicine has stated that these are basically variants of the age-old birth control pills that are dual combo of miniscule dosages of estrogen (lesser than 50 micrograms) and progestin that have had a safe track record.

Professor Estes further explained that the minor-varying hormonal composition in these pills cause lesser menses in those that have one. The novel progestin type that is utilized in certain pills assists in lowering mood swings and bodily symptoms that quite a few women experience prior to their menstrual cycle known as the PMDD or pre-menstrual dysphoric disorder. Even pimple or acne conditions are treated with this progestin type.

Patti J. Ross, Professor of Obstetrics and Gynaecology in University of Texas Medical School, Houston clears many doubts by stating that according to a generalised thumb rule, those pills that have estrogen assist in averting skin eruptions and pre-menstrual syndrome. She further added that the progestin type found in products such as Yasmin and Yaz have a different approach wherein they have a diuretic consequence that helps in reducing swelling, fluid- retention and weight increase.

The presently available birth control pills are quite lenient in comparison to those that were available in the past. In the earlier times, the pills had to be consumed at the exactly same time, daily, failing which there could be a possibility of ovulation. The new-fangled breed of birth-control pills has a buffer time zone wherein one can take them after a few hours, say if one doesn’t remember to have the morning tablet; one could still have it during the afternoon and not be hassled about it.