Monday, November 26, 2007

Golden Posts - STDs and Birth Control

Following are actual posts from popular forum

Guido on Abortion

the whole topic of abortion is (of course) a very contentious area, where religious beliefs, science and personal feelings are all components of a huge "mix" of conflicting ideas and emotions, defying our attempts to be rational and objective.

some people would have you believe that life begins at the moment of conception, others when the egg implants, or, by the arbitrary "legal deadline" for abortion, or, when the fetus in theory can sustain its own life (needing only nourishment), etc., etc.

one remote south american tribe (with no modern methods of birth-control) was discovered to allow the father to practice "birth-control" up to the 1st birthday of the child! after the child's first birthday such an act was considered murder.

which of all these options is right or wrong? at what point does "preventing life" become "taking life"? we probably all have varying opinions on this, but of course opinion isn't fact and definitive facts seem to be hard to come by.

without doubt, any answer we come up with (in a practical situation) is at best an uncomfortable, compromised one, often based on fear and/or material considerations ... all the more reason not to put ourselves in the awful position (of HAVING to decide) in the first place!

bottom line is ... next time we are flippant about birth-control, we should stop and consider the possible consequences, and the decision we might ultimately be forced to make and live with (one way OR the other) for the rest of our lives!

this is definitely an area where prevention is a LOT better than "cure".

Brandye on Being Late

I'll answer both personally and medically. As a teen, the interval between my periods varied from two weeks to six weeks. As I aged, this finally stabilized when I was about 17. Pretty typical.

I have patients who have four periods a year irregularly and I have them who have periods every two weeks. Those two are in treatment. Extreme physical stress (sport training) can cause the period to stop for months - even a year or more.

For teens a very broad range is normal. After one gets all the hormones balanced, individual, typical women may vary three days or so either side of the expected date. Illness, stress or medication can cause this to vary. Women who vary are often put on the pill to regulate the system. This is medication with contraception as a by-product.

For the last several years (in my 30s), every fourth Tuesday, I feel crappy and every fourth Friday, there it is.

Brandye on Condoms

Latex is very abrasive at a microscopic level. A "normal" session is probably not an issue. One of those marathons that universities seem to generate can leave a woman downright sore. The polyethylene are much smoother and cause less wear and tear. This also makes them preferable for anal sex.

Do not ignore female condoms. They are more expensive, look a bit strange in place and require some practice. On the plus side, the male actually slides inside them and often will notice them less than a sheath firmly surrounding him. Also try, with either regular or female condoms, a teaspoonful of spermicidal lubricant inside the condom. It does add a bit of protection but also allows the man to slide a little adding to the feeling.

I use female condoms once in a great while. I find them very satisfactory if he has already brought me off. They do cover the inner labia and reduce friction that pulls the clitoral hood so I lose a bit of sensation with them. The female condom can be in place for digital stimulation but you would have to add it after oral. Insertion will have to be the woman's job unless you train him.

Mrlink on Spermicides

Check out this link to the site info on Vaginal Spermicides and other forms of birth control.

In answer to your questions:

Vaginal spermicides come in three basic forms: creams, foams, and jellies.

Cream and jelly spermicides should never be used by themselves and are really only effective when combined with a conventional barrier method (i.e., condom, diaphragm, etc.). Foam spermicide can be used on its own, and if always used properly is around 95% effective. However, many people have difficulties using foam spermicide correctly every time they have sex. Some users do not completely fill the applicator ... others forget to shake the can. So, for a typical user, the effectiveness of foam spermicide is around 80% or less.

Spermicidal creams and jellies should be applied to the inside of a woman's cervical cap or diaphragm.

Always consult a physician before choosing any birth control method.


Vaginal spermicides tend to be very inconvenient. They must be applied no more than 20 minutes prior to intercourse. This requires a woman to always have to carry the spermicide and applicator with her whenever there is a possibility of vaginal intercourse.

Another limitation of spermicides is that they have a chemical taste and can be a nuisance during oral sex.

Some couples have found that spermicides provide too much lubrication, making intercourse less pleasurable.

If an allergic reaction is experienced (a rash or itchiness is a sign of this), then the use of that spermicide should be discontinued.

Most drugstores should carry these items - try a larger drugstore or ask the pharmacist.

Brandye on the Menstrual Cycle

The menstrual cycle is paced by two female hormones that are released into the bloodstream in varying combinations over the course of the month. At one mix, they start your period; at another mix they release an egg. The rest of the time they are moving back between those two events.

Let's follow a 28 day cycle - mine, perhaps. The first day of your flow is Day 1. At that time there is relatively more progestin and less estrogen. An egg has not attached to the wall of the uterus, so it sloughs off. That flow is the nutrients ready to help an embryo form if a fertilized egg arrives. If not, it is disposed of. For the first several days of the cycle, the flow continues. During this time there is a relatively low chance of pregnancy. As the flow ends, the two homones are reversing their mix gradually and after a fortnight, the estrogen peaks and the progestin bottoms out. That is the signal for the egg to leave the ovary and start its trip down the fallopian tubes. This is the time of greatest likelihood of becoming pregnant. It takes the egg a couple days to make it to the uterus. In the absence of sperm to fertilize it, the egg dies and passes on through. At the same time the two hormones begin reversing themselves, again, until at the end of the second fortnight, the flow begins again.

So the most likely time to become pregnant is half way between the two "first days" and the least likely is during the flow. The fertile period for the woman is about two days or a bit more; sperm may live up to two days in the uterus and fallopian tubes. So, at a minimum, you should abstain for about a week or one-quarter of your cycle.

The "rhythm method" is based upon the calendar, counting days. If 100 women use this as their only "protection," 40 + will become pregnant in a year. See the birth control section under natural methods. The basal temperature method involves taking your temperature every day and refining the calendar method by the body's temperature. It is a bit more effective but 20 of those women will still become pregnant. The most sophisticated of the natural techniques requires training, preferably including your partner, identifying the mucous plug that forms in the cervical os. It is rather involved and still not as reliable as most hormonal methods (pill, patch, implant) and not much better than barriers and spermicides, alone.

The natural methods are appropriate for stable relationships where pregnancy will be, perhaps, inconvenient but not a major upset. In the stable relationships, postponing sex for a week is no big deal. In most youthful romances, this is not likely.

Inspite of the above, women have become pregnant on every single day of a cycle, including during their periods. That is why I say the most likely time to become pregnant is when there is a bare penis in the vagina. In women whose period is erratic, so is ovulation. It is simply not adequately predictable for most young women to take a chance with unprotected sex.

Look at your calendar. Identify your last two "first days." Those are your least fertile days. Half way between them is your most fertile time.

Brandye on the Morning-after Pill

There are two approaches labelled as "morning after pill." One is Mifeprex or RU-486 and the other is a combination of regular birth control pills packaged in doses for this purpose. Only some brands are approved for this use. In all cases, the sooner the better. Mifestrone is used up to the time the first period is due; the birth control pills within 48 hours of intercourse. As directed, each is about 75% effective. That is three of four pregnancies are aborted.

I always have prepared packets of regular pills available for patients. I have never presecribed Mifeprex. In either case, the woman will be nauseous and ill feeling for a day or two. Worse with the Mifeprex.

Any woman who tries either of these should be prepared to follow up with a mechanical abortion if the pill does not work. They are intended to kill the fetus and, when not successful, will likely cause damage and deformity.

There are also "natural" or herbal abortifaceants. DON'T!! Yes, they have been used successfully for thousands of years. They have also been killing women and deforming babies for that period of time. They are, by definition, poisons. If they do not create spontaneous abortion, they WILL cause deformity of the fetus. If you try and fail with an herbal approach, you must have a mechanical abortion.

Some women who have both had an abortion and, on another occasion, used the pill approach say they would rather have the abortion.

Believe me, folks, you want to prevent the pregnancy; not terminate it. Once you have missed your period, the choices are limited and all undesireable.

Brandye on Effectiveness of Contraception

I have been reading the questions here for several months and have read the birth control information at "home" here at Sexinfo. Some questions repeat themselves and some data are wrong. For instance, the home page reference shows that withdrawal is more effective than a diaphragm and nearly as effective as condoms! Not so.

First: How is the effectiveness of birth control determined? This is done per 100 sexually active (once or more per week) using whatever form of protection for a year. As an example, if 100 women are active for a year with no protection whatever, 85+ of them will become pregnant.

Now for the various techniques. The little pamphlets and stuff that manufactureres distribute often show "theoretical effectiveness" but there is a great difference between theory and practice. The figures here are a compendium of various litereature and websites giving the best available real life experience.

Abstinence is the only 100% effective technique. I guess mutual masturbation would be right there, also, but as pleasant as this can be, it often leads to the next step. Be ready.

The hormonal approaches are the most effective - The Pill, The Shot, Implants. These have a theoretical effectiveness of 99% but in real life tests come in between 93 and 99 percent. That means that of every 100 women on the pill, about five will become pregnant in any given year. The reasons? pills are missed - this is the greatest problem and with today's low dosage, one pill missed can be critical. Other medication can interfere with hormonal techniques. Many anti-biotics cancel hormone contraception. My girlfriend is a midwife and just delivered twins to a woman on the pill! A consultant (specialist) prescribed an anti-biotic and did not warn her to use other protection. If you are prescribed anything, especially anti-biotics, tell the physician you are on the pill. Many dietary supplements can have a similar effect. Vitamin E should not be taken at the same time as the pill. If you take vitamin E, do it twelve hours apart from the pill. Discuss other dietary supplements before you take them while on any of the hormonal contraceptives.

Even 1 woman in 10,000 who has had her tubes tied will become pregnant! and one in 10,000 men who has a vasectomey will become a father!

Condoms are about 85% effective. That means fifteen of our 100 women will become pregnant using condoms properly. The problems here are beakage and leaking. The leaking I refer to is around the top. If you linger or try another go, semen will work its way out and into your vagina.

The chemical or spermicidal approaches alone are about 80% effective. So, twenty of our women will become pregnant using vaginal cream, foam, film, etc. It may have missed a spot or a particularly healthy sperm might swim too far, too fast without coming into contact with spermicide. If he makes it through the cervical os, he is home free. And if the ejaculate hits square on, many of them in the center of the squirt will be there!

Female barrier techniques are about as effective as the condom. That is the female condom, diaphragm or cervical cap. All three should be used with spermicide. In some studies, sperm have been found in the vagina more frequently with the female condom than with regular condoms. Sperm will be there when the diaphragm or cervical cap are used. You are depending upon the barrier to keep them out of the cervical os so the spermicide can do its job. Both the diaphragm and cervical cap must beft in place for several hours.

The sponge is a variant on these and has about the same effectiveness. It needs no prescription and can be effective for multiple times if left in place.

The flexible menstrual cup (Instead) is used by some women similarly to a cervical cap. It is not recommended for this purpose but is really not much different. A proble with these, as with the cervical cap, is that they can be moved away with penile thrusting.

Withdrawal is difficult to measure because there is no way to control the measurement. In all tests where vaginal fluids have been tested closely after withdrawal, sperm has been present in various numbers. Sometimes very few and sometimes a lot. Best guess is that withdrawal will leave about 50 of our favorite hundred women pregnant.

Anal sex is an alternative. Cetainly it reduces the number of sperm who find their way "in." but most of the ejaculate will drain out and be less than an inch from the vaginal entrance. Oral keeps them well away. No woman ever got pregnant being eaten or giving head. If that is the only sexual activity. Rubbing the penis against the vulva also reduces the number of sperm to get into you. If the shot does not come right at your vaginal entrance.

OK, so what do I recommend? To my young, especially teenaged, patients I recommend that whenever the penis is in view it be covered with a condom and before it gets close to the pubic area, there be spermicid in the vagina. It is also a good idea to place a small gob of vaginal jelly inside the condom. This forms a seal against the little buggers swimming around the end.

I made the mistake (and was lucky) of occasionally going bare during my period. Theoretically, this is not a time of fertility. In young women, however, whose periods are stil a bit variable, so is ovulation variable. The recommendation of condom and spermicide stands.

Semen is great stuff; I love to extract it from male friends. It is ull of sperm and those little devils can mess up your life plans in an instant.

Brandye on The Pill & Shot

There are at least three different issues regarding the PILL posted here. All are important but it appears that there is a bit of misinformation around. The pill is a wonderful contraceptive, but it is not perfect. Here is a more comprehensive treatment.

The PILL is the oral medication that provides hormones to control either ovulation or the receptivity to a fertilized egg growing in the uterus. Other hormonal approaches include shots, implants and, recently, a patch. The birth control pill is by far the most common and for many women the most acceptable.

The theoretical effectiveness of the pill approaches 100% - probably one woman out of a hundred would get pregnant each year using the pill exactly as prescribed. The actual effectiveness is about 95-96% - meaning that four or five sexually active women out of each 100 and using the pill will become pregnant.

Why the difference? The leading cause is carelessness or not understanding. Women have started on the pill and become pregnant the first month! It takes one complete cycle until you are protected. The first month that you are on the pill, keep up whatever effective contraception you have been using.

Missed pills are a problem with the low power pills being used today. With the original high dose pills missing one made little difference because there was still plenty of estrogen in the bloodstream. With todays smaller and safer doses, a missed pill can lower the hormone level to the point that ovulation takes place and pregnancy is possible.

Taking the pill with any other medication, or even dietary supplement, should be discussed with your physician or nurse. There are many different pills with different hormones in varying doses. Each one has different characteristics and may be neutralized by other drugs. Common anti-biotics are commonly used without warning from your doctor and neutralize most hormonal contraception. If you take anti-biotics, you will need additional protection for that month. Vitamin E, in large doses. has a known neutralizing effect. Other dietary supplements can also do you in.

Some women attempt to schedule their periods and take several months of their prescription consecutively. There are some valid reasons for this. Athletic competition; weddings; travel. There is, under test, a pill that both prevents conception and eliminates periods - do not ask your doctor for it, it still requires much testing. If you start messing with your cycle, get advice from whomever prescribes your pills. Some pills are more amenable to this than others. There is greater risk with some than with others. And remember, world records have been set and world champiobships have been won while the woman was having her period. Running, speed-skating, tennis, figure skating, swimming, bicycling. For many women, they are better off letting things flow naturally than trying to schedule periods. Many women conduct very active sex lives during their periods (I can vouch for that!). Long term hygiene devices are available for travellers allowing much longer times between changes than we are accustomed to with pads and tampons. There are alternatives to rescheduling your period and they do not include the possibly heightened risk of pregnancy when stopped.

Some (younger) women are taking the pill primarily for dysmenorrhea (difficult periods). Others primarily for acne and other simply to have regular periods. The pill is the preferred treatment for severe cramping and difficult periods. Not mild distress (we all have that) but really immobilizing problems. Yes, you are protected from pregnancy as well as any woman on the pill. But if you are a bit more relaxed in taking the pill exactly as prescribed, you are at higher risk.

And remember, the pill offers NO protection against sexually transmitted diseases. Comdoms are often a good idea even while on the pill

Brandye on Birth Control Systems

The effectiveness of birth control systems is based on 100 sexually active women using them for one year. How many will be pregnant at the end of that year. If 100 women use nothing and are regularly sexually active, 85 will become pregnant.

So, what does 95% effectiveness mean? It means that 95% of those 85 will not become pregnant. The use of percentages can be very misleading. Add to this the fact that the sellers try to look good by using theoretical rates rather than actual user rates. In all cases, with all systems, they are "more effective" in 30-something women than in teens! There are many reasons for this.

In actual use, if our 100 women have sex a few times a week for a year, using only condoms properly, 15+ will become pregnant. Adding spermicided in thae vagina and/or inside the condom, will reduce this to 3-5 pregnancies among our 100 women.

This is the time to become informed because after you are pregnant, it is too late.

When birth control systems are tested, there are many controls. I am aware of a drug company that calls all using women (during tests) at the same time every night and reminds them to take their pills. In actual use, sometimes we forget or take them at erratic times.

Condoms have been around for so long that clinical trials are not very modern and there is not a company rep there to roll it on. Be advised that "proper use" of a condom includes immediate withdrawal after male ejaculation. I hate that. We often ignore this little bit of proper use and semen leaks around the edges.

Condom breakage seems to run at under 5% but this is figured differently: it is the number of condoms that break divided by the number used. Fortunately, most of us have made it through a breakage but would have been less anxious for a couple weeks had there been a backup. Many prostitutes use two condoms! And are on the pill. The condom is mainly for disease and the pill for contraception. Read the data given here and send me a message through the control panel and I will be happy to explain further.

It is not as simple as a table of effectiveness, whether we are talking condoms or the shot.

Brandye on Responsibility for Contraception

The obvious answer is that in a loving relationship, there is a shared responsibility. So, guys. if she says "not this time" or "use a condom," it is your responsibility to comply. If "not now" is too frequent for your liking, it is time for discussion not forcing things.

Now, some girl talk. It is our female bodies that become pregnant. We have a responsibility to ourselves over any responsibility to any other. We are ultimately responsible for whether or not we become pregnant. I think it is great that vasectomy is so popular. I think it wonderful that men are overwhelmingy in favor of the their pill. Ultimately, I want to control my own reproduction - it is my body. If that means making love with women, so be it. If it is having my tubes tied, same. If it is using spermicide and requiring a condom that I put on him, fine. If I jack him off because we are not prepared, that is it.

I hear too many young, really young, women saying, "he told me it was OK" or "he did not really get in me" or "I thought I could not get pregnant then" or "it was just once" or "he said he had a vasectomy" or "he said he pulled out in time." Well, honey, guess who is pregnant! It is not he! And guess who is responsible: you are. Because you, more than any other, will live with the consequences.

Not many questions are raised here by people in permanent relationships. It is outside the permanent relationship where the greatest risks are. As a teen, at my aunt's advice, I always required that "he" provide the condoms. If he was unwilling to walk in and buy them, he should not be having sex. I always, however, had some with me along with some spermicidal preparation.

As we mature we learn to live with the monthly uncertainty. For sexually active women, pregnancy is always a possibility. Younger sexually active women are not psychologically prepared and the monthly worries affect all areas of their lives and, regrettably, often lead to other self-damaging behavior.

Every time you spread, you have a responsibility to your partner, your family (if still at home), the possibly resulting child and to yourself. Think it through before you say yes. Then prepare yourself.

Brandye on Anal Sex & STD’s

OK, I'll claim some expertise in this. Many urethral and prostate infections are caused by anal sex. There are many ways for bacteria to get into the male urethra but anal sex assures you they will be there.

Do not consider anal sex an alternative to vaginal sex to prevent pregnancy. Most of the ejaculate will leak out (incluing hundreds of millions of sperm) and that will put them very close to her vaginal opening. Sperm can be feisty little devils and pregnancy can occur.

Anyone taking a penis into the anus should be aware of certain things. The anus is designed as a one-way passage - out. The vagina is designed specifically to admit, hold and receive the deposit from a penis. The anus lacks the elasticity and flexibility of the vagina. When a penis enters the anus, tearing and distortion is almost inevitable. This makes one more susceptible to infection - STD or otherwise.

If anal sex is in your reportoire, lots of lubrication and ALWAYS a condom is called for. I am perfectly willing to suck a penis that has been in my vagina but I am not about to suck one that has been in my anus. Nor will I take it in my vagina.

Brandye on Spotting STD’s


Excuse the shouting (all caps). Read it again. Everything from the old fashioned clap to HIV can be present without no symptoms and can be passed on. Genital herpes go through active and latent stages and many think that if no sores are present, it is safe. Not so.

For women, any STD can result in sterility or worse. For men, they can be inactive and d oing damage for a long time.

Herpes is forever; HIV/Aids........

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