Protection for Every Occasion

Protection for Every Occasion

Birth Control techniques don't work unless they're used regularly

The following efficacy rates, provided by the U.S. Public Health Service, are yearly estimates based on several studies. Methods that are dependent on conscientious use are subject to a greater chance of human error and reduced effectiveness. Without contraception, some 60 to 85 percent of sexually active women would likely become pregnant within a year.

Male Condom: About 90% effective.

Use: Applied immediately before intercourse; used only once and discarded. Nonprescription.

Risks: Rare irritation and allergic reactions.

STD protection: Latex condoms help protect against sexually transmitted diseases, including herpes and HIV.

Female Condom: 74 to 79 percent effective.

Use: Applied immediately before intercourse; used only once and discarded. Nonprescription.

Risks: Rare irritation and allergic reactions.

STD Protections: May give some protection against sexually transmitted disease, including herpes and HIV; but not as effective as male latex condom.

Spermicides used alone:

Use: Applied no more than ah hour before intercourse. Nonprescription.

Risks: Rare irritation and allergic reactions.

STD Protection: Unknown.

Learn more about birth-control techniques. Photo by Elena

Sponge

72 to 82 percent effective.

Use: Can insert hours before intercourse and be left in place up to 24 hours; used once and discarded. Nonprescription.

Risks: Rare irritation and allergic reactions; difficult removal; very rarely, toxic shock syndrome.

STD Protection: None.

Diaphragm with Spermicide

82 to 94 percent effective.

Use: Inserted before intercourse; can be left in place 24 hours, but additional spermicide must be inserted if intercourse is repeated. Prescription.

Risks: Rare irritation and allergic reactions; bladder infection; very rarely, toxic shock syndrome.

STD Protection: None.

Cervical Cap with spermicide: At least 82 percent effective.

Use: Can remain in place for 48 hours, not necessary to reapply spermicide upon repeated intercourse; may be difficult to insert. Prescription.

Risks: Abnormal Pap test; vaginal or cervical infections; very rarely, toxic shock syndrome. 

STD Protection: None.

Pills: 97 to 99 percent effective. 

Use: Pill must be taken on daily schedule, regardless of the frequency of intercourse. Prescription.

Risks: Blood clots, heart attacks, strokes, gallbladder disease, liver tumors, water retention, hypertension, mood change, nausea; not for smokers.

STD protection: None.

Implant (Norplant): 99 percent effective.

Use: Effective 24 hours after implantation for approximately five years; can be removed by physician at any time. Requires prescription, minor outpatient surgical procedure.

Risks: Menstrual cycle irregularity; headaches, nervousness, depression, nausea and dizziness, change of appetite, breast tenderness, weight gain, enlargement of ovaries and/or fallopian tubes, excessive growth of body hair; may subside after first year.

STD Protection: None.

Injection (Depo-Provera): 99 percent effective.

Use: One injection every three months. Prescription.

Risks: Amenorrhea, weight gain, other side effects similar to Norplant.

STD Protection: None.

IUD: 95 to 96% effective.

Use: After insertion, stays in until physician removes it. Prescription.

Risks: Cramps, bleeding, pelvic inflammatory disease, infertility; rarely, perforation of the uterus.

STD Protection: None.

Was it the most glorious of the most monstrous moment when you met his Creative spirit? The German duo Heracut Graffiti at 1135 Dundas Street East, Toronto. Photo by Elena

Periodic Abstinence: 53 to 86 percent effective.

Use: Requires frequent monitoring of the body's functions and periods of abstinence. Instruction from a physician or clinic.

Risks: None.

STD Protection: None.

Surgical sterilization: Over 99 percent effective.

Use: Vasectomy is a one-time procedure usually performed in a doctor's office; tubal ligation is a one-time procedure performed in operating room.

Risks: Pain, infection, and, for female tubal ligation, possible surgical complications.

STD Protection: None.

The Vasectomy Option

Reversing the process is sometimes possible, but you better not count on it.

When it comes to birth control techniques, most of the options belong to women. But when it comes to sterilization, the man takes center stage. That's because vasectomy has long been regarded as both simpler and safer than its female equivalent, tubal ligation. For couple ready to conclude their child-bearing, vasectomy is the better course, say doctors. More than half a million men elect this option each year.

Not that vasectomy carries no worries. Two recent studies have raised the possibility that men with vasectomies may have some higher risk of developing prostate cancer. While the research is considered too preliminary to require revising current medical practice, further investigation of the question is warranted.

In a vasectomy, the tube that carries sperm to the penis is cut. The procedure can be done on an outpatient basis and requires only 15 to 20 minutes. The doctors injects a local anesthetic in the scrotum and around each of the two vas deferens, the tubes that carry sperm from the testicles to the penis. After making a small incision in the scrotum, the doctor cuts and closes the tube with ties. After the operation, a man will still produce sperm, but the sperm can't enter the penis. Seminal fluid continues to be produced, nevertheless, and erection and ejaculation still take place.

Post-operative complications are relatively rare, and minor in most cases. They can include bleeding, infection, and the development of painful lumps in the scrotum. Risks can be greatly minimized by having the operation done by a doctor who performs it frequently.

Reversal of a vasectomy is often possible, but success is by no means a certainty. Advances in microsurgery techniques make the chances of successfully reconnecting the vas 98 percent, but even is the vas is reconnected, there is only a 50 to 70 percent chance that the man will be able to fertilize an egg. That's because men who have had vasectomies often form antibodies against their own sperm. The antibodies don't appear to harm the man's health, but they can destroy fertility.