From: elf@coho.halcyon.com (Elf Sternberg) Newsgroups: alt.sex,alt.sex.wizards Subject: The alt.sex FAQ, Part 12: CONTRACEPTION Date: 23 Jul 1996 19:13:34 GMT Organization: Northwest Nexus Inc. Originator: superdj@marge.cs.mcgill.ca (David Johnson) Moderator: elf@halcyon.com (Elf Sternberg) Archive-name: alt-sex/faq/part12 CONTRACEPTION What are the various methods of contraception and their effectiveness rates? % of women experiencing an accidental pregnancy in the first year of use ------------------------------------------------- Lowest Lowest Method Expected Typical Reported ------------------------------------------------- Chance 85 85 43.1 Spermicides 3 21 0.0 Periodic abstinence 20 Calender 9 14.4 Ovulation Method 3 10.5 Symptothermal 2 12.6 Postovulation 1 2.0 Withdrawal 4 18 6.7 Cervical Cap 6 18 8.0 Sponge Parous women 9 28 27.7 Nulliparous women 6 18 13.9 Diaphragm 6 18 2.1 Condom 2 12 4.2 IUD Progestasert 2.0 3 1.9 Copper T 380A 0.8 3 0.5 Pill Combined 0.1 3 0.1 Progestogen only 0.5 3 1.1 Injectable progestogen DMPA 0.3 0.3 0.0 NET 0.4 0.4 0.0 Implants NORPLANT (6 capsules) 0.04 0.04 0.0 NORPLANT (2 rods) 0.03 0.03 0.0 Female sterilization 0.2 0.4 0.0 Male sterilization 0.1 0.15 0.0 _________________________________________________________________ Associated Risk statistics with Contraception Activity Chance of Death in a Year Risks for men and women of all ages who participate in: Motorcycling 1 in 1,000 Automobile driving 1 in 6,000 Power boating 1 in 6,000 Rock climbing 1 in 7,500 Playing football 1 in 25,000 Canoeing 1 in 100,000 Risks for women aged 15 to 44 years: Using Tampons 1 in 350,000 Having sexual intercourse (PID) 1 in 50,000 Preventing pregnancy: Using birth control pills nonsmoker 1 in 63,000 smoker 1 in 16,000 Using IUDs 1 in 100,000 Using diaphragm, condom or spermicide NONE Using fertility awareness methods NONE Undergoing sterilization: Laparoscopic tubal ligation 1 in 67,000 Hysterectomy 1 in 1,600 Vasectomy 1 in 300,000 Continuing pregnancy 1 in 14,300 Terminating Pregnancy: Illegal abortion 1 in 3,000 Legal abortion Before 9 weeks 1 in 500,000 Between 9-12 weeks 1 in 67,000 Between 13-15 weeks 1 in 23,000 After 15 weeks 1 in 8,700 The source is the 1990-1992, 15th Revised Edition of Contraceptive Technology. Authored by too many doctors to cite. However, this book is used by millions of doctors around theworld as an authority on contraception. Its authors gather their sources from data published by several different statistic gathering organizations (such as the Centres for Disease Control) and then compile and interpret it in their book. Happy Reading. Common Methods of Contraception Diaphragm Has a failure rate of 2% (i.e. out of 100 women who primarily use the diaphragm, two become pregnant in any year). Always use spermicide; both partners must learn how to place it properly. It has few associated risks; it cannot become 'lost' because the vagina is only a few inches long. Can 'slip' and press against the rectum; this can be uncomfortable. Also, some men can feel the diaphragm during intercourse. Some women have recurrent yeast infections when using the diaphragm. The average diaphragm costs about 20-30 dollars, but it must first be sized and fitted by a gynecologist, so there is the cost of a doctor's fee. Must be replaced every two years to ensure correct fit and product lifespan. A tube of Gynol II costs around 11 dollars and is good for 24 doses of spermicide. The major disadvantage to the diaphragm is that it must be used one of two ways; either it is inserted before any sort of sexual play, in which case the taste of spermicide can become an issue if the couple wishes to engage in oral sex, or is inserted after oral sex but before intercourse, which can be considered a major interruption of play and may lead to not using it all. (SOURCE: "The New Our Bodies, Ourselves" The Boston Women's Health Book Collective, 1984. Pgs 225-228.) Reality, The Female Condom The female condom is a soft, loose-fitting plastic pouch made of polyurethane (not latex) that lines the vagina. It has a semi-stiff plastic ring at each end. The inner ring is used to insert the device inside the vagina and hold it in place. The outer ring partly covers the labia area and holds the condom open. The female condom is market in the United States by Wisconson Pharmaceuticals under the name Reality. In the United Kingdom and Canada it is marketed under the name Femidom. Market acceptance testing has been going on for over a year, and on August 15, 1994, Wisconson Pharmaceuticals began widespread marketing of Reality. In theory, the polyurethane construction of the female condom makes it viable to use with oil-based lubricants, and Wisconson Pharmaceutical's hotline states that this is safe. The female condom is also the best viable alternative available for those people who are allergic to latex. The female condom should notbe used for anal sex-- the anus has no upper end and the outer ring is not enough to prevent it from being pushed into the anus and become lost. INSERTING THE FEMALE CONDOM. The female condom can be inserted up to 8 hours before sex. However, most women prefer to insert it between 2 and 20 minutes prior to sexual intercourse. The condom should be removed immediately after sex. Squeeze the inner ring with your thumb and middle finger, placing your index finger down upon the plastic inside the inner ring. Still squeezing, spread the labia apart. With your hand positioned with your palm towards you, insert the female condom into the vagina. Push the inner ring and pouch the rest of the way into the vagina until the inner ring is up past the pubic bone. The outside ring should now lie against the vulva, covering the opening of the vagina. THE FEMALE CONDOM AFTER INSERTION During intercourse, the female condom may move or shift. It should not be pushed into the vagina, and the outer ring is intended to prevent this. However, it may happen. If so, stop intercourse, fix the ring, and apply more lubricant to the penis or in the pouch. After intercourse, the female condom should be disposed of in a trashcan. Do not flush the female condom in the toilet. EFFECTIVENESS The pregnancy rate for the female condom under normal use is expected to be comparable to that of the male condom (13%). However, because of a lack of familiarity with the device, initial results have been discouraging, with rates as high as double that (26%). The female condom requires the use of an external, water-soluble lubricant. A package of Reality, the brand available in the United States, comes with three female condoms and a small bottle of lubricant (1/2 oz). The lubricant is comparable in quality to Astroglide. The female condom requires practice to use properly. Be prepared to take your time inserting it the first time. Those who have experience using a diaphragm will find the process familiar. The female condom has not been tested in its efficiency to prevent disease. It is expected to be as effective as a male condom. However, the insertion process calls for two steps: inserting the ring, where the hand is outside the pouch and in contact with vaginal fluids, and then fitting the ring, where the fingers are inside the pouch, thus spreading those fluids about the pouch where the penis will go. While there are solutions to this problem (have each partner do one of these steps, wear gloves for half the process, or wash hands before the fitting stage), none of them are adequate for most people. The female condom should not be considered a viable protection for STDs in cases where the woman is suspected to have a mucosal infection such as herpes or HPV. In the United States, Reality has been available primarily through Planned Parenthood. Wisconson Pharmaceuticals has started shipping to drug stores and it should be available throughout the U.S. in the last quarter of 1994. Reality is somewhat pricey-- three condoms and a small bottle of lubricant cost approximately $7.00 US. PERSONAL OBSERVATIONS. My wife and I were part of a marketing test group for Reality. It's expensive, difficult to learn how to use, and not very effective at preventing STDs without extraordinary measures. However, I happen to like it. Without enough lubricant, it will stick to the skin of the penis and act just as a male condom. With enough lubricant it feels much better than a male condom-- the penis responds mostly to friction, and that's what Reality supplies. A friend of mine who is allergic to latex thinks they're a gift from heaven. Some gay men have tried using Reality for anal sex, with mixed but generally positive results. Wisconson Pharmaceutical has announced, rather loudly, that they have no intention of making the modification necessary to make Reality truly viable for anal sex. Reality comes with an instruction booklet. The booklet is hilarious, mostly because of the name of the product. For example: * Use a new Reality with each and every sex act. * Read instructions carefully before using Reality. * The booklet explains how to use Reality. * Don't tear Reality. * Reality only works when you use it. * Make sure Reality is not twisted after insertion. * Reality should not be noisy during sex. * Reality may shift during sex. * Keep Reality out of the reach of children. If you have the opportunity to purchase and try Reality, do so at least once. Get three condoms and a bottle of lubricant and try them out. Any new reproductive technology is worthwhile, and who knows-- you might like them. Postcoital contraception (the "morning-after" pill): The morning-after pill will prevent pregnancy up to 72 hours after unprotected intercourse. It reduces the risk of pregnancy to about 1 to 2%; in comparison, the risk of pregnancy after mid-cycle unprotected intercourse is normally about 15 to 26%. The morning-after pill should not be used for routine contraception, as the failure rate is relatively high and it has unpleasant side-effects such as nausea. After an "accident", however, it may be very useful. See your doctor as soon as possible after unprotected intercourse to obtain it. Reference: "Contraceptive Technology" Condoms This is a posting of information about types of condoms which are significantly larger or smaller than average. I got it out of a book called "The Condom Book" or something similarly imaginative. One thing that was apparent from reading through the descriptions was that advertising on size (or for that matter thickness or ribbing or whatever) is often misleading. A brand which is claimed to be smaller than average frequently isn't outside the normal variation. There may also be differences in size based on variations in manufacturing and these figures were probably based on single samples. Different size measurements for different styles of the same brand may indicate such variations or be an attempt to provide some size variation, in which case getting the precise style named is important. All measurements are flat and don't take into account elasticity, which might influence comfort when worn. Typical condom flat widths range from 2" to 2-1/8" (meaning two and one eighth, not two minus an eight). All the condoms listed here are both lubricated and reservoir ended. Company names are listed in parentheses. Extra words which may appear in the name on some packages are listed in square brackets. It is possible I've copied some numbers wrong (and other disclaimer noises). SLIMMER CONDOMS Mentor (Mentor): 2" by 8", not smaller, but has adhesive inside Bikini (Barnetts): slightly less than 2" by 7-1/4", packaged in that frustrating plastic wrapper [Sheik] Fetherlite (Schmid): 1-7/8" by 7-1/2" Hugger (Circle): 1-7/8" by 7-1/8" Slims (Circle): 1-7/8" by 7-3/4" to prevent slippage, rather expensive though WIDER CONDOMS Excita (Schmid): 2-1/4" by 8-1/4", Excita Extra has spermicide [Lifestyle] [Horizon] Nuda (Ansel): 2-5/8" head, 2-1/8" shaft, by 8-1/8" [Ramses] NuForm (Schmid): 2-1/2" upper, 2+" lower, by 8-1/4, has benzocaine anaesthetic Rough Rider (Ansel): 2-1/2" by 8" thick but doesn't block sensations, raised studs Sheik Ribbed (Schmid): 2-1/4", forgot to note length (Note wide variation in Sheik. Elite with spermicide and Lubricated (with benzocaine?) are both 2-1/8". Fetherlite is 1-7/8".) Trojan-Enz Lubricated (Carter-Wallace): 2-1/4" by 8" LONGER CONDOMS Man-form Lubricated (Protex): 2" by 8-3/4" long packaged in that frustrating plastic wrapper [Trojan] Naturalube (Carter-Wallace): 2" by 8-5/8" -- Elf Sternberg I'm not inclined to write pompous elf@halcyon.com books about unanswerable questions. Public key available That strikes me as a tremendous waste http://www.halcyon.com/elf of time. - Stephen Jay Gould