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Contraception or birth control, refers to the many ways in which people control their reproductive capacity. One of the functions of intercourse is the furthering of the species. However, with the wide availability of contraception, sex has become unlinked from its purely biological capacity and has increasingly become, instead, a means of personal expression, intimacy, and enjoyment.
We have come a long way from the days of ancient Egypt when women used to place crocodile dung in their vaginas as a primitive form of spermicide. Today, there many safe and effective birth control methods. Remember that making a decision about the form of contraception you will use is an important one -- and one in which you need to take several factors, including your own feelings, into account. The best form of birth control is the one that you will use effectively and consistently.
Abstinence
One of the oldest and most reliable forms of birth control is choosing not to have intercourse. Abstinence can involve the wide range of nonpenetrative means of sexual expression, which are perfectly safe in terms of preventing conception if not necessarily a means of having safer sex.
Barrier
Barrier methods of birth control all function by imposing a physical barrier between the female's unfertilized egg and the male's sperm.
Male Condom
The male condom is a sheath that is placed over the penis to prevent ejaculate from entering the vagina. Popularly believed to have been named after the mythical Dr. Condom, condoms reportedly were used by the ancient Egyptians as early as 1350 B.C.E. Condoms made from linen were common in the late 1500s, when they were used primarily to protect against syphilis. The first vulcanized rubber condoms became available in the 1840s. Today, condoms are almost always made of latex. Condoms are available over the counter at most grocery stores, drugstores, and even gas stations. Used alone and correctly, condoms are approximately 88 percent effective and also provide an excellent means of having safer sex.
Diaphragm
A diaphragm is placed along the back wall of a woman's vagina prior to intercourse. It functions as an obstacle to sperm trying to enter the uterus and a container for holding spermicide near the opening of the cervix. The diaphragm was the first widely available form of effective birth control for women. Diaphragms need to be fitted by a physician and therefore require a prescription. However, the spermicide that must be used along with the diaphragm is available over the counter. Used correctly with a spermicide, the diaphragm is approximately 82 percent effective.
Cervical Cap
Although the cervical cap functions similarly to the diaphragm, it attaches to the neck of the uterus via suction. Like a diaphragm, a cervical cap needs to be fitted by a physician and therefore requires a prescription. Used alone and correctly, it is approximately 64 percent effective.
Female Condom
The female condom is a new form of birth control designed to function as an analog to the male condom. Similar in shape to a soda can, the female condom lines the vagina, providing protection against sperm and infections. The female condom is available over the counter and is packaged with lubricant, which must be used on the inside of the condom to prevent tearing. Used alone, the female condom is approximately 89 percent effective.
Hormonal
All hormonal forms of birth control function by simulating pregnancy in a woman. Because a woman does not ovulate and is unable to conceive while she is pregnant, hormonal forms of birth control are very effective.
Oral
There are two major types of oral contraceptive : combination pills, also known as the Pill, containing synthetic forms of both estrogen and progesterone; and progesterone-only pills, sometimes known as the mini-Pill. When used correctly, each is more than 98 percent effective. Because the Pill is so effective and convenient to use, its introduction in the 1960s is credited with having played a large role in the sexual revolution.
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Implants
Implants function in much the same way as oral contraceptives, with the exception that it's not necessary to take a pill on a regular basis. The two most common forms of implants are Norplant and Depo-Provera. Both forms are more than 99 percent effective. Depo-Provera, which looks no different from a normal injection, is effective for three months. Norplant, a set of tiny rods implanted in a woman's arm by a medical professional, provides protection for up to five years.
Spermicides
All spermicides involve the placing of a chemical that is hostile to sperm directly in the vagina. In theory, spermicides eliminate any motile sperm before they reach an unfertilized egg. All spermicides are available over the counter and are approximately 79 percent effective when used alone. When used with a condom, spermicides are more than 98 percent effective. Some forms of spermicide, such as Nonoxynol-9, also act as viricide, helping to protect the user from infections such as HIV.
Foam, Creams and Jellies
Contraceptive foam is a light mixture of spermicide and air, which is inserted into the vagina with an applicator. Spermicidal creams and jellies are identical to foam except in texture. Unlike foam, however, spermicidal creams and jellies do not expand and therefore may be more likely to leak from the vagina. There is, however, a new form of gel available with adhesive properties that theoretically enable the product to remain effective for up to twenty-four hours.
Film
Vaginal contraceptive film, also known as VCF, is a small square of spermicide that is placed along the back wall of the vagina. VCF remains effective for approximately one hour.
Suppositories and Tablets
Spermicidal suppositories and tablets are designed to dissolve once they are inserted into the vagina. While spermicidal suppositories and tablets are convenient to carry and use, the fact that they need to dissolve to be effective may make them a less reliable form of birth control.
Contraceptive Sponge
The contraceptive sponge, which looks similar to a diaphragm, is a synthetic sponge coated with spermicide. Used alone, the contraceptive sponge is approximately 75 to 83 percent effective. Although the contraceptive sponge is no longer available, it may be sold again in the future.
IUDs
Intrauterine devices, or IUDs, are small devices inserted into a woman's uterus by a physician. IUDs usually are made of synthetic materials and often remain in place for several years, providing constant protection of up to 98 percent effectiveness. However, there can be numerous side effects from using an IUD and many women are not appropriate candidates for this form of birth control.
Fertility Awareness
Fertility awareness methods are contingent on correctly predicting the time of ovulation. If a woman is able to avoid intercourse during the several-day period before and following ovulation, she greatly reduces her chances of becoming pregnant. Because fertility awareness is a difficult method to use correctly and consistently, it has a relatively low effectiveness rate. Using multiple forms of fertility awareness, however, can increase this method's reliability. Depending on how well and consistently this method is used, effectiveness rates range from 80 to 91 percent.
Surgical
Surgical methods of ensuring contraception are available for both men and women. It is important to recognize that these methods, which are more than 99 percent effective, are considered permanent and therefore irreversible. Male sterilization is not castration and in no way interferes with ejaculation. Sometimes known as vasectomy, this surgical procedure involves the cutting or tying off of the vas deferens, which prevents sperm from reaching the ejaculatory duct. Female sterilization, which is not to be confused with hysterectomy, does not involve the removal of the uterus, Fallopian tubes, or ovaries. Sometimes known as tubal ligation, the procedure instead involves the tying of the Fallopian tubes so that sperm cannot reach an unfertilized egg.
Ineffective Techniques
All of the following actions are unreliable -- and therefore ineffective -- means of birth control: withdrawal; douching; breast-feeding; taking birth control pills only on the day of, the day before, or the day after intercourse; standing or being in water while (or after) having intercourse; having intercourse for the first time; and having only infrequent intercourse.
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