Contraception - Abstinence

Monday 22nd March 2010

If you are looking for a contraceptive that is 100% effective at preventing pregnancy and sexually transmitted diseases then abstinence is the perfect contraceptive for you.

While the idea of abstinence is not taught in many schools, in my opinion it should be. A good sex education class should cover all bases including how to say no and how to say no to sex.

There has been considerable debate over whether abstinence is a true form of birth control and if it is worth teaching to young people. Research shows that teens whose sex education is at least half abstinence-based are less likely to experience an unplanned pregnancy than those who receive contraceptive education alone; and women who report no sex education at all have the greatest number of unplanned pregnancies. It seems that abstinence education is important, and many young people do select abstinence as their method of choice.

Some people argue that sexual abstinence is not a true form of birth control. But, birth control is any act, drug, or device that is intended to prevent pregnancy. This means that choosing to abstain is really a contraceptive. Did you know that among teens abstinence is the most popular method of birth control? Among people aged 15-19, fewer than half have ever had sex. Over one in ten women of reproductive age have never had sex at all.

What are your feelings on abstinence? Should we be teaching our children about it in schools and at home as well as telling them about contraceptive devices?

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Contraception - The Morning After Pill

Monday 15th March 2010

The morning after pill can be used by a woman to prevent pregnancy after having unprotected sex.

While it is very effective at preventing pregnancy if they are used soon after having unprotected sex, they are not a barrier to protect you from any sexually transmitted infections.

The emergency contraceptive pill can be taken up to three days (72 hours) after you have had unprotected sex.

If it is taken within 24 hours of having unprotected sex, the emergency contraceptive pill is effective in preventing 95% of pregnancies. However, the later the emergency contraceptive pill is taken, the lower the success rate.

The emergency contraceptive pill is available free of charge from your GP and most family planning clinics. A number of community pharmacists can also prescribe it to those who are under 18 years of age, including teenagers who are under 16.

If you are over 16 years of age, you can buy the emergency contraceptive pill over-the-counter (OTC) at pharmacies for around £26 and some pharmacies, such as Lloyds, are now selling it online.

The emergency contraceptive pill should not be used as a regular method of contraception.

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Contraception - Patches

Monday 8th February 2010

The contraceptive patch (transdermal) is a form of hormonal contraception that is worn by a woman to stop her getting pregnant when she has sex.

However, unlike like barrier methods of contraception, such as condoms, the contraceptive patch does not protect you from getting sexually transmitted infections (STIs).

The contraceptive patch is very reliable and easy to use. You stick it on a clean, dry, hair-free area of your body, such as your buttocks, stomach, chest (apart from your breasts) or the outside of your upper arm. Make sure the area of skin you choose is clean, dry and not hairy, and that it is not going to be rubbed by tight clothing. You should not put the patch on areas of the skin that are broken or irritated. The patch needs to be changed for a new one each week.

The patch protects you from pregnancy by introducing hormones into your body which prevent your ovaries from releasing an egg.

Every day, the patch gives you a dose of the female sex hormones, oestrogen and progestogen, that move through your skin and into your bloodstream. These hormones are similar to the hormones that are made naturally by your body, and they control your periods and help to prepare your body for pregnancy.

The hormones in the contraceptive patch stop your ovaries from releasing an egg each month (ovulation) which could then be fertilised by sperm. The combined oral contraceptive pill works in this way too.

The contraceptive patch also has some other effects. It makes the mucus in your cervix (entrance to the womb) get thicker. This makes it difficult for sperm to move through the mucus and into your womb, where it could reach an egg. It also makes the lining of your womb thinner, so that it is harder for an egg to attach to the womb where it could be fertilised.

If you start using the patch on the first day of your period, it starts working straight away. This means you can have sex without getting pregnant. If you start using it on any other day, you need to use an additional form of contraception for the first seven days.

The contraceptive patch is not suitable for everyone. If you are thinking of using the patch, the healthcare professional that you see will first ask you about your health and your family medical history. It is very important to tell them about any illnesses, or operations, that you have had, or medications that you are currently taking.

You will not be able to use the patch if:

• you are, or think you might be, pregnant,
• you are breastfeeding, or
• you smoke and you are over 35 years of age.

There are also some medical conditions that mean that you cannot use the contraceptive patch. You will not be able to use the patch, if you have or have ever had any of the following conditions:

• thrombosis (blood clots) in a vein or artery,
• a heart problem, or disease affecting your blood circulatory system (including high blood pressure),
• serious migraines, or migraines with aura (visual problems),
• breast cancer,
• active disease of the liver or gall bladder,
• diabetes, and
• bleeding from your vagina that does not have an obvious cause (such as between periods, or after sex).

If you weigh more than 90 kilograms (14 stone) the contraceptive patch may not work as effectively, so you may want to think about using other forms of contraception.

In some women, the contraceptive patch can cause skin irritation, such as itching and soreness. It also does not protect you against sexually transmitted infections (STIs) so you may need to use condoms as well.

Some women get mild side effects when they first start using the contraceptive patch. These include:

• headaches,
• nausea (sickness),
• breast tenderness,
• mood changes, and
• slight weight gain, or loss.

However, these side effects usually settle down after a few months.

Breakthrough bleeding (bleeding between periods) and spotting (very light, irregular bleeding), is common in the first few cycles of patch use. This is nothing to worry about if you are using the patch properly, and you will still be protected against pregnancy.

Some medicines can make the patch less effective. If you are prescribed new medicine by a healthcare professional, you should tell them that you are using the patch. If you are buying over-the-counter (OTC) medicine, you should ask the pharmacist for advice because some complementary medicines, such as St John's Wort, can affect how the patch works. You might need to use an extra form of contraception while you are taking the medicine, and for two days afterwards.

If you have any questions regarding the contraceptive patch, please feel free to ask them in the comments box below. You can keep your comments anonymous too!

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Contraception - The Pill

Monday 18th January 2010

Welcome to the first part of our series on contraception. Today we are going to kick off the show by taking a closer look at the Combined Oral Contraceptive (COC).

The combined oral contraceptive pill contains two hormones, oestrogen and progestogen. It may be taken by women to prevent pregnancy. Sometimes, the COC pill may also be taken for:

• painful or heavy periods,
• premenstrual syndrome, or
• endometriosis.

It works by:

• Preventing ovulation (the release of an egg from the ovary each month).
• Thickening the mucus in the neck of the womb, so it is harder for sperm to penetrate into the womb and reach an egg.
• Thinning the lining of the womb, so there is less chance of a fertilised egg implanting into the womb and being able to grow.

The COC pill is one of the most effective methods of contraception. When taken correctly, less than 1 woman out of a 1000 taking the COC pill for a year, will get pregnant.

Starting the COC pill

The COC pill is usually started on the first day of your period (Day 1 of the menstrual cycle). If this is done, you will be protected from pregnancy straight away and you won't need additional contraception.
The COC pill may also be started up to Day 5 of your menstrual cycle. This gives protection from pregnancy straight away unless you have a short menstrual cycle (your period is every 23 days or less). If you have a short menstrual cycle, you will need additional contraception (e.g. condoms) until you have taken the COC pill for 7 days.
The COC pill may be started at any other time in your menstrual cycle. However, you will not be protected from pregnancy straight away and you will need additional contraception until you have taken the COC pill for 7 days.
If you have had a miscarriage or abortion, the COC pill can be started up to 7 days after this and you will be protected from pregnancy straight away. If started more than 7 days after the miscarriage or abortion then use additional contraception until you have taken the COC pill for 7 days.
If you have just had a baby and are not breastfeeding, the COC pill can be started on Day 21 after the birth. You will be protected against pregnancy straight away. If started later than 21 days after giving birth, you will need to use additional contraception until you have taken the COC pill for 7 days.

The Combined Oral Contraceptive (COC) pill is generally well tolerated and very few women will experience side effects.

Some of the side effects reported include:

• breakthrough bleeding and spotting - especially during the first 3 months of taking,
• breast tenderness and breast enlargement,
• change in shape of the cornea (front covering of the eye) resulting in discomfort when wearing contact lenses,
• depression (low mood),
• fluid retention,
• headache,
• migraine,
• nausea (feeling sick) or vomiting (being sick),
• reduced libido (interest in sex),
• rise in blood pressure,
• rise in blood sugar,
• stomach upset,
• temporary infertility after stopping the COC pill,
• vaginal thrush,
• weight gain.

The Combined Oral Contraceptive (COC) pill may interact with other medicines. Some of the more commonly known interactions are listed below. However, this is not a complete list. If you want to check that your medicines are safe to take with the COC pill, you can ask your doctor or pharmacist (chemist) or read the Patient Information Leaflets that come with your medicines.

The COC pill may interact with broad spectrum antibiotics. These include the following:

• amoxicillin,
• ampicillin,
• azithromycin,
• cefadroxil,
• cefixime,
• cefradine,
• cefalexin,
• cefpodoxime,
• clarithromycin,
• co-amoxiclav,
• co-fluampicil,
• doxycycline,
• erythromycin,
• metronidazole,
• minocycline,
• oxytetracycline,
• tetracycline,and
• tinidazole.

Broad spectrum antibiotics may reduce the effectiveness of the COC pill.

If you are prescribed one of these antibiotics, use additional contraception (e.g. condoms) while you are taking the antibiotic and for 7 days after finishing the course. If the 7 days runs beyond the end of a pill pack, skip the pill free break and start a new pack straight away. In the case of the Every Day (ED) pill - if the 7 days runs into the inactive pills, skip the inactive pills and start a new pack straight away.
If you are prescribed a long course of one of these antibiotics, after you have taken it for 3 weeks or more you don't need additional contraception. But, if you are then also prescribed a short course of a different antibiotic later, you will need to use additional contraception again as above.

The COC pill may also interact with medicines that speed up how quickly the liver breaks down oestrogen and progestogen. These include:

• aprepitant,
• bosentan,
• carbamazepine,
• griseofulvin,
• modafinil,
• nelfinavir,
• nevirapine,
• oxcarbazepine,
• phenytoin,
• phenobarbital,
• primidone,
• rifabutin,
• rifampicin,
• ritonavir,
• rufinamide,
• St John's Wort (Hypericum), and
• topiramate.

As these medicines speed up the process of the liver breaking down the oestrogen and progestogen in the COC pill, they reduce the effectiveness of the COC pill.

If you are prescribed a short course of one of these medicines, use additional contraception while you are taking the medicine, and for four weeks after you stop taking it.

If you are prescribed a long course of one of the above medicines, remind your prescriber that you are taking a COC pill. You will need to think about switching to another method of contraception while you are taking it, and for 4-8 weeks after you stop taking it.

Talk to your GP, or prescriber, about other methods of contraception. An alternative (except when taking rifampicin, or rifabutin) is to take two COC pills a day. However, this is an unlicensed use of the COC pill and it should only be taken in this way on the advice of your GP.

Lamotrigine

The combined oral contraceptive (COC) pill can speed up how quickly the liver breaks down lamotrigine. This reduces the amount of lamotrigine in the blood, making it less effective at controlling fits. Tell your GP if you decide to start (or stop) taking the COC pill because your dose of lamotrigine may need to be adjusted.

As you can see, although the combined oral contraceptive is extremely effective, it does have it's negative side.

If you are considering taking the pill and have any more questions about it, please feel free to ask them in the comments box below.

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An Introduction To Contraception

Monday 11th January 2010

Contraception is the use of hormones, devices or surgery to prevent pregnancy. It gives women and couples the ability to decide if and when they want a baby.

There are several types of contraception available, each working in a different way.

Over the next 11 weeks (every Monday) we will be taking a closer look at each method of contraception. How it works, side effects and answering any questions you have to help you choose the right method of contraception.

So, next week we are going to start our Contraception campaign off with the UKs most popular pregnancy prevention method, The Pill.

If you don't want to miss any of our posts on this issue then make sure you add us to your favorites!

See you tomorrow.

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