Contraception myths: The withdrawal method, the 'morning after' pill and period sex

Written by Natika H Halil
A story recently hit the headlines of a woman in Colombia using a potato as a method of contraception - which went badly wrong. According to Colombia Reports, she began to feel abdominal pain as roots were growing on the potato after two weeks, and doctors had to remove the object. She reportedly said her mother had advised her to try the contraception method.

At sexual health charity FPA we’ve never come across anyone using vegetables as contraception, but whether this story actually happened or not, we do know that people of all ages are relying on myths and misinformation to prevent pregnancy instead of finding a contraceptive method to suit them.

We take a look at some commons myths, and why it's so important to understand the facts:

MYTH: If your partner withdraws before he ejaculates you won’t get pregnant

There’s been a lot in the news recently about the so-called withdrawal method. But having a partner pull out before he comes is NOT a method of contraception and leaves women at risk of pregnancy. This is because it’s still possible for a sexually excited man to release fluid from his penis even without having an orgasm. This is known as pre-ejaculation fluid or pre-cum and, as it has sperm in it, it can lead to pregnancy.

MYTH: The only contraception choices are condoms or the pill

Although these two methods are still the most well know there are actually 15 methods of contraception available in the UK, all free through the NHS. Sadly, there are still only two choices for men (the male condom and sterilisation), although research into both the male pill and male contraceptive injection is ongoing. Women have a choice of 13 methods, including four methods of long-acting reversible contraception (LARC) which they don’t need to remember to take or use every day or every time they have sex.

MYTH: You can’t get pregnant if you do it standing up

We still hear this one a lot. Sperm are very strong swimmers and gravity alone is not going to stop them reaching and trying to fertilise an egg! If you don’t use contraception then it’s possible for a woman to get pregnant whatever position you were having sex in.

MYTH: You can’t get pregnant if you have sex during your period

Many women think that they’re only fertile for a few days each month, and so they believe they can’t get pregnant during their period and throughout most of their menstrual cycle. There are two factors that make this a myth. Firstly, many women have irregular menstrual cycles so it can be very hard to know for sure ovulation (when an egg is released) has taken place. Secondly, sperm can actually live in the body for up to 7 days so they can be hanging around ready and waiting to fertilise an egg.

MYTH: You can’t get pregnant if it’s the first time you have sex

This persistent myth is still out there and leading to unplanned pregnancies. If egg meets sperm then it’s possible to get pregnant, whether it’s the first, tenth or thousandth time you’ve had sex.

MYTH: Two condoms are safer than one

Although you might think that an extra layer will offer you extra protection, this isn’t true, and using two condoms actually increases the risk of them splitting or breaking. A male condom used correctly is 98% effective at preventing pregnancy and a female condoms used correctly is 95% effective.

MYTH: You can’t get pregnant if you go to the loo or douche straight after sex

Going to the loo or douching (washing the inner and outer female genitals) won’t help to prevent a pregnancy. Again, this is down to sperm being fantastic swimmers. By the time a woman has got to the loo, or started to have a wash, the sperm are already well on their way and this isn’t going to stop them.

MYTH: It’s OK to re-use a condom if you haven’t got a new one

This isn’t safe – condoms (both male and female) are designed to be used once only, so don’t attempt to wash them out and use them again.

www.loveandindulgence.com.au

HPV: Separating Fact From Fiction

By The Redhead Bedhead, April 14, 2014

Takeaway:This STI is about as common and widespread as it is misunderstood.

Source: 72soul/Dreamstime.co

The first time I ever heard of genital warts was in an article in a women’s magazine in the late '90s. It spoke of a young woman who, after one sexual experience with a cruel partner who told her nothing about the status he obviously new about, developed genital warts and, according to this incredibly helpful and not at all sensationalist (can you hear my sarcasm?) article would now have it FOR LIFE! I got it in my head at that moment that genital warts were one of the worst things that could happen to someone. 

Years later, the medical community has learned so much more about human papillomavirus (HPV) - the cause of genital warts. HPV is the most common sexually transmitted infection. It is passed on through genital contact, most often during vaginal and anal sex. HPV may also be passed on during oral sex and genital-to-genital contact, even when the infected partner has no signs or symptoms. 

Maybe you didn't know that. Maybe there's a lot more you don't know about HPV. Here we'll separate fact from fiction when it comes to this incredibly common STI. 

HPV Fiction: Once you have it you have it for life

FACT: Most people will have HPV at some time in their lives. For a lot of people, it causes no symptoms and goes away on its own. That’s right; it can come and go without your knowledge. How so? Our bodies are smart. In 90 percent of cases, the immune system will clear the virus all on its own. 

HPV Fiction: You’ll know if you have it

FACT: You can have the genital HPV virus and exhibit no symptoms at all. Many people don’t know they are infected when they pass the virus on to a partner. As men function primarily as carriers of the virus and there is no effective test to tell if they have it, they are usually unaware of their status unless they contract a wart-causing strain. 

Plus, HPV can be present in your system for years before manifesting symptoms, so it’s possible to have the virus even if years have passed since sexual contact with an infected person. This is how HPV can come and go without an infected person even knowing about it.

HPV Fiction: HPV = Cancer

FACT: There are more than 100 different strains (or types) of HPV, 40 of which are sexually transmitted. Each type of HPV is identified by an assigned number.

Some types of HPV can cause warts, which most commonly occur on the hands and feet, in the genital area and around the anus, but they can be on any part of the body. The types of HPV that cause warts do not usually cause cell changes that may develop into cancer. We call these "low risk HPVs". The types of HPV that can cause warts include types 6, 11, 42, 43 and 44. 

Some strains of HPV can cause cellular changes called dysplasia, which increases the risk of cancer in the cervix, mouth or throat. We call these "high risk HPVs." Specific high-risk strains include 16, 18, 31, 33 and 45, with types 16 and 18 causing approximately 70 percent of cervical cancers. The other types cause most of the remaining 30 percent of cervical cancers.

HPV Fiction: Condoms will prevent the spread of HPV

FACT: HPV is spread via skin-to-skin contact, so condoms do not protect they way they do with infections spread via bodily fluids (although they help). Additional barriers like gloves and dental dams can provide additional protection. FC2 condoms for women are another option, because they offer a bit more genital coverage than traditional condoms. Also, if you are eligible for them, HPV vaccines can offer protection against certain strains of the virus. 

Fiction: An HPV diagnosis is something to be embarrassed about

FACT: First and foremost, don’t allow any STI diagnosis to make you feel embarrassment or shame. Sex educator Ashley Manta has produced some wonderful videos about dealing with the feelings that come up after the diagnosis of an STD. 

Finally, know that it’s not just you. A friend recently told me about giving her history to a new (and awesomely sex-positive) doctor and saying, "Oh, I forgot to put down that I’ve had HPV!! Is that a problem?" While making his notes, the doctor responded, "No, because really, who hasn't".

HPV is incredibly common. How common? So common that most sexually-active men and women will get at least one type of HPV at some point in their lives. In fact, around 79 million Americans are infected with HPV right now, while 14 million people become newly infected every year. HPV is the most common STI. It’s definitely not just you. 

So that's HPV. In many cases, it's nothing to worry about. And it's never anything to be ashamed about. Practice safer sex, visit your doctor if you have concerns about HPV and, for women, have a regular pap smear if you're sexually active. Oh, and the best way to protect yourself? Learn the facts.

www.loveandindulgence.com.au

11 Things You Don't Know About Pelvic Inflammatory Disease

I really wanted to share this great article on a disease that isn't spoken enough of. Why? I myself experienced PID in my mid 20's due to unsafe sex.

As I did not know I had PID in my system as it does not show much as in symptoms, I found myself unfortunately sterile as a result and unable to bare children. 

So please all read this important blog and lets get more educated on how to stay healthier.

Mel

By Alice Gray, February 7, 2014

Takeaway:PID has painful side effects, yet many of us know almost nothing about it.

Source: Sebastian Kaulitzki/Dreamstime.com

You've probably heard of pelvic inflammatory disease (PID), but what is it exactly? It's a bacterial (or sometimes fungal or parasitical) infection that causes inflammation to the female upper reproductive tract - most commonly the fallopian tubes, ovaries and uterus. It's not a condition that gets mentioned frequently, but the Centers for Disease Control (CDC) estimates that up to 750,000 women are diagnosed with PID every year. And getting it can be a big deal: PID can damage the fallopian tubes and tissues around the uterus and ovaries, causing serious consequences such as infertility, ectopic pregnancy, abscesses and chronic pain in the pelvic area. Plus, because it's often a side effect of sexually transmitted infections (STIs) such as chlamydia and gonorrhea, it can be a sign that you've been infected.

Unfortunately, many women have never heard of PID. Here are a few things worth knowing.

It is most frequently caused by STIs

No one wants to discuss having having an STI, and many people don't even realize they have one. But if you're sexually active, you should get tested because the most common cause of pelvic inflammatory disease is chlamydia, followed by gonorrhea. These two common bacterial STDs often come without symptoms. Fortunately, they, like PID, can be easily treated with a course of antibiotics. (The testing isn't that bad, promise! Read more in Scared of STD Tests? You Shouldn't Be.)

Childbirth, miscarriage, abortion, surgery and an IUD can also cause PID

Anything that touches your cervix has the potential to let in bacteria, parasites and fungal infections, all of which can cause pelvic inflammatory disease.

You may be treated as if you and/or your partner have an STI

If you're diagnosed with PID, you will be treated with antibiotics. Your doctor may also prescribe them to your partner as a precautionary measure. Don't be offended. Untreated STIs are the leading cause of PID, so many doctors feel that it's better to be safe than sorry and treat both partners when possible. Yes, this is awkward when telling said partner. Yes, you should do it anyway. (Communication is a form of protection. 

PID is a common condition

It is estimated that more than 750,000 women in the U.S. have an episode of acute PID each year. Exact numbers for the total number of infections can be difficult to determine as PID has few symptoms, and often goes undiagnosed.

PID is the leading cause of infertility in young women (under 25)

The inflammation caused by PID causes the formation of adhesions (scar tissue) in the fallopian tubes, ovaries and uterus. This scar tissue can eventually block the fallopian tubes, preventing eggs from passing through. It is also a major factor in causing ectopic pregnancies. Getting treated for PID early reduces the likelihood of fertility problems.

PID can lead to chronic pelvic pain

Left untreated, or even treated late, PID can cause chronic pelvic pain. This can manifest as severe pain during intercourse and/or pain in the lower abdomen (which can also be quite severe). 

The pain changes in severity depending on the time of the month

During ovulation, scar tissue becomes easily inflamed, which increases pain during intercourse. If you have PID, you might want to avoid penetration during that particular time of the month, or find positions that don't hurt as much.

No pain does not mean no problem

Depending on the cause of PID, you may have different symptoms. PID caused by chlamydia is normally asymptomatic, which means that many women only discover they have it when they seek treatment for infertility. However, you may find that you have symptoms such as: 

• Higher-than-normal body temperature.
• Fatigue
• Irregular periods
• Lower back pain
• Rectal pain
• Unusual vaginal discharge
• Vomiting

Nobody likes visiting the gynecologist, and with many of the symptoms you might not even think you need to. But irregular periods and unusual vaginal discharge should always be looked into. Lower back pain is a frequent symptom of many gynecological conditions as well.

PID can cause abscesses

An abscess is essentially an infected sore, and in PID, this can occur on the lips at the entrance of the vagina (known as Bartholin's cysts), as well as in the fallopian tubes and ovaries. This is normally treated with antibiotics. If the abscess does not respond to antibiotics, it may require surgery to drain it safely. It is vital that abscesses inside the pelvis be treated or removed as soon as possible, because they are potentially life threatening if they burst.

If you've had it once, you are likely to have it again

Sad but true: Women often experience repeated episodes of PID. The more often you get PID, the more likely you are to get it again in the future. The condition tends to return if the initial infection is not totally cured (which is why it is very important to complete a course of antibiotics), or because a sexual partner has not been tested and treated for STIs (another very important conversation to have). 

Even if your partners are STI-free and you've completed your course of antibiotics, if the first episode of PID has damaged your cervix, it becomes easier for bacteria to move into your reproductive tract, putting you at risk for developing the condition again. Repeated episodes of PID are correlated with an increased risk of infertility.

Using condoms and getting tested for STIs can help prevent PID

PID isn't always caused by STIs, but contracting an STI is the most preventable cause of the disease. Practicing safer sex and eliminating these most common culprits will increase your chances of avoiding PID. Plus, safer sex is sexy sex. And there's nothing sexier than taking good care of the your body and your health.

Honey, I Have Herpes

By Anna Lekas Miller, July 9, 2014

Takeaway: Many people with herpes live full, normal lives. That includes dating, having healthy long-term relationships and, yes, having sex.

I really like you, but I have to tell you something … I have herpes.

Astoundingly, 1 million people in the United States are living with genital herpes, and one in every six people between the ages of 19 and 49 have the infection. And that's just herpes. According to the Center for Disease Control (CDC), there are between 55 and 65 million people living in the United States with an incurable sexually transmitted infection (STI) - and these are only the cases that have been tested, documented and reported to the CDC. 

Even though STIs - especially genital herpes, or HSV-2 - are so prevalent, they still carry an enormous stigma. In fact, herpes ranks No.2 - only after HIV/AIDS - as the condition associated with the most stigma and self-consciousness, higher than obesity and disability.

According to popular culture, anyone with herpes, or "the herp,"must be promiscuous, or has fooled around with someone who is. They’re branded for life, and are assumed to have genitals that resemble hamburger meat. Like one character in 2009 comedy "The Hangover" says, "What happens in Vegas stays in Vegas - except for herpes; that shit’ll come back with ya." 

But here's the truth: There are many people living with herpes. Living full, normal lives. That includes dating, having healthy long-term relationships and, yes, having sex. 

Viruses, Bacteria and Parasites Don't Discriminate

"One of the biggest misconceptions about STDs and STIs is that they only happen to a certain kind of person," Jenelle Marie, founder of The STD Project told me. "But viruses, bacteria and parasites don’t discriminate! We’re human. Our bodies are not infallible."

Marie, 29, has been living with genital herpes since she was 16. Now, after years of coming out to partners, friends and family members, she has started The STD Project, an online information resource and support network to share stories, and answer all the tough questions that arise when anyone is diagnosed with an STI. 

"When I was diagnosed, my doctor basically said 'here is a prescription and here is the door,'" Marie said. "He didn’t give me resources or tell me about websites or tell me that millions of people are living with herpes and contract it every year. He didn’t tell me that it was manageable."

Many sexual health websites, such as Planned Parenthood, the CDC and even WebMD have information about STIs, how to get tested and how to reduce transmission, but few give recommendations on how to live your life if you're diagnosed with an STI, particularly if it's incurable. That leaves those who have been diagnosed to seek out the scant information that's available on their own - and they're often faced with more media that perpetuates stigma than valuable information on how to proceed. 

Another major misconceptions about sexually transmitted infections is getting tested. A standard test looks for HIV, syphilis, gonorrhea and chlamydia, but not Herpes. To be tested for HSV-2 - the virus that causes herpes - you have to either exhibit visible symptoms of an outbreak, or ask and pay extra for a specific test. This is the case with many other STIs as well. A standard pap smear only reveals one strain of HPV, and there is no test for men to tell whether or not they are carriers. 

Unfortunately, what that means is that many people who get tested leave the clinic with the assumption that they're in clear. In reality, they haven't been tested for everything that they could have - or be at risk of passing on. (Get some tips on how to avoid infection in The Ultimate Guide to Safe Sex.)

Honey .... I Have Something to Tell You

According to a study by Dr. Anna Wald, a virologist at the University of Washington, only half of those infected with genital herpes divulge their status to regular partners. This drops to 20 percent for casual hook ups. The reality is that the more you communicate with sexual partners about your status, the safer they'll be. 

"I don’t think you necessarily have to tell someone on the first date. I don’t say, 'Hi! I’m Jenelle. I have genital herpes. Want to get a coffee?’ But it definitely is important to tell them before you put them at risk," Marie said.

She also recommends arranging a casual date in a private setting to tell any potential partner about an STI. This should include giving them the necessary information to let them make an informed decision about whether they want to pursue a sexual relationship. 

"I tell people the full story. I tell them when I contracted it, that I have genital herpes - I say the full word - then I also tell them what I know," Marie said. 

"I give them some basic information about what it is, how you contract it and transmit it, what it does to your body, how I maintain it and manage it. Then I tell them that there is a lot more information online and I encourage them to do their own research", she said.

"Then I leave. It’s important to let someone process the information on their own."

Does an STI Mean No More Sex?

According to a WebMD survey of 2,000 people - 25 percent of whom had herpes - most uninfected respondents said they would not be interested in pursuing a relationship with someone who had the disease. Even so, in practice, despite the risk, the stigma and the perpetual unpleasantness of the conversation, Marie says she has never been rejected because she carries the herpes virus.

"My ex-husband said, 'That’s it?! I thought you were going to tell me you were pregnant with another guy’s baby!" Marie laughs. 

"My current boyfriend said, 'That’s all you had to tell me? I thought you were going to tell me a horrible secret that you weren’t who you said you were."