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Contraception misconceptions

Medical & health articles 12 Jun 2018
Scattered pills on pink background 800 450

As we get older, we can laugh at some of the 'urban myths' about pregnancy that we believed as young girls. Toilet seats and public pools were often decried as being not only responsible for harbouring sexually transmissible infections, but unwanted sperm.

Of course, neither are true. But do you know which of these statements is true?

  • you can't get pregnant during your period
  • breastfeeding protects you from pregnancy
  • the withdrawal method is effective.

If you said 'none', you're correct. Yet many women today still believe one or all of these are true. What is true is that if you are sexually active, you need to use a reliable form of contraception and continue to use it for 1-2 years after menopause. However, with such a wide range of choice of contraceptives on the market, it can be hard to choose which type to use.

So we asked Jean Hailes specialist women's health GP, Dr Amanda Newman, about some common contraception misconceptions.

1. Relying on the 'withdrawal method'

You're aroused and your partner is too, but you don't have a condom handy. Or maybe you feel that putting on a condom will spoil the mood or sensation of sex. So instead of using any contraception, your partner says he will withdraw his penis just before he reaches orgasm. This is the withdrawal method – and it is not an effective contraception method.

"In fact, it is not a form of contraception at all," says Dr Newman. "If your partner doesn't get the timing right, you are at risk of unplanned pregnancy," she says.

Even if your partner does withdraw before ejaculating, you could still end up conceiving. "Before ejaculation occurs, a small amount of lubricating fluid is released from the penis and it contains sperm," says Dr Newman. "Though the levels of sperm in pre-seminal fluid are not high, they can still cause unplanned pregnancy."

2. Forgetting to take your contraceptive pill

Oops! On Saturday night you forgot to take your pill. On Sunday you forgot again. You figure it's not a big risk. Wrong.

"For the pill to maintain maximum effectiveness, it absolutely needs to be used regularly," says Dr Newman.

If you miss a pill, read the guidelines in your pill packet – you will need to use another form of contraception , or abstinence, for a period of time. In future, to help you remember your pill each night, set a routine; take it when you set your alarm, or clean your teeth.

The pill contraception

3. Using oil as lubrication with condoms

Oil-based lubricants such as petroleum jelly, lotions, olive, coconut or baby oil should be avoided as they can weaken condoms, making them vulnerable to ripping or breaking, says Dr Newman. "Instead, use condoms with special lubricant available from your chemist," she says.

As latex can deteriorate from exposure to heat and light, store your condoms in a cool dry place and don't use them if they are out of date. Make sure you're also careful of jewellery or jagged fingernails, which could cause tiny tears big enough to allow semen to leak through during sexual intercourse.

4. Thinking you can't conceive during your period

This is one of the oldest myths about contraception. Although ovulation most often occurs in the middle of your cycle, there's no guarantee that will happen every month, says Dr Newman. "The time of ovulation can differ from month to month and be disrupted by outside influences such as stress, medications and illness," she says. "This means there is a chance of conceiving at all times of the month, including the days when you have menstrual bleeding."

It's also important to remember that sperm can live up to five days in a woman's body. "So if you happen to ovulate early in your cycle, or if you have a long period and a short cycle between periods, then unprotected sex during menstruation may leave you at risk of unplanned pregnancy," says Dr Newman.

Bed sheets morning after

5. Using the 'morning-after pill' as contraception

"When taken within three to five days (depending on which type) of unprotected sex, the morning-after pill can help to prevent pregnancy," says Newman. "Though it is usually effective, some women still become pregnant after taking it, so the morning after pill should not be used as a form of regular contraception."

The morning-after pill is, however, a very helpful option if you have had unprotected sex, a condom breakage, missed one or more of your usual contraceptive pills, or had a stomach bug or diarrhoea, which may have lessened your coverage from the contraceptive pill.

6. An IUD is 'not for young women'

"It used to be thought that IUDs were best for women who had already had a baby," says Dr Newman. "Now we think they are a wonderful choice for women of all ages."

An IUD (intra-uterine device) is a soft piece of plastic that contains copper or a hormone called progestogen. It is more than 99% effective in preventing pregnancy. Once inserted via the vagina into your uterus by your doctor, it is usually left in place for several years. This means you don't need to remember to take a pill daily, or see your doctor for a prescription frequently. However, you should monitor it regularly.

"Make a habit of checking your IUD strings at the end of every menstrual period," says Dr Newman. "If you cannot feel the strings, see your doctor as soon as you can and avoid sex until you're sure that the IUD is properly in place."

Another form of contraception that does not need frequent remembering is the hormone-containing rod that is inserted under the skin in your upper arm. It can stay there for three years, which makes it very cost-effective.

7. Breastfeeding as birth control

Even though you may not have established a regular menstrual cycle after giving birth, you may still be ovulating while breastfeeding. The bottom line? "You should use contraception once your baby is six weeks old," says Dr Newman.

You may need to use a form of contraception different from what you used prior to your pregnancy, so see your GP to discuss this.

8. Not checking your diaphragm

The diaphragm is a thin rubber dome with a flexible rim that you insert inside the vagina to cover your uterus and stop sperm from entering. It should be inserted no more than two hours before sex and left in place for 6-8 hours after intercourse. But once your diaphragm has been fitted for you by your GP or women's health specialist, that doesn't mean you don't need to check it.

"Diaphragms can develop tiny holes or tears that can allow semen through, so they should be regularly checked by pouring water into the rubber dome to see if any fluid leaks through," says Dr Newman. "Also, if you gain or lose weight, it is important to see your women's health GP or nurse to check that your diaphragm is still a good fit. Even if used conscientiously, the diaphragm is not a reliable form of contraception."

9. Only thinking about protection from pregnancy

Though methods such as the contraceptive pill and IUD are very effective in helping to prevent unplanned pregnancy, they do not protect against STIs – to do this you need to use condoms.

Sheet of condoms contraception

10. Not discussing condoms before you have sex

"It only takes one unprotected sexual encounter to put yourself at risk of unplanned pregnancy or contracting a sexually transmissible infection," says Dr Newman.

Don't ever let a sexual partner talk you into having unprotected sex. The best approach is to have a frank conversation before you are naked or in the middle or foreplay. Here are a few ways you can bring up the topic:

  • "I want to make sure we use condoms. Do you have some, or I should I get mine?"
  • "I'm really attracted to you, but before things go too far I want to talk about protection, because I wouldn't ever contemplate having unsafe sex."
  • "I know it can be a bit embarrassing to discuss, but I think we should figure out what we're going to do about contraception. I always use condoms because I don't want to take any risks with my health or my future."

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