Category Archives: Contraception

We must acknowledge adolescents as sexual beings

Share

As a teenager, Dr. Venkatraman Chandra-Mouli experienced shame and was often denied access when he tried to purchase condoms. Forty years later, adolescents around the world still face barriers to contraceptive access. In this blog, Dr. Chandra-Mouli discusses those barriers and how they can be overcome.

Dr. Venkatraman Chandra-Mouli recalls feeling shame and was often denied access when he tried to purchase condoms as a teenager.

By Dr. Venkatraman Chandra-Mouli

I grew up in India. While in my late teens and studying to be a doctor, I met the girl whom I married some years later. A year or so into our relationship we started to have sex. We decided to use condoms. Getting them at a government-run clinic was out of question. They were known to provide free condoms called Nirodh, which were said to be as smelly and thick as bicycle inner tubes. Asking our family doctor was also out of question. He knew my mother and I had no doubt that he would tell.

So, I used to walk to pharmacies, wait until other customers had left, and then muster up the courage to ask the person behind the counter for upmarket Durex condoms. Sometimes I was successful and walked out feeling like a king. Other times, I was scolded and sent away. I still recall my ears burning with shame. That was 40 years ago, but I know from adolescents around the world with whom I work that they continue to face many barriers to obtaining contraceptives.

Different adolescents, different barriers

In many societies, unmarried adolescents are not supposed to have sex. Laws and policies forbid providing them with contraception. Even when there are no legal or policy restrictions, health workers refuse to provide unmarried adolescents with contraception.

Married adolescents are under pressure to bear children. Many societies require girls to be nonsexual before marriage, fully sexual on their marriage night, and fertile within a year. In this context, there is no discussion of contraception until they have one or more children, especially male children.

Most societies do not acknowledge the sexuality of groups such as adolescents with disabilities or those living with HIV. Neither do they acknowledge the vulnerability of adolescent girls and boys in humanitarian crises situations.

Finally, no one wants to know or deal with non-consensual sex, resulting from either verbal coercion or physical force by adults or peers. Girls who are raped may need post-exposure prophylaxis for HIV, emergency contraception, or safe abortion—all of which are taboo subjects.

Overcoming these barriers

These powerful and widespread taboos have resulted in limited and inconsistent progress on improving adolescent contraception access. This has to change. We must acknowledge adolescents as the sexual beings they are. We must try to remember what a joy it was to discover sex when we were adolescents. We must give adolescents the information, skills, and tools they need to protect themselves from unwanted pregnancies and sexually transmitted infections.

With that in mind, I recommend the following:

  • We need to provide adolescents with sexuality education that meets their needs.
  • We need to change the way we provide adolescents with contraceptives by offering them a range of contraceptives and helping them choose what best meets their needs, and use a mix of communication channels—public, private, social marketing and social franchising to expand their availability. We must go beyond one-off training to use a package of evidence-based actions to ensure that health workers are competent and responsive to their adolescent clients.
  • We need to address the social and economic context of girls’ lives. In many places, adolescent girls do not have the power to make contraception decisions. Even when they are able to obtain and use contraception, an early pregnancy in or out of union may be the best of a limited set of bad options – when they are limited education and employment prospects.

To reach the 1.2 billion adolescents in the world, we must move from small-scale short-lived projects to large-scale and sustained programs. For this, we need national policies and strategies, and work plans and budgets that are evidence-based and tailored to the realities on the ground. Most importantly, we need robust implementation so that programs are high quality and reach a significant scale while paying attention to equity.

We need government led programs that engage and involve a range of players including adolescents. For this to happen, coordination systems must be in place to engage key sectors such as education, draw upon the energy and expertise of civil society, recognize the complementary role that the public, the private sector and social marketing programs can play, and to meaningfully engage young people.

Some countries have shown us that this can be done. Over a 15-year period, employing a multi-component program including active contraceptive promotion, England has reduced teenage pregnancy by over 50%. This decline has occurred in every single district of the country.

Ethiopia is another outstanding example. Civil war and famine in the mid-1980s had catastrophic effects on the country. However, over a 12 year-period, with an ambitious basic health worker program, Ethiopia has increased contraceptive use in married adolescents from 5% to nearly 30% . It has also halved the rate of child marriage and female genital mutilation, although this decline is more marked in some provinces than in others. These countries have shown that with good leadership and strong management progress is possible.

There will be logistic and social challenges in moving forward. Understanding and overcoming them will require leadership and good management, which is why a strong and sustained focus on implementation must be combined with monitoring and program reviews to generate data that could be used in quick learning cycles to shape and reshape policies and programs.

There is likely to be backlash from those that oppose our efforts to provide adolescents with contraceptive information and services, and to empower them to take charge of their lives. We must do our best to bring these individuals and organizations on board. But we must not be silenced or stopped. We must stand our ground and we must prevail. We owe that to the world’s adolescents.

Complete Article HERE!

Share

Contraception influences sexual desire in committed relationships

Share

The role of human sex outside of reproduction remains something of an evolutionary mystery. But scientists believe that it is partly about tying the parties in the relationship together.

By Liv Ragnhild Sjursen

How often women in heterosexual couples desire sex depends on how committed the relationship is and what type of birth control the woman uses.

Sex is quite wonderful when the goal is to have children. But sex can also serve as a “glue” in a committed relationship.

Most animals have periods when they come into heat, and outside of these periods they don’t find sex interesting at all.

Humans, however, are constantly interested in sex. This interest can seem like a waste of energy, but an evolutionary perspective may explain why we function this way.

More sex with progesterone and commitment

A new study from NTNU and the University of New Mexico confirm that sex is important for pair–bonding between men and women in relationships.

The researchers also found a correlation between the type of oral contraceptive women use and how often couples have sex.

The findings were recently published in the scientific journal Evolution & Human Behavior.

“The function of sex in humans outside ovulation is an evolutionary mystery. But we believe that it has to do with binding the parties in the relationship together,” says Leif Edward Ottesen Kennair, a professor of psychology at NTNU.

Kennair worked with Trond Viggo Grøntvedt, Nick Grebe and University of New Mexico Professor Steve Gangestad to ask hundreds of Norwegian heterosexual women about contraception, sex and relationships.

Their results show that of women in long-term relationships and who are using hormonal contraception, those who are more committed to their relationships have more sex with partners, as one might expect.

“But this association was especially true when the contraceptive that women used had potent levels of synthetic hormones that mimic the effects of the natural hormone progesterone, and lower levels of the hormone oestrogen,” Gangestad said.

“We’re talking about intercourse here, not other types of sex like oral sex, masturbation and such. This strengthens the idea that sex outside the ovulation phase has a function besides just pleasure,” says Grøntvedt.

Big differences between types of contraceptives

Hormonal contraceptives, like birth control pills, implantable rods and patches, contain two types of hormones:

Oestrogen, which naturally peaks just before ovulation when naturally cycling women can conceive offspring, and hormones that have the same effect as progesterone, which naturally peaks during the extended sexual phase, a time when offspring cannot be conceived.

The levels of each hormone type vary in different contraceptives. Hence, some contraceptives mimic hormones that are more characteristic of ovulation, whereas others mimic hormones when women can’t conceive.

The women who used contraception with more oestrogen were most sexually active when they were in a less committed relationship.

On the other hand, women who used contraception with more progesterone were the most sexually active when they were faithful and loyal to their partners.

“Before we did this study, we didn’t know how much difference there was between the two types of hormonal contraceptives,” says Grøntvedt.

A credible holistic picture

The researchers surveyed two groups of women. All the women were using hormonal contraception and were in committed, heterosexual relationships.

One group consisted of 112 women that researchers followed over a 12-week period. The women were asked how often and when in their cycle they had sex.

The second sample group consisted of 275 women in long–term relationships who used hormonal contraception.

This group was not followed over time, but the researchers asked them how many times they had had sex in the past week. This type of study – using data collected at a specific point in time – is called a cross-sectional study.

Both groups were asked to indicate the type of contraception they were using, and if a pill, which brand it was.

“Since we examined these two groups using different methods – a snapshot for the one group and a longitudinal study for the other – we can be confident that the results provide a reliable overall picture,” Grøntvedt said.

Natural or synthetic hormones had similar effects

The basis for the NTNU study was a 2013 American study, where 50 women and their partners answered a series of questions about their relationships, menstrual cycles and frequency of sex.

None of these women were using any kind of hormonal contraception, so only their natural hormones were involved.

The study showed that women initiated sex more in the extended sexual phase – when they were not ovulating and progesterone was the dominant hormone – if they were invested in the relationship.

NTNU researchers wanted to verify the American results in their study, but with participants who were using a hormonal contraceptive that simulates a natural cycle.

Their results were the same as in the US study, in which women were not using any hormonal birth control.

The researchers were thus able to show that how often women have sex is linked to how committed they feel towards their partner and the type of hormone they are governed by, whether natural or synthetic.

“A lot of social psychology studies that have led to cool discoveries through the ages have lost status, because it hasn’t been possible to copy them and verify the results.”

“We are extremely pleased to have been able to verify the results of the study by Grebe and his colleagues, and we are equally pleased that we have also made new discoveries,” Kennair says.

Complete Article HERE!

Share

The Type Of Contraceptive You Use Could Influence Your Sexual Behavior

Share

By Ben Taub

In the animal kingdom, sex serves a pretty straightforward purpose, allowing the birds and the bees to reproduce. Humans, however, have rather more complicated sex lives, and do the dirty for pleasure as well as procreation.

According to new research from the Norwegian University of Science and Technology and the University of New Mexico, the amount of sex that women have with their partners is controlled by the same hormones that are influenced by oral contraceptives. Because different types of pill affect these hormones in different ways, the brand you use could shape your sexual appetite.

Given that sex tends to be a vigorous activity, it makes little sense – from an evolutionary perspective – for women to be interested in such an energy-consuming activity when they are not ovulating, and therefore not fertile. Yet, unlike other animals, women maintain their sexual desires during this phase of their menstrual cycle.

In a previous study, researchers found that women in committed relationships actually tend to be most sexually active during this period of non-ovulation, also known as the extended sexual phase. In contrast, single women were found to be more interested in sex when they were ovulating.

This led the researchers to suggest that extended sexuality may serve to strengthen the bond between partners, which would explain why only women in relationships were most horny during this phase. Furthermore, the fact that this part of the menstrual cycle is characterized by a spike in progesterone indicates that this hormone may be responsible for this urge.

The menstrual cycle is controlled by hormones like progesterone and estrogen.

Since none of the women in this study were taking oral contraceptives, a separate team of researchers decided to repeat the experiment using women who were on the pill. Because some types of pill contain hormones that mimic progesterone, thereby preventing women from ovulating, the researchers predicted that only women in committed relationships would experience an increase in sexual behavior while using these particular pills.

In contrast, other pills contain estrogen, thereby inducing a more natural menstrual cycle.

The results of the study are now published in the journal Evolution and Human Behavior, and reveal that women taking contraceptives containing progesterone did indeed become most sexually active when they were in committed relationships. Those using estrogen-based pills, meanwhile, tended to become most interested in sex when they were single.

“The function of sex in humans outside ovulation is an evolutionary mystery. But we believe that it has to do with binding the parties in the relationship together,” said study co-author Leif Edward Ottesen Kennair in a statement.

According to these findings, progesterone may be the driving force behind this tendency, which means that meddling with your hormones by using oral contraceptives could have a major impact on your interest in sex.

Complete Article HERE!

Share

One Of The Willie Worrisome

Share

Name: lup92
Gender: Male
Age: 15
Location: England
I’m 15 and masturbate often but have had no form of sex although my girlfriend wants to start. However my penis and scrotum have extremely small lumps all over. I also have a purple red large lump on the rim of my bellend. What do I do? Should I start? Or do I risk giving something to my girlfriend?

A quick note before we begin. I’m a Ph.D. kind of doctor. not MD type of doctor. You know that, right? While I know my way around the human body, I never offer medical advice of any sort. And, just so you know, no self-respecting physician, MD kind of doctor, is gonna offer you medical advice online either without seeing you in person first. Which, if you ask me, is a real good thing.

teen intimacy

Here’s the thing about lumps and bumps and discolorations of the skin anywhere on your body, especially on your precious willie, pup. They are signs that all is not well. Do us all a big favor and have your johnson looked at by a physician. Your health is nothing to fool around with. Everything you describe could be completely harmless, but you don’t want to take the chance that it isn’t, right? And here’s a tip: don’t do it for your girlfriend. DO IT FOR YOU! It’s your dick, you gotta lean how to take care of it. And there’s no time like the present to start properly lookin’ after it.

willy_worryJust so you know, I’m not suggesting that your have a STI (Sexually Transmitted Infection). I mean, how could you? You’ve only been wanking, right? Still, if you’re concerned enough to write to me about it, you should take yourself in for a look-see. Since you are underage, you’ll probably need one of your parents to arrange the appointment. But if you are typical teenager, you’ll probably be embarrassed to discuss this with your parents. Still, there’s no getting around this. I think your parents will be proud of you for being proactive about your health and wellbeing. Besides, there’s nothing to be ashamed about.

Another option is to contact a sex-positive resource near you. Check out the folks at FPA. Surely they’ll have a resource for you.

Please take care of this ASAP.

There is one more thing. And I’m gonna be as blunt as I know how. If you think you’re old enough to fuck, you’re old enough to know all about condoms and how to use them. If ya don’t, you’re just a dumb kid who may function like a grown-up, but doesn’t know how to behave like one. And I don’t want to believe that about you.

What it is with young people (old people too) who are still fuckin’ clueless about unprotected sex in this day and age? I have nothing against younger people being sexual. That pretty much is to be expected. But I am totally opposed to kids having kids! Like I said, if you’re old enough to swing it around, you’re old enough to know how to swing it responsibly.

Good luck

Share

Vatican Roulette

Share

Name: Ricardo
Gender: Male
Age: 20
Location: Miami
I have understood that there is a certain period while women have their period that they can have unprotected sex without risk of getting pregnant, is this true? And if it is when is this period? After or before the PMS? And how long does it last? Thanks.

Nope, darlin’, there’s no such thing as a 100% foolproof, absolutely certain period in a woman’s menstrual cycle that she can have unprotected sex without the risk of gettin’ pregnant. This is a myth, and a mighty risky myth at that. If you’re considering this practice as an effective means of birth control, you’re playing Russian Roulette, or better Vatican Roulette, with your dick.

Ok so here’s the low-down on the rhythm method also known as “fertility awareness.” It is not a reliable way to prevent pregnancy for most people. Over 25% of couples that rely on the rhythm method to prevent pregnancy will accidentally conceive. Ya see, one has to be a freakin’ rocket scientist to use the rhythm method correctly and consistently. A woman is generally infertile around 10 days a month. Make one slight miscalculation on when that infertile period begins and you gonna be toast.

The rhythm method is dependent on the couple not have sex around the time of ovulation. But the trick is accurately determining precisely when ovulation happens. Couples can try to track this by using a calendar and a thermometer to measure body temperature. A woman’s temperature will rise a coupe of degrees just before ovulation. But very few women are as regular as clockwork. And lots of things, like stress, prescription medications, even antihistamines can throw a woman’s cycle of by a day or two. The fertile period around ovulation lasts 6 to 12 days. So absolutely no unprotected fucking during this period.

Even when used perfectly, the rhythm method is a highly ineffective means of avoiding a pregnancy. That’s because the methods formula makes several assumptions that are not always true. Sure, one can keep track of past menstrual cycles to predict the length of future cycles. However, the length of the pre-ovulatory phase can vary significantly, depending on a woman’s over all health. Like if for some reason she ovulates early, this will fuck up the rhythm method formula big time. The formula will indicate she is still infertile, when actually she is quite fertile. Look out!

The rhythm method also assumes that all vaginal bleeding is true menstruation. But that’s simply not the case. If you incorrectly identify the onset of menstruation, even by one day, you’ll render your calculations inaccurate. Again, you will be toast, pup.

And consider this, sperm can live in a woman’s reproductive system for up to 7 days. And fertilization may occur even days after fucking. I mean with risks like these, wouldn’t it be safer and easier just to slip on a condom?

If by chance you are trying to reconcile your religious indoctrination (the rhythm method is the only means of family planning embraced by the Catholic Church) and your youthful libido, you may be playing with fire. In the final analysis, it’s not only your life that’s on the line here. Think about it; wear a rubber.

Good luck

Hey dr dick! What’s that toll-free podcast voicemail telephone number? Why, it’s: (866) 422-5680. DON’T BE SHY, LET IT FLY!

Share