The Guide to Getting It On (125 page)

There has been concern about bone density loss associated with progestin-only birth control, so women should make sure they are getting sufficient calcium and vitamin D. Female athletes at risk for Female Athlete Triad should talk about the advisability of using Progestin-only methods with their healthcare provider.

Progestin-only pills need to be taken at the same time every day. If you are more than three hours late in taking one, bleeding can start and the effectiveness can decrease. While progestin-only pills require extreme compliance, the Minera IUD, Implanon implant, and Depo shot are progestin-only methods that can be hassle free for years at a time.

If You Forget to Take a Pill:
Many women forget to take 2 or 3 pills a month. Not that any guy could remember to take a pill every day, but this not good. Skipping makes the pill less effective; considerably so. If you forget to take your birth-control pill, check with your healthcare provider or your pharmacist. Also, your pill pack info should tell you how to make up for a missed pill or visit the pill’s website. We have links for these in the birth control section at
www.Guide2Getting.com
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With most types of combination pill, if you missed only one pill, you will be told to take the pill you forgot right away and to take the next pill as scheduled. It would be wise to use a backup method such as a condom for at least a week. The exception is if the pill you forgot to take is during your week of placebo or sugar pills. In that case, no harm, no foul—get out of jail free.

If you missed two pills but remember it on the day (or night) of your second missed pill, you might be told to take both of the forgotten pills right away, and to take the next day’s pill when you would normally take it. Use a backup method for at least a week.

If you missed two pills on but didn’t remember them until the third day, your healthcare professional might tell you to double up now and double up again the following day. Use a backup method for at least a week.

If you missed three pills, call your healthcare provider right away! Emergency contraception might be in order, in addition to prayer.

Birth Control Patch or OrthoEvra

The patch is a hormone-based contraceptive that eliminates having to take birth-control pills. It is a small 2” square that is applied to the skin. It can be placed on the hips, butt, abdomen, upper arm, or shoulder blade, but not on the breasts or extremities. Users need to replace it once a week. After three consecutive weeks with a new patch, women go patch-free for a week to have a period. The patch contains a dose of hormones similar to birth control pills. However, instead of having to swallow them in pill form, the hormones are absorbed through the skin. While the patch is not as effective for women who weigh over 198 pounds, it is still more effective than condoms. There is no research on whether the patch remains effective while swimming.

There have been safety concerns about increased numbers of blood clots being caused by the Patch. The FDA recently reviewed the data and by a vote of 19 to 5 decided to keep it on the market. They believe the benefits outweigh the dangers.

Depo-Provera: Three Months at a Shot

Depo-Provera is a progestin-only pill-in-a-shot that lasts for 12 weeks. Women seem to either love it or hate it. If you hate it, you are stuck with it in your body for 3 months. One of the main side effects of Depo is irregular bleeding. Some women bleed a lot and some don’t bleed at all. Some women find that Depo stops their periods altogether for three months.

Birth Control Implant Effective for Three Years

The birth control implant a matchstick-sized rod that is inserted in the arm under the skin. It provides highly effective birth control for three years. User error is impossible. The implant is a progestin-only method that decreases or stops period bleeding in 80% of the women who use it. Yet a side effect for some women is irregular bleeding, especially during the first three months. Brand names for the implant are Implanon and Nexplanon. Since it needs to be removed at the end of three years, make sure your healthcare provider is experienced at placing it near the surface of the skin.

The Diaphragm

The diaphragm is a shallow latex or silicone cup that a woman puts spermicide into and then places over her cervix before she has intercourse. Diaphragms used to be as common as sex itself, but not many women use them now. They require a goop-and-insert routine each time a woman has sex. However, the diaphragm has no hormonal side effects.

The diaphragm may be a good choice for a woman who doesn’t need to use birth control often, including someone who has a long-distance partnerwhere most of the sex is on the phone or Skype. For women with latex allergies, they are finally making non-latex diaphragms out of silicone.

Fitting a diaphragm can be as much art as science. Diaphragms can also cause a feeling of pressure on the bladder. They must be left in for eight hours after the last intercourse. If a woman’s lover is the kind who does a rapid reload and fire, she’ll need to squirt in extra spermicide but she doesn’t need to take the diaphragm out. She will need to get a new diaphragm every year or two, which should be accompanied by a refitting.

FC Female Condom — The Vagina Liner

The FC Condom is a pouch that’s inserted into the vagina. It forms a thin protective barrier between the penis and the walls of the vagina. Because it sits in the vagina, the man doesn’t have to pull out as soon as he comes. It is especially valued by couples where a penis is extra wide or has a foreskin that doesn’t do well with male condoms. The female condom used to known as “Reality” and was made of polyurethane. It is now called the FC Condom in North America and is now made of nitrile. Nitrile is cheaper to manufacture and it doesn’t make the squeaking noises when the penis thrusts that the older model was known for. Also, the warmth from the woman’s vagina passes easily through the nitrile material.

The female condom can be installed in the vagina long before lovemaking begins, so putting it in needn’t interrupt the flow or spontaneity of lovemaking.It gives women more control in protecting themselves and it can even be used in water. Some women report that the ring around the outside of the condom helps stimulate their clitoris during intercourse.

A male condom should never be used at the same time as a female condom. The friction between a bagged penis and a vagina liner has the potential to cause material failures if not combustion. Unfortunately, the female condom hasn’t caught on in North America. It isn’t cheap and some couples find it to be strange. Like the male condom, it doesn’t provide the best of birth control effectiveness. It is being used by some straight and gay couples for anal intercourse, although it’s doubtful that the instructions include this small detail. Couples who use it for anal sex often remove the inner ring before inserting it into the anus. The female condom of the future will possibly be made of a gel that forms a thin mesh barrier when it mixes with vaginal lubrication.

Spermicides: Sponges, Films, Foams, Gels, Suppositories & Jellies

Spermicides are chemicals that are used to kill sperm and hopefully reduce the risk of pregnancy. They are placed in the vagina before intercourse. The forms they come in include films, foams, sponges, suppositories, and jellies. Most are made with the chemical nonoxynol-9 (N-9). When used by themselves, spermicides can be less effective than other birth control methods, including condoms. If you are using spermicides for protection against pregnancy, it is best to use them along with condoms.

Spermicides can be bought over-the-counter and they can be an alternative for women who aren’t able to use hormonal methods. They can be messy and taste really nasty. The chemicals in spermicides can cause irritation in either partner, which increases the chance of getting STIs. Spermicidally-lubricated condoms can cause irritation as well.