<< Sex education doesn't have to be embarrassing

By Libby Hartigan,
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Birth Control Pill

Concept:
A woman takes a hormone pill every day that stops ovulation, so no egg is released. Basically your body is tricked into thinking it’s already pregnant.

Success Rate:
With typical use, five women in 100 become pregnant in one year. With perfect use, less than one woman in 100 will become pregnant in one year.

Pros:
Provides non-stop protection against pregnancy. You’ll know exactly when your period is going to come. You’ll have less PMS and cramps. Your risk of pelvic inflammatory disease is lower and you’re less likely to have iron deficiency and anemia. A new California law states that as of January 2000, health insurance must help cover the cost of the pill.

Cons:
Offers no protection against STDs including HIV. It can cause side effects such as nausea, headaches, moodiness, weight gain or loss, breast tenderness or bleeding between periods. Some women have no side effects, but usually side effects go away after a few months. You need to remember to take the pill every day at the same time, and you must use a back-up method.

How To Get It:
Through a prescription from a doctor or a family planning clinic; the cost runs $18-$30 a month plus the cost of the medical visit, which can cost between $15-$120. (Many clinics have sliding scale fees—so an exam may be free or cost as little as $5.)

Condom

Concept:
A plastic or latex sheath (rubber) covers the penis and collects the semen, preventing sperm from entering a woman’s vagina. It should be used with a spermicide or another form of birth control such as birth control pills, Depo-Provera or Norplant.
Success Rate:
With typical use, 14 women in 100 will become pregnant in one year. With perfect use, three women in 100 will become pregnant in one year.

Pros:
It provides good protection against most STDs, including HIV, the virus that causes AIDS. Plus, it’s cheap, easy to carry around and can be bought at any drugstore without a prescription. They make it possible for a man to take responsibility for birth control.

Cons:
It can break especially if it’s not put on correctly; likewise, it can leak if not withdrawn carefully. Condoms must not be used with any oil-based lubricants like Vaseline or massage oil. Some people are allergic to the rubber. Some people say it reduces their pleasure.

How To Get It:
At drugstores and supermarkets; costs $6-$8 per dozen, depending on the brand. They are often available free at family planning clinics. For STD protection plastic or latex condoms are best; animal skin condoms do not provide reliable protection.

Depo-Provera Injection

Concept:
A woman gets a shot of the hormone progestin in her arm or hips every three months. Like the Pill, Depo-Provera prevents pregnancy by keeping the ovaries from releasing eggs.

Success Rate:
Less than one woman in 100 will become pregnant in a year using this method.

Pros:
Once you get the shot, you don’t have to think about it for another three months.

Cons:
You have to see a doctor for another shot every three months. Offers no protection against STDs including HIV. As with Norplant, a common side effect is irregular periods, such as a longer or heavier menstrual flow, spotting between periods or no bleeding for months at a time. Less common side effects are weight gain, sore breasts, nausea, nervousness, dizziness, depression, skin rashes or spotty darkening of the skin, hair loss, increased hair on the face or body, increased or decreased sex drive. Depo-Provera may increase the risk of cervical cancer. If you want to get pregnant, you will probably have to wait at least 10 months after you stop using it before your ovulation cycle returns to normal.

How To Get It:
Requires a medical visit every three months with a doctor or family planning clinic; the cost is about $35 per shot, plus the cost of the office visit which ranges between $15-$120 each visit.

Diaphragm

Concept:
A woman uses spermicide to coat this dome-shaped rubber cup with a flexible rim. Then she places it inside the vagina to cover the cervix, where it blocks sperm. The cervical cap, another contraceptive option, performs a similar function but is not nearly so widely available.

Success Rate:
With typical use, 20 women out of 100 become pregnant in one year. With perfect use, six women out of 100 become pregnant in one year.

Pros:
It can be put in place up to six hours before intercourse and can stay there for 24 (though fresh spermicide should be applied each time you have intercourse). It is usually not felt by either partner during sex. Also, may offer a little protection against certain STDs. If you want to become pregnant, you can just stop using it.

Cons:
Won’t protect effectively against most STDs including HIV; can increase the risk of urinary tract infections and toxic shock syndrome. Can be messy (thanks to the spermicide) and clumsy to use until you get the hang of it. Also, it has to stay in place for six hours after intercourse and then needs to be washed thoroughly with soap and water. You need to check the diaphragm from time to time for weak spots or tiny holes. You also need to have a pelvic exam and check the size annually. Gaining or losing a lot of weight, having an abortion or other changes might mean you need a different size. If you’re uncomfortable touching yourself, you might have a hard time using the diaphragm.

How To Get It:
Through a prescription from a doctor or family planning clinic; the cost is $30-$40 plus medical exam and fitting, which ranges from $20-$120. The spermicidal jelly, cream or foam costs from $8-$15 a tube, depending on the size. A diaphragm will last about two years.

Female Condom

Concept:
A thin plastic sheath, shaped like a sock with flexible rings at each end. The ring at the closed end holds the pouch in place inside the vagina, while the ring at the open end remains outside the vagina. The pouch collects semen and prevents it from entering the vagina. It should be used with a spermicide or another form of birth control such as the Pill, Depo-Provera or Norplant.

Success Rate:
With typical use, 21 out of 100 women will become pregnant. With perfect use, five out of 100 will become pregnant.

Pros:
Protects against STDs, including HIV, and you can get it without a prescription. Also, you can insert it up to eight hours before having intercourse.

Cons:
The outside ring can slide inside the vagina during intercourse; also, a woman may feel less sensation. Can be awkward to use; must be removed right after intercourse, before you stand up, to prevent semen leakage. May be hard to use if you’re uncomfortable touching yourself.

How To Get It:
Buy it at drugstores or supermarkets or get it from family planning clinics; the cost, $1.25-$3.70 each.

Norplant

Concept:
Six soft matchstick-sized capsules are inserted under the skin of a woman’s upper arm, and these nodes release hormones that prevent pregnancy. You are given a local anesthetic and the capsules are inserted through a small cut, a procedure that takes 10-15 minutes.
Success Rate:
Less than one woman in 1,000 becomes pregnant in one y ear. It is the most effective form of birth control available, except for abstinence.

Pros:
It protects against pregnancy for up to five years—without your having to do a thing. Plus, it starts working within 24 hours of insertion.

Cons:
Doesn’t protect against STDs including HIV; may cause irregular periods, headaches, depression, weight gain, hair loss, breast tenderness or acne. Some women may be able to see the rods under the skin. Having the rods removed can be a hassle and it might leave a small scar. Some women forget when they are supposed to have it removed and this can lead to accidental pregnancy.

How To Get It:
Requires a medical visit with a doctor or family planning clinic; the cost is $400-$700, while removal runs $80-$200. Some clinics may have Norplant available more cheaply. It’s a lot of money, but it lasts five years.

Methods to Avoid

Rhythm method
The rhythm method is a way of tracking your body’s ovulation and avoiding sex during the time of the month when you are fertile. The problem is, it’s very hard to do this accurately, especially since teenagers’ menstrual cycles are often irregular.

Having intercourse during your period
First of all, just because you’re bleeding doesn’t mean you’re having your "true" period; some women bleed during ovulation. And it’s often hard to predict when you’ll ovulate. So you’d better use protection whenever you have intercourse, all month long. (Sex during your period is also a riskier time for HIV transmission.)

Peeing after intercourse
A myth! Urinating after sex does nothing to protect against pregnancy because the urinary opening is near to, but not inside, the vagina. So sperm won’t be touched by the liquid rush.

Douching
Rather than rinsing sperm out of the vagina, douching could actually send them swimming upstream toward an egg. (It can also increase the risk of infection.) All in all, a bad idea!