Safe Sex

About 85% of sexually active women who do not use contraceptives become pregnant within a year. A woman can also become pregnant while breastfeeding and from about 10 days after childbirth and even during her menstruation. Withdrawal of the penis prior to ejaculation during intercourse (coitus interruptus) and periodic abstinence do not effectively prevent pregnancy nor provide protection against STDs. Here you can read more about several forms of contraceptives.

 Boy learning to use condoms in a sexual education workshop in Poland, July 2003. Image copyright Women on Waves 2004.

You can prevent an unwanted pregnancy with:
1- Total Abstinence
2- Use of contraceptives

To prevent unwanted pregnancy always use a form of contraception when you are sexually active.

Contraception methods
No method of contraception gives a 100% protection.
The male latex condom is the only contraceptive method considered highly effective in reducing the risk of STDs. Birth control pills, Implant and IUDs do not protect against STD infection.

For the Woman

DIAPHRAGM is a rubber disk with a flexible rim that covers the cervix and must be used together with

spermicide. It is available by prescription only and must be sized by a health professional. The diaphragm protects for six hours and should be left in place for at least six hours after the last intercourse but not for longer than a total of 24 hours.

ORAL CONTRACEPTIVES protect against pregnancy by the combined actions of the hormones estrogens and progestin. The hormones prevent ovulation. The pills have to be taken every day as directed and do not work after vomiting or diarrhoea. Side effects of the pill can be nausea, headache, breast tenderness, weight gain, irregular bleeding, and depression.

DEPO-PROVERA is a hormonal contraceptive injected into a muscle on the arm or buttock every three months. The injection must be repeated every 3 months. The menstruation can become irregular and sometimes even absent.

IMPLANTS (such as Norplant or implanon) are made up of small rubber rods, which are surgically implanted under the skin of the upper arm, where they release the contraceptive steroid levonorgestrel. Their protection lasts from 3 to 5 years. Side effects include menstrual cycle changes, weight gain, breast tenderness and loss of bone mass.

IUD is a T-shaped device inserted into the uterus by a health-care professional. The IUD can remain in place for 5- 10 years. IUD’s have one of the lowest failure rates of contraceptive method. Sometimes the IUD can be expelled and a woman has to check each month after her period with her finger if she can still feel the threads of the IUD. Other side effects can include abnormal bleeding, and cramps but this occurs mostly only during and immediately after insertion.

FEMALE STERILIZATION is done surgically. The tubes are ligated as a result of which the egg-cells can not encounter the sperm cells anymore and thus the woman can not get pregnant. It is a permanent form of contraception.

EMERGENCY CONTRACEPTION must be taken within 72 hours of unprotected sex in order to prevent an unplanned pregnancy. A woman must take 1 Norlevo and a second pill 12 to 24 hours later. Beside Norlevo, most combination (estrogens and progesterone) birth control pills can also be used. Take within 72 hours of unprotected sex. One dose 100 µg ethinylestradiol + 500 µg levonorgestrel (2-4 birth control pills), 12 hours later a second dose.

MORNING-AFTER IUD must be inserted within 5 days of unprotected intercourse. The IUD can stay for 5 to 10 years.

For the Man

CONDOMS are mostly made from latex rubber and can be used only once. Some have spermicide added to kill sperm. They act as a mechanical barrier, preventing direct vaginal contact with semen, infectious genital discharges, and genital lesions. Condoms are the most effective method for reducing the risk of infection from the viruses that cause AIDS and other sexually transmitted diseases (STD’s). It is important to use it well and put the condom on before intercourse

MALE STERILIZATION also known as vasectomy, is a quick operation performed under local anaesthesia with possible minor postsurgical complications, such as bleeding or infection. The ability to get an erection and an ejaculation does not disappear. The sperm cells are just a very small part (1%) of the fluid and a man will not notice any difference in ejaculation. The body will absorb the sperm cells.

Safety rates of different methods of contraception

Estimated Effectiveness:

• Male Latex Condom 86%.
• Female Condom 79%.
• Diaphragm with Spermicide 80%.
• Oral Contraceptives Over 95%.
• Injection (Depo-Provera) Over 99%.
• Implant (Norplant, Implanon) Over 99%.
• IUD (Intrauterine Device). 98-99 %
• Surgical Sterilisation Over 99%
• Emergency Contraceptives: 75%.

Lowest expected Typical Use Pregnancy-rate Pregnancy-rate
• Male Sterilisation 0.15% 0,1%
• Female Sterilisation 0.5% 0,5%
• Implant 0.09% 0,9%
• Hormone Shot 0.3% 0,3%
• Combined Pill 5% 0,1%
• Minipill (Progestin only) 5% 0,5%
• IUD 0.8% 0,6%
• Condom 14% 3%
• Diaphragm 20% 9%
• Periodic abstinence 5-40%
• No Method: 85% 85%