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Question 1 My boyfriend has been talking about having sex for sometime now. I have been stalling the issue. But the fact is that I want to be sure that he use a condom every time we do it. I don't know how to tell him this. Can you help me?

It is encouraging to know that you are aware of condom usage. A small act of awareness can help prevent life shaking disasters! It is extremely important for you to frankly communicate about condom usage with your boyfriend. Indirectly, you may gauge his opinion on the increasing trends in unintended pregnancies and sexually transmitted infections by raising the subject.
You also need to put across the argument that if he loves you then he would take all precautions to make sure that you are safe. Tell him that a responsible adoption of condom usage would safeguard them with any unwanted incidents in the future. Remember that love is no more blind-love but with responsibility.

 

Question 2 What contraceptives can adolescents use?

In general ,adolescents are eligible to use any method of contraception and should have access to a variety of contraceptive choices.Age alone does not constitute a medical reason for not using a particular contraceptive. However social and behavioural issues are important considerations in the choice and use of a certain method.While adolescents may choose to use the method available in their communities,it is also important to bear in mind the sporadic nature of sexual contact and often the need to conceal sexual activity and contraceptive use. Also many adolescents are at an increased risk of contacting Sexually transmitted infections (STIs)and HIV due to the fact that are more likely to indulge in risk taking behviour. So besides preventing unwanted pregancies at an early age it is also important to use a contraceptive that safegaurds against STIs and HIV.

The more suitable methods for adolescents would be an oral pill or dual use of the condom and oral pills.These methods when used correctly and consistently will protect against pregnancy as well as STIs and HIV.

 

Question 3 What is oral contarception or the contraceptive ‘pill’?

Contraceptive pills or oral contraception is a hormonal method of contraception that can be used by women. It contains two hormones, oestrogen and progestogen, which prevent an egg from being released by a woman’s ovary each month and also make the uterine environment hostile to implantation of the egg. It is an effective and reversible method of contraception.

A woman of any reproductive age group is a suitable candidate for oral pills.However it is important to consult a doctor for screening of any contraindications before starting them. The pills may produce symptoms like nausea, headaches and weight gain in some women . Some drugs, such as antibiotics may affect its reliability. Contraceptive pills do not protect against sexually transmitted infections and HIV. Hence it is impotant to use condoms for dual protection since most young females have increased susceptibility to sexually transmitted infections.

The oral contraceptive pills have to be started within five days after the start of menstrual bleeding.However new users should normally start it on the first day of their cycle.One tablet is to be taken daily preferably at bedtime for 21 consecutive days followed by a 7days break.It shold be started ogain the next week on the same day of the week ,the pill finished).

 

Question 4 What is the progestogen-only pills (POP)or ‘mini pills’?

The Progesterone Only Pill or mini pill, unlike the combined pill contains only one hormone - progestogen. It works by acting on the cervical mucus, encouraging it to form a thick barrier to stop sperm entering the womb, and makes the lining of the womb thinner, to prevent it from accepting a fertilised egg.

These pills have to be taken at the same time each day, or at least within three hours of that time.There must be no breaks between packs.Some women have a better tolerance to these pills compared to the combined oral contracptive pills.However minipills can cause irregular bleeding, or periods may cease altogether during the time you take it. It is important to remember that they do not offer protection against sexually transmitted infections and HIV.

 

Question 5 What is a contraceptive injection?

Contraceptive injections are also known as ‘progesterone only injectables’.These are injected intramuscularly and contain hormones that provides a longer acting alternative to the pill. It works by slowly releasing the hormone ‘progestogen’ into the body which inhibits the relase of the egg from the ovary and makes the lining of the uterus thin so that it becomes unsuitable for implantation.

Two commonly used preparations are DMPA and NET-EN.

DMPA injections have to be repeated every 3 months and NET–EN every 2 months.The repeat injections can be given upto 2 weeks late without requiring any additional contraceptive protection.

The return of fertility after their discontinuation is usually delayed for several months(4-8 months).

Irregular bleeding is a possible side effect. You should not choose this method of contraception if you think you might be pregnant or if you do not want your periods to change. Injections also offer no protection against sexually transmitted infections and HIV.

 

Question 6 What is the male condom?

Male condoms are made of very thin latex and required to be placed over a man’s erect penis. They act as a physical barrier and trap sperm at the point of ejaculation.

Condoms are readily available from pharmacists,family planning clinics,vending machines and departmental stores. When used correctly and consistently, male condoms are the most effective method of preventing infections for those engaging in sexual intercourse, and can be highly effective in protecting against pregnancy as well.

The male condom has to be put on the penis as soon as it becomes erect and before any contact takes place with the vagina. They also have to be used with care as they can slip off or split. Men need to withdraw as soon as they have ejaculated and be careful not to spill any semen. Condoms should never be used with oil based products such as Vaseline and suntan oil, as these will damage the rubber and reduce effectiveness.

Condoms can be 94% - 98% effective depending on how correctly and consistently they are used.they are used.

 

Question 7 Are there any contraindications to using the condom?

Only one medical condition prevents use of condoms- severe allergy to latex rubber (severe redness, itching, swelling after condom use).

In general, anyone CAN use condoms safely and effectively if not allergic to latex.

 

Question 8 If I take birth control pills, do I still need to use condoms?

Condoms have a larger role to play than just prevent pregnancy. They protect an individual from sexually transmitted infections; birth control pills are prescribed only to prevent pregnancy. They do not provide protection from sexually transmitted infections (STIs).

 

Question 9 What are the important precautions to observe when using a condom?

Always use a fresh, new latex condom for each act of sexual intercourse.

 

Do not use condoms that are brittle, unusually sticky or discolored (usually the result of age) because these condoms may not prevent infection and may break during the act. The manufacturing date on the package should not be more than three years.

 

If extra lubrication is needed, only water-based lubricants should be used. Good lubricants include spermicides, glycerine, and specially made products. Water can be used also. Do not use petroleum or oil based lubricants, such as petroleum jelly (Vaseline), skin lotions, baby oil and cooking oils, as  they weaken the latex.

 

Question 10 What is the procedure to use condoms?

The penis should be erect (hard) and the condom should be put on before the penis touches the vagina, mouth or anus.

§         Carefully open the condom packet-don't use your teeth, fingernails or anything sharp to prevent nicking the condom-and remove the rolled up condom.

§         Most condoms have a nipple-shaped end on it. Pinch that together to squeeze out the air before placing the condom on the head of the erect penis. This is the tip where the semen will go when the male partner ejaculates (comes) after his orgasm.

§         Carefully roll the condom down the erect (hard) penis. If the condom will not roll, then it's not turned the right way. Throw it away and start over. Do not unroll and then re-roll a condom.

§         The unrolled condom should cover the majority of the penis shaft. Check for air bubbles and squeeze them out before the covered penis is inserted.

§         When intercourse is complete, hold the condom securely at the base of the penis and withdraw before the penis goes soft. Holding the condom prevents it from slipping or spilling.

§         Throw the condom away after it's been used. Never reuse a condom.

§         Always use a new condom for each sexual act.
Human error causes more condom failure than manufacturing errors.

 

Question 11 What can I do if the condom has split or slipped off during intercourse?

Immediately insert a spermicide into the vagina, if it is available. Also, washing both penis and vagina with soap and water should reduce the risk of STIs, however it does not completely eliminate the risk.

It is advisable to use emergency oral contraception to prevent pregnancy.

 

Question 12 What is the emergency contraceptive pill?

Emergency contraception (EC) should be undertaken within 72 hours of unprotected sexual intercourse; the sooner it is started, the more effective it will be in preventing pregnancy (recent data indicate that EC is effective <120 hours).It has to be taken in two doses one as soon as possible after unprotected sex and another 12 hours later.

However EC should not be used as a regular form of birth control.

Common adverse effects of EC include nausea, emesis, headache, irregular bleeding, breast tenderness, and abdominal cramping .An antiemetic can be prescribed to prevent nausea and emesis.If emesis occurs within 1 hour after a dose, the dose should be repeated

 

Question 13 What is an IUD (Intrauterine Device)?

It is a small plastic or metal (copper) device usually shaped like a ‘T’ that is inserted into the uterus.This procedure takes just a couple of minutes when performed by professionals well versed with the technique.

It works by afecting the motility of the sperms and the transport of the ovum(female egg) or by stopping an egg settling in the womb.

It can stay in place for five years. Some IUD’s can stay in place for ten years.

It is unsuitable for women who have more than one sexual partner as this can increase the risk of infection. IUD’s sometimes can cause periods to be heavier and more painful. The doctor who fits any intrauterine device should show you how to check the IUD by feeling for the threads. The IUD offers no protection against sexually transmitted infections and HIV.  It is 98% - 99% effective in preventing pregnancy.

 

Question 14 Does a person need to use condoms to protect against STIs when having oral or anal sex?

STIs can pass from one person to another during any sex act that involves penetration (inserting penis into any part of another person’s body). It is thus very important to use a condom when having oral, genital , or specially anal sex with a partner who may have an STI or if the partner has an STI in the past.

 

Question 15 What should I do if I have forgotten to take the ‘pill’?

If you have forgotten to take the pill and it is within 12 hours,take the delayed pill at once and continue with the rest of the schedule.There is no reason to worry.

But is more than 12 hours have passed,take the most recently delayed pill and continue the rest as usual.Take extra precautions for next 7 days either by using a condom or by avoiding sexual intercourse. Now check how many pills are left in your pack.If it is seven or more,the next pack should be started with an usual 7 day break.But if the left out pills  are less than 7 ,the next pack should be started without a break.This means that you not have a ‘period’ until the end of two months but this will do no harm.

 

Question 16 If I take birth control pills, do we still need to use condoms?

Yes! Birth control pills are prescribed only to prevent pregnancy. They do not protect you from sexually transmitted diseases (STDs).

 

Question 17 How do you use condoms?

The penis should be erect (hard) and the condom should be put on before the penis touches the vagina, mouth or anus.
· Carefully open the condom packet-don't use your teeth, fingernails or anything sharp so you don't nick the condom-and remove the rolled up condom.
· Most condoms have a nipple-shaped end on it. Pinch that together to squeeze out the air before placing the condom on the head of the erect penis. This is the tip where the semen will go when the male partner ejaculates (comes) after his orgasm.
· Carefully roll the condom down the erect (hard) penis. If the condom will not roll, then it's not turned the right way. Throw it away and start over. Do not unroll and then re-roll a condom.
· The unrolled condom should cover the majority of the penis shaft. Check for air bubbles and squeeze them out before the covered penis is inserted.
· When intercourse is complete, hold the condom securely at the base of the penis and withdraw before the penis goes soft. Holding the condom prevents it from slipping or spilling.
· Throw the condom away after it's been used. Never reuse a condom.
· Always use a new condom for each sexual act.
Human error causes more condom failure than manufacturing errors.

 

Question 18 Why don't teenagers protect themselves if they are having sex?

It's not always because people don't know. Sometimes they. . .

  • are embarrassed about buying or getting condoms
  • under peer/date pressure
  • are not able to make decisions under the influence of alcohol and drugs
  • lack knowledge about safe sex
  • believe using birth control pills is enough protection
  • are embarrassed about asking questions

don't think ahead of time

 

 

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