Contraceptives - Their importance to Seniors
We are fully aware that the subject of contraceptives is controversial
- many people do not believe in any contraception except abstinence or Fertility Awareness Methods (FAMs), sometimes called the "rhythm method." Then again, people over 60 do not normally need contraceptives for birth control.
However, statistics tell us that people over 50 can be
quite sexually active, often with younger partners who do need birth control.
And sexually active people of any age can get sexually transmitted diseases.
Scientists have been hard at work to develop "methods of choice" to avoid
unwanted pregnancies, and at the same time, to find a way to avoid venereal
disease (STD's). The drug RU-486, that induces early abortions is in the midst
of political controversies
Another new contraceptive is on the way. It is a unique new vaccine made from
sperm cells. It would involve a pill or an injection that a woman could use to
signal her immune system to develop antibodies to the protein in the head of the
male sperm. The antibodies would then bind to the sperm cells and destroy their
ability to fertilize the woman's eggs. Its effects would wear off in two to five
years and leave women with the option of conceiving if they wished. It is not
yet on the market.
are easy to get, easy to carry, easy to use, and are the most common method of
birth control. They also help protect against sexually transmitted diseases.
Condoms are sheaths of thin rubber or animal tissue that fit over the erect
penis during intercourse.
Condoms catch semen before, during, and after ejaculation, thereby preventing
sperm from entering the uterus. Latex condoms are believed to offer better
protection than animal tissue condoms. The use of condoms is sometimes faulted
for interfering with the spontaneity of sex, and some say, for decreasing
Condoms are highly effective if used properly. Condom breakage is usually due to
improper use. Condoms are to be used only once and then thrown away. Using a
substance like Vaseline to lubricate the condom can contribute to its breakage.
KY jelly is a proper lubricant. Condoms are easily obtained at most drugstores
and are reasonable in price.
BIRTH CONTROL PILLS
are available only by prescription and are the most effective temporary method
of birth control. Birth control pills consist of one or both of two compounds
similar to the natural hormones that regulate the menstrual cycle. Women on
pills have more regular periods, fewer ectopic (tubal) pregnancies, and less
cramping, blood loss, iron-deficiency anemia, and pelvic inflammatory disease.
The pill appears to offer some protection from ovarian and endometrial cancer,
noncancerous breast tumors, and ovarian cysts. However, there are some long-term
risks. Ask your doctor.
Birth control pill users may experience minor reactions, including breast
tenderness, nausea, vomiting, weight gain or loss, and spotting between periods,
which often clear up after two or three months. Serious problems are rare. But
as a woman gets older the possibility of blood clots, stroke, heart attack, or
liver tumors may increase, particularly if the woman smokes, has high blood
pressure, high cholesterol levels, or diabetes. A woman on the pill should
immediately report to her doctor unusual swelling or pain in the legs; yellowing
of skin or eyes; pain in the abdomen, chest, or arms; shortness of breath;
severe headache; severe depression; or eye problems such as blurred or double
People over 50 can be quite sexually active, often with younger partners who do
need birth control. And sexually active people of any age can get sexually
INTRAUTERINE DEVICES (IUDs)
are small pieces of shaped plastic (usually containing copper and/or hormones)
that are inserted into the uterus. IUD threads coming through the cervix into
the vagina help check placement. IUDs generally create a condition in the
fallopian tubes and uterus that hinders a pregnancy from occurring. Some types
can remain in place for a long time, if there are no problems. Others have to be
A complete pelvic examination will indicate whether an IUD is appropriate and
what kind may be used. The user may experience some pain during the brief time
of insertion, especially if the user has never been pregnant. Some users report
cramps, heavier menstrual bleeding, and spotting. Most adjust in a few months,
but some may require removal for pain, bleeding, or infection. Sometimes the
uterus pushes out an IUD, and in rare cases, a dangerous infection may occur.
A woman is cautioned to never try to remove an IUD herself and to have regular
checkups. The IUD may be inserted by a private doctor or a clinic. IUDs are very
effective but expensive initially.
DIAPHRAGMS AND CERVICAL CAPS
Are rubber barriers that fit securely in the vagina and cover the cervix. Both
devices block the sperm from the entrance to the uterus. They must always be
used with contraceptive cream or jelly to keep sperm from getting past the
Properly fitted, the diaphragm or cervical cap should not be felt by either
partner during sexual intercourse. There are no side effects except in rare
instances of allergic reaction to the material the device is made from or to the
spermicide used. Contraceptive creams and jellies used with diaphragms and
cervical caps may offer some protection against certain sexually transmitted
diseases. A checkup for size is needed every year, or if weight is gained or
lost, or following pregnancy.
A diaphragm can be inserted up to 6 hours before intercourse and may be left in
place for 24 hours. Each time sex is repeated, more jelly, cream, or foam must
be inserted in the vagina. A diaphragm fits against vaginal walls and may not
fit if the woman gains or loses say 10 pounds. A cervical cap is a suction cup
that fits directly over the cervix. The cap doesn't require additional
spermicide if sex is repeated, the diaphragm does. Just put some in the cup
before insertion. The diaphragm may become dislodged in the woman-superior
position, or in women with relaxed vaginas (that may result from childbirth).
A cervical cap can be inserted anytime before intercourse and can be left in
place for 48 hours. It can be used by women who cannot hold a diaphragm because
it fits like a suction cup over the cervix and doesn't depend on the pelvic
muscles to hold it in place. Because the cap may become dislodged before or
during intercourse, it should be checked occasionally to see if it is properly
positioned. A prescription is needed for the purchase of both diaphragms and
consist of contraceptive sponges, foams, creams, jellies, and suppositories that
are inserted deep into the vagina to stop or kill the sperm. Sponges are
doughnut-shaped, 2 inches in diameter, and made of soft, synthetic material
impregnated with spermicide. They fit over the cervix, a polyester loop allows
easy removal. Sponges come in one size; there is no need for a fitting. The
sponge absorbs sperm and provides a physical barrier to prevent sperm from
entering the uterus. All spermicides spread into the crevices of the vagina,
forming barriers that paralyze and block sperm from entering the uterus.
FERTILITY AWARENESS MEDTHODS (FAMs)
are systems designed to help a woman estimate the time in her menstrual cycle
when an egg is most likely to be produced and she is fertile. In women whose
periods are regular, an egg is released about 14 days before the start of her
next expected period. A woman may be fertile five days before the egg is
released (ovulation), during ovulation, and up to three days after ovulation.
During those days it is unsafe to have unprotected intercourse without risking
Fertility awareness techniques can be used to prevent or to plan a pregnancy and
are acceptable to couples with religious concerns about birth control. The
method requires keeping a daily chart of body changes and it needs expert
instruction for successful use. A fertility awareness method with abstinence
requires the self-control of both partners. Even with correct use, failure may
be more likely than with other methods. Frustration can result from long periods
In the basal body temperature method, abstinence must last from menstruation
until after ovulation. Body temperature is taken each morning before getting out
of bed. A small but significant rise of less than one degree occurs when the egg
is released. After three days of the higher level, the unsafe period is past.
The vaginal mucus system associates changes in a woman's vaginal moisture with
phases of her menstrual cycle. Normally cloudy, tacky mucus will become clear
and slippery and will stretch between the fingers when the egg is released. When
slippery mucus appears, abstinence becomes necessary and must continue until
four days after the final day that the slippery mucus is observed.
Each fertility awareness method can be used alone, but it is better to combine
awareness with the basal body temperature method and the vaginal mucus system.
All three methods used together have a fairly high degree of reliability. Charts
are carried by family planning clinics. Temperature kits can be bought at
As we have said before, older couples seldom have to worry about the above
information. But, life being as it is, with all sorts of exceptions and an
unpredictable future, who knows what could happen.