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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.

CONDOMS

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 sensation.

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 vision.

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.

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 replaced periodically.

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 barrier.

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 cervical caps.

OVER-THE-COUNTER SPERMICIDES

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 pregnancy.
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 of abstinence.
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 drugstores.

CONCLUSION

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.

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