The Guide to Getting It On (126 page)

Tubal Ligation or Essure for Women, Vasectomy for Men

Tubal ligation and vasectomy are permanent forms of birth control. They are highly popular and have a failure rate of 1% or less. Both are done on an out-patient basis. Neither procedure will cause a change in a person’s sex drive, and many people report they enjoy sex more once they don’t have to worry about pregnancy. They are the best form of birth control if you are not interested in having children or more children.

In tubal ligation, a thin tube-like instrument is passed through a small incision that is slightly below a woman’s belly button. The surgeon seals the fallopian tubes with clips, rings, or with electrical current. In order to see the fallopian tubes, a harmless gas is put into the abdomen. The gas is let out once the tubes have been sealed. Afterward, the eggs from the ovaries can no longer reach the womb. The total procedure takes about 15 to 20 minutes. Tubal ligation does not stop a woman’s periods, but it does stop her fears about becoming pregnant. A newer method of female sterilization is called Essure. This is a non-surgical method of sterilization where spring-like coils are inserted to block the fallopian tubes.

A vasectomy begins with a small incision that is made in the scrotum. The physician reaches the vas deferens or sperm-carrying tubes with a thin instrument. The tubes are then sealed so that sperm does not mix with ejaculate. The procedure should take less than 20 minutes. There is also a newer method called the No-Scapel vasectomy where the scrotal skin is not cut with a scalpel. Instead, an opening in the scrotum is made with a special instrument to help decrease bleeding and pain. The rest of the procedure is like a conventional vasectomy. Since sperm makes up less than 5% of each ejaculation, the volume of semen that a man ejaculates will appear to be the same. The only thing that will be missing are concerns about pregnancy.

Oral Sex and Hand Jobs

If a woman uses oral sex or a handjob to satisfy her partner instead of vaginal intercourse, her chances of becoming pregnant are zero and her chances of getting a horrible disease like HIV are next to zero. She doesn’t need a prescription to give oral sex and hand jobs, nor must she have the money to purchase them.

Natural Family Planning — May the Cervix Be with You

Natural Family Planning is an attempt to define which parts of the month a couple can enjoy intercourse with a low probability of conception, and which times are best to avoid. Natural family planning requires far more knowledge, planning and discipline than other methods of birth control. The effectiveness is not usually very high and can vary greatly. There are several variations of natural family planning, including the cervical mucus method, the two-day method, the calendar method, the standard days method, the symptothermal method and the temperature method.

One of the indicators of fertility is when the mucus that comes from the cervix starts to look clear like raw egg white and is slippery and stretchy. This is the cervix’s siren call for sperm. This is one of the signs that natural family practitioners look for as an indicator of fertility. When the mucus looks like this, the couple either abstains from intercourse or needs to use an alternative method of birth control such as a condom.

Natural family planning should not be considered unless the partners are monogamous and committed, and have a total understanding of what’s involved. Even then, it is anything but infallible. It would also be less than optimal to practice NFP when you are younger and your ovulation is not as consistent as it might eventually be.

There are two styles of natural methods, the NFP or natural family planning and FAM or fertility awareness methods. FAM encourages couples to use a backup method such as condoms or a diaphragm during unsafe periods, where NFP is more religion based and anti-contraception. Toni Weschler’s
Taking Charge of Your Fertility--10th edition
is the bible of NFP. Also be sure to get the accompanying software for the book to help you do the best planning possible. Get it at
www.tcoyf.com
. If you are trying NFP and find yourselves having intercourse during a less-than-optimal time, the man should pull out and ejaculate on the side. However, some religious groups might not approve.

Coitus Interruptus, Withdrawal or Pulling Out

One of the problems with birth control is that people don’t think they need a backup method. But what happens when you’ve forgotten to take your pill for the second day in a row or the condom didn’t get put on in the heat of passion? Why not consider pulling the penis out before the man ejaculates, with him ejaculating to the side instead of inside? This is known as withdrawal or coitus interrputus, which is Latin for “pull it out before it spits.”

Withdrawal is when the man pulls his penis from the woman’s vagina before he is about to ejaculate and shoots his semen off to the side. One of the biggest problems in recommending withdrawal is that there have been absolutely no empirical studies to determine whether it works. We also know that up to 40% of men do have sperm in their precum which is mobile and capable of impregnating a partner. This could make withdrawal ineffective for these men even if they correctly pull out before they ejaculate.

Withdrawal was the only method of birth control used during the fertility decline in Europe, and was probably the only effective method of birth control used in the 1800s when the average size of the American family decreased from 7 children to 3.5. So it does work for some couples. The question is whether you want to risk having 3.5 children.

One of the world’s most quoted experts on birth control recently informed us that if he were concerned about pregnancy, he would use a far more effective method of birth control than withdrawal. If he were concerned about sexually transmitted infections, he would use condoms as well.

Breastfeeding or LAM (Lactational Amenorrhea Method)

Ovulation stops for six months after childbirth in women who are exclusively and consistently breastfeeding their baby. The mom must breastfeed at least every four hours and she must not substitute any other food. This assumes she has not had a period since giving birth.

Emergency Contraception And Morning-After Pills

Emergency contraception is something that is done after having had intercourse in the hope of preventing conception. There are currently three forms of emergency contraception: pills called Plan B and Ella, and the copper IUD.

Both Plan B and Ella work by preventing the egg from leaving the ovary. To be effective, they need to be taken before the egg has entered the Fallopian tubes, so it is imperative they are taken as soon as possible after intercourse. Do not wait until the next day!

Plan B works by interrupting the release of the egg from the ovary if and only if it is taken before the LH surge. If it is taken after the LH surge begins, it is not effective. Ella, the newest form of emergency contraception, contains a second-generation antiprogestin called ulipristal acetate. Ella stops the release of an egg even if it is taken after the LH surge, which is why it is more effective than Plan B.

Contrary to what some abstinence-only groups have claimed, neither Plan B nor Ella cause an abortion. This is why you need to take them as soon after unprotected intercourse as possible, because once you ovulate, they don’t work. Plan B is taken as one pill, while the generic version of Plan B is two pills. You can take both of the generic pills at once. Plan B does not require a prescription if you are over 17, and males can buy it as well as females. However, as of presstime, you need to ask the pharmacist for Plan B. Unfortunately, you need a prescription for Ella. Plan B has been shown to be extremely safe, even if taken multiple times. People often confuse Plan B with Mifepristone which causes an abortion. (Mifepristone was known as RU-486 during clinical trials, and in the US it is called Mifeprex.)