From: elf@coho.halcyon.com (Elf Sternberg)
Newsgroups: alt.sex,alt.sex.wizards
Subject: The alt.sex FAQ, Part 12: CONTRACEPTION
Date: 23 Jul 1996 19:13:34 GMT
Organization: Northwest Nexus Inc.
Originator: superdj@marge.cs.mcgill.ca (David Johnson)
Moderator: elf@halcyon.com (Elf Sternberg)
Archive-name: alt-sex/faq/part12

CONTRACEPTION

What are the various methods of contraception and their effectiveness 
rates?


% of women experiencing an accidental pregnancy in
 the first year of use


-------------------------------------------------
                    Lowest                  Lowest
Method              Expected   Typical   Reported
-------------------------------------------------
Chance                   85        85        43.1

Spermicides              3         21         0.0

Periodic abstinence                20
  Calender               9                   14.4
  Ovulation Method       3                   10.5
  Symptothermal          2                   12.6
  Postovulation          1                    2.0

Withdrawal               4         18         6.7

Cervical Cap             6         18         8.0

Sponge 
   Parous women          9         28        27.7
   Nulliparous women     6         18        13.9

Diaphragm                6         18         2.1

Condom                   2         12         4.2

IUD
  Progestasert           2.0        3         1.9
  Copper T 380A          0.8        3         0.5

Pill
  Combined               0.1        3         0.1
  Progestogen only       0.5        3         1.1

Injectable progestogen   


     DMPA                0.3       0.3        0.0
     NET                 0.4       0.4        0.0

Implants
  NORPLANT (6 capsules)  0.04      0.04       0.0
  NORPLANT (2 rods)      0.03      0.03       0.0

Female sterilization     0.2       0.4        0.0

Male sterilization       0.1       0.15       0.0

    
     
_________________________________________________________________ 
   
Associated Risk statistics with Contraception


Activity                        Chance of Death in a Year

Risks for men and women of all ages who participate in:
     Motorcycling                       1 in 1,000
     Automobile driving                 1 in 6,000
     Power boating                      1 in 6,000
     Rock climbing                      1 in 7,500
     Playing football                   1 in 25,000
     Canoeing                           1 in 100,000

Risks for women aged 15 to 44 years:
     Using Tampons                      1 in 350,000
     Having sexual intercourse (PID)    1 in 50,000

Preventing pregnancy:
     Using birth control pills
          nonsmoker                     1 in 63,000
          smoker                        1 in 16,000
     Using IUDs                         1 in 100,000
     Using diaphragm, condom or spermicide   NONE
     Using fertility awareness methods       NONE
     Undergoing sterilization:
          Laparoscopic tubal ligation   1 in 67,000
          Hysterectomy                  1 in 1,600
          Vasectomy                     1 in 300,000

Continuing pregnancy                    1 in 14,300

Terminating Pregnancy:
     Illegal abortion                   1 in 3,000
     Legal abortion
          Before 9 weeks                1 in 500,000
          Between 9-12 weeks            1 in 67,000
          Between 13-15 weeks           1 in 23,000
          After 15 weeks                1 in 8,700

The source is the 1990-1992, 15th Revised Edition of Contraceptive 
Technology. Authored by too many doctors to cite. However, this book 
is used by millions of doctors around theworld as an authority on 
contraception. Its authors gather their sources from data published 
by several different statistic gathering organizations (such as the 
Centres for Disease Control) and then compile and interpret it in 
their book. Happy Reading.



Common Methods of Contraception

Diaphragm

Has a failure rate of 2% (i.e. out of 100 women who primarily use the 
diaphragm, two become pregnant in any year). Always use spermicide; 
both partners must learn how to place it properly. It has few 
associated risks; it cannot become 'lost' because the vagina is only 
a few inches long. Can 'slip' and press against the rectum; this can 
be uncomfortable. Also, some men can feel the diaphragm during 
intercourse. Some women have recurrent yeast infections when using 
the diaphragm.

The average diaphragm costs about 20-30 dollars, but it must first be 
sized and fitted by a gynecologist, so there is the cost of a 
doctor's fee. Must be replaced every two years to ensure correct fit 
and product lifespan. A tube of Gynol II costs around 11 dollars and 
is good for 24 doses of spermicide.

The major disadvantage to the diaphragm is that it must be used one 
of two ways; either it is inserted before any sort of sexual play, in 
which case the taste of spermicide can become an issue if the couple 
wishes to engage in oral sex, or is inserted after oral sex but 
before intercourse, which can be considered a major interruption of 
play and may lead to not using it all. 

(SOURCE: "The New Our Bodies, Ourselves" The Boston Women's Health 
Book Collective, 1984. Pgs 225-228.)  
     
   
Reality, The Female Condom

The female condom is a soft, loose-fitting plastic pouch made of 
polyurethane (not latex) that lines the vagina. It has a semi-stiff 
plastic ring at each end. The inner ring is used to insert the device 
inside the vagina and hold it in place. The outer ring partly covers 
the labia area and holds the condom open. The female condom is market 
in the United States by Wisconson Pharmaceuticals under the name 
Reality. In the United Kingdom and Canada it is marketed under the 
name Femidom. Market acceptance testing has been going on for over a 
year, and on August 15, 1994, Wisconson Pharmaceuticals began 
widespread marketing of Reality.

In theory, the polyurethane construction of the female condom makes 
it viable to use with oil-based lubricants, and Wisconson 
Pharmaceutical's hotline states that this is safe. The female condom 
is also the best viable alternative available for those people who 
are allergic to latex. The female condom should notbe used for anal 
sex-- the anus has no upper end and the outer ring is not enough to 
prevent it from being pushed into the anus and become lost.
 
INSERTING THE FEMALE CONDOM.

The female condom can be inserted up to 8 hours before sex. However, 
most women prefer to insert it between 2 and 20 minutes prior to 
sexual intercourse. The condom should be removed immediately after 
sex.

Squeeze the inner ring with your thumb and middle finger, placing 
your index finger down upon the plastic inside the inner ring. Still 
squeezing, spread the labia apart. With your hand positioned with 
your palm towards you, insert the female condom into the vagina. Push 
the inner ring and pouch the rest of the way into the vagina until 
the inner ring is up past the pubic bone. The outside ring should now 
lie against the vulva, covering the opening of the vagina.
 
THE FEMALE CONDOM AFTER INSERTION
  
During intercourse, the female condom may move or shift. It should 
not be pushed into the vagina, and the outer ring is intended to 
prevent this. However, it may happen. If so, stop intercourse, fix 
the ring, and apply more lubricant to the penis or in the pouch. 

After intercourse, the female condom should be disposed of in a 
trashcan. Do not flush the female condom in the toilet.
 
EFFECTIVENESS

The pregnancy rate for the female condom under normal use is expected 
to be comparable to that of the male condom (13%). However, because 
of a lack of familiarity with the device, initial results have been 
discouraging, with rates as high as double that (26%). The female 
condom requires the use of an external, water-soluble lubricant. A 
package of Reality, the brand available in the United States, comes 
with three female condoms and a small bottle of lubricant (1/2 oz). 
The lubricant is comparable in quality to Astroglide. 

The female condom requires practice to use properly. Be prepared to 
take your time inserting it the first time. Those who have experience 
using a diaphragm will find the process familiar. 

The female condom has not been tested in its efficiency to prevent 
disease. It is expected to be as effective as a male condom. However, 
the insertion process calls for two steps: inserting the ring, where 
the hand is outside the pouch and in contact with vaginal fluids, and 
then fitting the ring, where the fingers are inside the pouch, thus 
spreading those fluids about the pouch where the penis will go. While 
there are solutions to this problem (have each partner do one of 
these steps, wear gloves for half the process, or wash hands before 
the fitting stage), none of them are adequate for most people. The 
female condom should not be considered a viable protection for STDs 
in cases where the woman is suspected to have a mucosal infection 
such as herpes or HPV.

In the United States, Reality has been available primarily through 
Planned Parenthood. Wisconson Pharmaceuticals has started shipping to 
drug stores and it should be available throughout the U.S. in the 
last quarter of 1994. Reality is somewhat pricey-- three condoms and 
a small bottle of lubricant cost approximately $7.00 US.
 
PERSONAL OBSERVATIONS.

My wife and I were part of a marketing test group for Reality. It's 
expensive, difficult to learn how to use, and not very effective at 
preventing STDs without extraordinary measures. However, I happen to 
like it. Without enough lubricant, it will stick to the skin of the 
penis and act just as a male condom. With enough lubricant it feels 
much better than a male condom-- the penis responds mostly to 
friction, and that's what Reality supplies. A friend of mine who is 
allergic to latex thinks they're a gift from heaven. Some gay men 
have tried using Reality for anal sex, with mixed but generally 
positive results. Wisconson Pharmaceutical has announced, rather 
loudly, that they have no intention of making the modification 
necessary to make Reality truly viable for anal sex.

Reality comes with an instruction booklet. The booklet is hilarious, 
mostly because of the name of the product. For example:
   
     * Use a new Reality with each and every sex act. 
     * Read instructions carefully before using Reality. 
     * The booklet explains how to use Reality. 
     * Don't tear Reality. 
     * Reality only works when you use it. 
     * Make sure Reality is not twisted after insertion. 
     * Reality should not be noisy during sex. 
     * Reality may shift during sex. 
     * Keep Reality out of the reach of children. 
       
   If you have the opportunity to purchase and try Reality, do so at 
least once. Get three condoms and a bottle of lubricant and try them 
out. Any new reproductive technology is worthwhile, and who knows-- 
you might like them.


Postcoital contraception (the "morning-after" pill):

The morning-after pill will prevent pregnancy up to 72 hours after
unprotected intercourse.  It reduces the risk of pregnancy to about 1 
to 2%; in comparison, the risk of pregnancy after mid-cycle 
unprotected intercourse is normally about 15 to 26%.

The morning-after pill should not be used for routine contraception, 
as the failure rate is relatively high and it has unpleasant 
side-effects such as nausea.  After an "accident", however, it may be 
very useful.  See your doctor as soon as possible after unprotected 
intercourse to obtain it.

Reference: "Contraceptive Technology"


Condoms

This is a posting of information about types of condoms which are 
significantly larger or smaller than average. I got it out of a book 
called "The Condom Book" or something similarly imaginative.

One thing that was apparent from reading through the descriptions was 
that advertising on size (or for that matter thickness or ribbing or 
whatever) is often misleading. A brand which is claimed to be smaller 
than average frequently isn't outside the normal variation. There may 
also be differences in size based on variations in manufacturing and 
these figures were probably based on single samples. Different size 
measurements for different styles of the same brand may indicate such 
variations or be an attempt to provide some size variation, in which 
case getting the precise style named is important. All measurements 
are flat and don't take into account elasticity, which might 
influence comfort when worn. Typical condom flat widths range from 2" 
to 2-1/8" (meaning two and one eighth, not two minus an eight). All 
the condoms listed here are both lubricated and reservoir ended. 
Company names are listed in parentheses. Extra words which may appear 
in the name on some packages are listed in square brackets. It is 
possible I've copied some numbers wrong (and other disclaimer 
noises). 

SLIMMER CONDOMS

Mentor (Mentor):                        2" by 8", not smaller,
                                        but has adhesive inside

Bikini (Barnetts):                      slightly less than 2" by
                                        7-1/4", packaged in that
                                        frustrating plastic
                                        wrapper

[Sheik] Fetherlite (Schmid):            1-7/8" by 7-1/2"

Hugger (Circle):                        1-7/8" by 7-1/8"

Slims (Circle):                         1-7/8" by 7-3/4"
                                        to prevent slippage,
                                        rather expensive though

WIDER CONDOMS

Excita (Schmid):                        2-1/4" by 8-1/4", Excita
                                        Extra has spermicide

[Lifestyle] [Horizon] Nuda (Ansel):     2-5/8" head, 2-1/8"
                                        shaft, by 8-1/8"

[Ramses] NuForm (Schmid):               2-1/2" upper, 2+" lower,
                                        by 8-1/4, has benzocaine
                                        anaesthetic

Rough Rider (Ansel):                    2-1/2" by 8" thick but
                                        doesn't block sensations,
                                        raised studs

Sheik Ribbed (Schmid):                  2-1/4", forgot to note
                                        length

(Note wide variation in Sheik. Elite with spermicide and
Lubricated (with benzocaine?) are both 2-1/8". Fetherlite is
1-7/8".)

Trojan-Enz Lubricated (Carter-Wallace): 2-1/4" by 8"

LONGER CONDOMS

Man-form Lubricated (Protex):           2" by 8-3/4" long
                                        packaged in that
                                        frustrating plastic
                                        wrapper

[Trojan] Naturalube (Carter-Wallace):   2" by 8-5/8"

    
--

Elf Sternberg               	I'm not inclined to write pompous
elf@halcyon.com             	books about unanswerable questions.
Public key available        	That strikes me as a tremendous waste
http://www.halcyon.com/elf  	of time.
                            			- Stephen Jay Gould