Last Friday, the Health and Counselling Centre and the UTM Sexual Education Centre held a workshop titled “Contraception and Safe Sex,” hosted by Dr. Erin Kraftcheck, a family doctor working with the HCC, and Tanya Harrison, the head nurse practitioner.
“When you think of contraception, it breaks down into two categories: permanent, and reversible or temporary,” says Kraftcheck.
Permanent contraceptive methods include tubal ligation and vasectomy—which is not something that would ordinarily be considered an option for post-secondary students. External condoms are the most popular form of birth control for post-secondary students, which are usually complemented with the use of a secondary contraception method. Kraftcheck emphasizes that with condoms, it’s important to check the expiry date, ensure they are not stored anywhere too hot, and make sure not to open the packages with your teeth.
The external condom, typically referred to as the male condom, is an external barrier form of birth control which also provides protection against STIs. With typical use, the condom fails 18 percent of the time, usually due to engaging in sexual activity before stopping to put on a condom prior to ejaculation. Pre-ejaculation fluids can sometimes contain enough sperm to fertilize an egg, so the condom should be put on prior to any genital contact. With perfect use, the condom still fails approximately two percent of the time.
The insertive condom, typically referred to as the female condom, is another external barrier form of birth control. It can be inserted ahead of sexual activity and does not require that the condom be withdrawn immediately after, but should be withdrawn before standing up to avoid any potential leakage while still inside the pelvis. With typical use, the insertive condom fails approximately 21 percent of the time, and five percent of the time with perfect use. The insertive condom is still new in terms of popularity, with only one percent of the total production of condoms being insertive condoms. There is a greater risk of sliding inside the vagina during sex, but according to Dr. Kraftcheck, the largest detriment to this type of condom is the user’s comfort level with how to properly use and discard the insertive condom.
“It usually takes about five tries to get comfortable with using the insertive condom [properly],” shares Kraftcheck.
The most common non-barrier forms of contraceptives are the pill, the patch, and the ring. The pill must be taken once a day at the same time or within three hours. The newer versions of the pill have lower quantities of hormones in them, which makes the body very susceptible to pregnancy if not taken properly. The hormones in the pill are tricking the user’s body into thinking it is in the earliest stage of pregnancy, making it unnecessary to ovulate. If you miss taking the pill for a couple of days, the body starts the ovulation cycle, which can explain why people have claimed to have gotten pregnant while taking the pill.
“If you forget one time, as soon as you remember the pill, you can take it. If you take the pill at dinner and remember in the morning you can take the pill right away, but then take your pill at dinner like you usually would. If you don’t remember until the next night, you take two pills at dinner,” says Kraftcheck.
The ring is once-a-month birth control. It is inserted into the pelvis and releases a tiny bit of hormone constantly for three weeks, with no hormone for the fourth week. At the end of the three weeks, it is pulled out and tossed in the garbage. This form is not as popular, because less individuals are comfortable and confident with the insertion of the ring. It can also be difficult to locate the ring when it’s time to remove it.
“It can be difficult to find [the ring] sometimes if it gets back behind the cervix, but it will never disappear,” Kraftcheck says. “Sometimes there’s a misconception that the female anatomy is open to the stomach, and it’s not. It’s a closed-off pouch inside the pelvis, and even if you couldn’t find it, it can’t get lost up inside. But you might have to come into the doctor’s office and get the doctor to help you take it out.”
The ring can also be removed from the body for up to three hours, but it is not recommended.
The patch is a once-a-week birth control. It can be placed on the upper arm, the abdomen, the thigh, or the bikini area. Once a week, you remove the patch and apply it to a different area. Individuals with the patch need to avoid hot tubs and saunas, as the high levels of heat can cause the hormones to absorb at a faster rate. If the patch begins to lose its adhesiveness early, you need to remove it and apply a new patch for the remainder of the week, but then reapply a new patch at the usual time to maintain your cycle.
Hormonal methods, such as the pill, the patch, and the ring, will be less effective at a body mass index over 35.
“Estrogen is stored in fat cells. With a higher BMI, more hormone will be stored than used to prevent ovulation,” says Kraftcheck. However, there are pills which have higher doses of the hormone, and any concerns over the effectiveness should be discussed with a clinician before starting the contraception, as well as any other possible side effects.
The most dangerous risk with taking hormonal birth control is a blood clot, but it is still a low risk. The other possible side effects include moodiness, breast tenderness, headaches, acne management, lighter periods, assistance with iron deficiency and anemia, lessening of menstrual cramps, a more regular menstrual cycle, and protection against endometrial cancer.
The HCC also offers a variety of contraceptive and safe sex measures, including condoms, flavoured condoms and lubricant, prescriptions for hormonal contraceptives, and a variety of contraceptives themselves at no cost or reduced cost.