Contraceptive Options

Birth Control Pills | Condoms | Depo-Provera | Emergency Contraception | More Info

Abstinence

Do you love me? If you answer "Yes," does that mean you must have sexual intercourse? Many students at Geneseo--more than you think--answer the second question "No" for a variety of reasons. Despite common perceptions, not everyone is "doing it" at Geneseo. Not everyone is ready or willing to have sex. If you are thinking about having sex for the first time, some factors to consider are described below.

Do You Have a Healthy Relationship?

Are you in a new relationship, or one that has lasted for a long period of time? Even if you are not currently in one, have you thought about what a "healthy and loving" relationship would require? Here are some questions to help you enhance your expectations of such a relationship:

• Do you and your partner have a mutual understanding of the following terms: romance, intimacy, respect, monogamy, trust, commitment? How do these terms apply to your relationship? Have you talked about these issues with each other recently?
• Can you be assertive and communicate honestly with your partner, especially about personal issues (such as expectations, past and current sexual history, and various forms of contraception including abstinence)?
• Are alcohol and/or other drugs used to reduce inhibitions or lessen honest communication about desires, expectations, or emotional support between you and your partner?
• Do you accept yourself, your strengths and weaknesses, your feelings, and do you tell them to your partner?
• Do you measure your self-worth by what you believe and do, and not by what your partner measures your?
• Do you have realistic expectations about the relationship?
• How do you go about making effective decisions concerning aspects of your relationship?

After personally answering these questions, we encourage you to communicate your responses with your partner. Your personal commitment to communicate is an essential factor in establishing a healthy, loving relationship.

Are You Ready for Sex?

The first step in taking on the responsibilities required in a sexual relationship is making sure you have established and understand your sexual values and beliefs as well as those of your partner. The following questions may help you evaluate whether you are ready for sexual intercourse.

• Do you feel comfortable with your present level of involvement with your partner?
• What do you imagine as a possible result of having sexual intercourse with your partner? How will you feel about yourself? How will you feel about your partner?
• How do you feel about your partner? Do you respect and trust your partner?
• Can you discuss prevention of pregnancy and sexually transmitted infections (STIs)? Do you feel comfortable taking the responsibility to prevent pregnancy and STIs? Have you discussed what both of you will do if pregnancy occurs?
• Do you feel pressured to have sexual intercourse?
• Are you comfortable talking to your partner about your decisions?

Decide yourself what level of sexual intimacy is right for you before getting into a sexual situation. You have control over your sexuality and have the right to do only that for which you feel ready. Even if you have had sex in the past, you can decide to abstain if that is what you want to do now.

Abstinence...A Change of Thought

If you decide on abstinence, it does not mean you must abstain from sexual intimacy. There are many forms of sexual expression other than sexual intercourse. Some people choose not to have sexual intercourse (vaginal, anal or oral) for a variety of reasons. They:

• prefer to wait for religious or moral reasons
• want to wait until there is a commitment in the relationship such as marriage
• do not feel physically or emotionally ready
• do not want to risk pregnancy
• do not want to risk getting a sexually transmitted infection
• do not feel that they have the time or energy to establish a sexual relationship

The advantages of abstaining from sexual intercourse include:

• no risk of pregnancy
• decreased risk of STI transmission
• no expense for contraception
• opportunity to make a deliberate decision about when, where, and how to express your sexuality

The decision to say "no" is enhanced by a personal commitment and plan for how you will handle a situation in which intercourse is a possibility. An "insurance policy" of always having a back up method of contraception and condoms in case you decide to say "yes, just this once."

Non-penetrative safer sex or abstinence can be fun and intimate. See "101 Ways To Make Love Without Having Sex" (available in the Reproductive Health Center waiting room) for some ideas. Be creative and use your imagination; sex can be pleasurable and safe at the same time. For more information on abstinence, including a discussion of oral sex and masturbation, check out the SmarterSex.org web site.

Birth Control Pills

This section reviews use of birth control pills. Wait until you get your period to start taking the pills. Take your first pill the Sunday following the onset of your period. However, if you start your period on a Sunday, take your pill that day. Continue to take one pill a day approximately the same time every day; the evening is the best time. You will have your period while you are taking the last seven pills.

Plan to take the pill about the same time everyday to keep a steady level of hormone in your body. If the pills are taken after a meal or at bedtime, the possibility of nausea lessens for many women. After all the pills are gone in the pack, start taking the next pack regardless of whether your period has stopped or not. If you miss one period, continue taking the pill and call the your provider.

If you forget one pill, take that pill as soon as you remember it. If you forget two pills, take two pills each day for the next two days, complete the rest of the pill cycle, and use another method of birth control (such as foam and condoms) during the rest of the cycle.

You may experience side effects during the first one or two months you are on the pill. They are: occasional spotting, mild nausea, breast tenderness and/or enlargement, and a slight weight gain. These side effects should diminish as your body adjusts to the pill. If such side effects are troublesome for several months, be sure to tell us when you pick up your next cycle of pills. Mid-cycle spotting or bleeding ("breakthrough bleeding") sometimes occurs during the first one or two months. If bleeding is heavy and troublesome for more than one day, please call us but DON'T STOP TAKING THE PILLS. If you take each day's pill on schedule, you are not risking pregnancy.

If any of the following symptoms occur, please call your presribing provider immediately:

1. Persistent pain or numbness or weakness in the arms or legs.
2. Pain in the chest or shortness of breath.
3. Sudden severe headaches, with or without nausea or vomiting.
4. Dizziness.
5. Fainting.
6. Disturbance of vision or speech.
7. Severe depression.
8. Yellowing of the skin or eyes.

If any other medication is prescribed for you, please tell the medical provider that you are taking birth control pills. It has been discovered that some medications can lower the effectiveness of oral contraceptives and that oral contraceptives can lower the effectiveness of some medications. Cigarette smoking while using oral contraceptives is strongly discouraged. The nicotine and estrogen combine to increase the risks of cardiovascular problems such as stroke, heart attack and blood clots.

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Condoms and Spermicides

What are Condoms and Spermicides?

A condom, also called a prophylactic or rubber, is a thin sheath that fit snugly over an erect penis to act as a barrier. The closed end of the condom catches the semen, so that it cannot pass into your partner at the time of ejaculation. There are many types of condoms available: latex rubber, polyurethane, lambskin, lubricated, and spermicidal. Most condoms sold in the U.S. are latex condoms which come in a variety of textures and colors. Latex and polyurethane condoms are the only condoms which prevent transmission of HIV.

A spermicide is a chemical that is inserted into the vagina prior to intercourse to kill sperm and act as a barrier to the cervix. Spermicides are available in the form of foam (most effective), films, creams, jellies, and suppositories.

How Effective are Condoms and Spermicides?

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Depo-Provera

What is Depo-Provera?

Depo-Provera is an injectable progestin (hormone) that acts similarly to other progestin-only contraceptives. Depo-Provera works by preventing the development of the egg and by changing the cervical mucus, thus helping to prevent the sperm from reaching the egg. One injection provides 12 weeks of protection so you must return to your health care provider every 12 weeks for another injection. Depo-Provera can be used safely and effectively as a contraceptive by most women. Depo-Provera does not protect against STIs, so always use a condom.  You must return to your health care provider every 12 weeks for another injection. Depo-Provera tends to make a woman's periods less regular, and spotting between periods is fairly common. Some women stop having periods completely. If your pattern of bleeding concerns you, return to your health care provider for follow-up.  Furthermore, you should contact your provider if you develop any of the following:  weight gain, depression, headaches, frequent urination, or heavy bleeding.

Benefits and Disadvantages

Depo-Provera is greater than 99% effective in preventing pregnancy in both theory and actual use.

The specific benefits include:

• causes no serious complications such as those occasionally associated with estrogen-containing pills (contains no estrogen)
• provides highly effective, long acting protection against pregnancy
• convenient, does not interfere with intercourse
• decreases menstrual cramps in some cases
• reduced risk of Pelvic Inflammatory Disease, endometrial and ovarian cancers

Some of the disadvantages may include:

• causes menstrual cycle irregularities for most users
• may decrease bone density
• may experience weight gain, water retention, breast tenderness
• long term lipid effects are unknown
• requires an injection
• provides no protection against sexually transmitted diseases (STIs)
• Depo-Provera is not a good choice if you want to be pregnant in the next year or two, as it may take from nine to twenty-four months after you stop taking Depo-Provera to regain your fertility

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Emergency Contraception

Emergency Contraceptive Pills, or ECPs, are not a true form of contraception. Rather, ECP is a means to protect yourself against pregnancy after an unexpected incident of unprotected sex, whether consensual or non-consensual. Additional information about ECP can be found on our Other Sexual Health Issues page.

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More Information

Method Match helps you to select the contraceptive that best meets your needs--you can compare up to four methods based on effectiveness or frequency of use to detemine which is right for you.

Family Practice notebook.com contains an excellent section on Contraception Management which includes detailed information concerning various contraceptive methods. The site also provides particularly useful information about oral contraceptives, including guidelines for managing possible side effects.

Some of the above information was adapted from the
Duke University Student Health Center.

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