Other forms of Contraception

Contraceptives for Men

Withdrawal: Withdrawal before ejaculation is a form of natural contraception, but it is extremely risky and most people find it unsatisfactory Condoms. The only other form of male contraception currently available is the condom. The average rate of pregnancy for couples who rely on condoms for protection is 12%. Even for those who use a good–quality condom correctly, the annual risk for pregnancy is 3%. When the condom is used with spermicidal lubricants, either foams, creams, or jellies, protection is increased. The spermicidal lubricant also prevents tearing.

Condoms:Condoms made of latex rubber that are contoured for better fit and that contain a spermicide are effective but are less protective than if a man uses a condom and the women a spermicidal vaginal contraceptive. The condom should be put on before intercourse when the penis is erect, long before ejaculation, the male can discharge drops of semen that can cause pregnancy. Even with a vasectomy, men who are not in a monogamous relationship with an HIV–negative partner should always wear a latex condom during sex for protection against sexually transmitted diseases, vasectomy is not protective.

Implants:Implants of levonorgestrel (Norplant) offer another effective, long–term contraceptive option. Like Depo–Provera, levonorgestrel is a progestin and contains no estrogen. Six pellets containing the hormone are surgically implanted beneath the skin of a woman’s upper arm. (a newer system, Jadelle, uses two implants and may prove to be as effective as the Norplant system.) The pellets slowly release progestin, thereby preventing pregnancy even more effectively than oral contraceptive pills. The method has some distressing side effects but they are not common, and only 10% of women request removal. Implants provide 99% effective contraception for five years.

Intrauterine Device (IUD ):The intrauterine device (IUD) is a small T–shaped plastic device that is inserted into the uterus. An IUD’s contraceptive action begins as soon as the device is placed in the uterus and stops as soon as it is removed. It is 97% effective, although within a year some women expel them. They also increase the risk for infection and should be replaced every four years.

Psychological Implications

The word “Sterilization” has a deep emotional connotation for many people. Even though a couple may rationally accept the idea of a vasectomy, it is extremely important for each partner to be as open as possible about any negative feelings they might associate with the procedure. For instance, a woman might believe, incorrectly, that a vasectomy is emasculating, but she might not want to express this idea to her partner. On the other hand, some women may fear that vasectomy may make their partner more attractive to other women and encourage outside affairs.

Some studies have indicated that men with poor self–images, including concerns for their own physical health or sexual ability, are likely to have a difficult time adjusting psychologically to vasectomy. Men who have the operation only for the sake of their partner’s health and not because they want the procedure for their own reasons may also have difficulties. Such thoughts on the part of either partner can have devastating consequences on a relationship if they surface only after the procedure has been performed.