Choosing safe sex on Valentine’s Day: Birth control myths busted
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Questions of where best to celebrate Valentine’s Day — and with whom — may abound, but one must also consider the how. How can couples enjoy the pleasures of intimacy during this hyped yet inescapable greeting card occasion, free from the worry of sexually transmitted diseases, or an unplanned pregnancy? For those in committed relationships and are sexually active, the anxiety over getting pregnant may even be the bigger concern.
Sadly, there are sexually active couples, particularly younger ones, who tend to resort to handy information found in the wilderness of the internet when confronted with glitches during the act. Say, your condom broke, or you forgot to take the pill, or maybe you were simply lost in the moment – panic gets the better of the internet-savvy who turns to Mr. Google for desperate solutions. A quick search on Google could bring up millions of results on how to prevent pregnancies, from tried and true modern contraceptives to traditional methods. There’s also the presence of the most questionable and hilariously absurd practices. How does one sift through these and separate the myths from the facts?
Dr. Junice Melgar, executive director of Likhaan Center for Women’s Health, is here to help and has lent her expertise in debunking and/or proving the various contraceptives and birth control practices as seen on the internet.
Separating the myths from the facts
1. Withdrawal or pull-out method
Perhaps your partner does not like using condoms, but is it a legitimate excuse?
“[Withdrawal is] not an effective method because men could have secreted small amounts of semen prior to ejaculation, which could cause pregnancy,” said Dr. Melgar. “If the woman or couple does not want to use contraceptive methods, the better option is the use of fertility awareness-based methods (FAB or natural family planning as we know it), which involves scientifically identifying the fertile and non-fertile periods in the menstrual cycle and timing sex during the non-fertile period.”
2. Having sex during or a day after period
There’s a popular belief that it’s always safe during the red days, since menstruation supposedly indicates that a woman is not fertile – but can she really be not? And if she could be, is having sex during or a day after period actually effective for preventing pregnancies?
“[It] could be effective, following the FAB/cycle beads method,” said Dr. Melgar. “However, for women with very short cycles, women could ovulate around the menstrual dates so FAB does not work.”
3. Breastfeeding
“Pure breastfeeding (i.e without other elements like water), 6 or so times a day after delivery until 6 months after delivery, is very effective. Breastfeeding suppresses the ovary from producing and releasing an egg,” she said.
Unfortunately, only women who have recently given birth and therefore can breastfeed can use this method.
Definitely a NO for these methods
1. Drinking 7-Up or Coca-Cola with aspirin, Cortal or paracetamol after sex
Swilling pain relief medication with soda seems like an odd pairing, although questions on forums surrounding its viability as a form of contraception and abortifacient are not that hard to find online. But does the pairing work?
“Aspirin and paracetamol do not have contraceptive effects,” said Dr. Melgar. “Aspirin and Cortal are often used to induce abortion after conception or pregnancy has begun. However, these are also not effective as abortifacients.”
2. Drinking salt solution
Some think that a mix of salt and water immediately after unprotected sex can be taken as emergency contraception. But does it work?
It has “no contraceptive effects,” says the doctor.
3. Jumping or dancing after sex
Vigorous physical exertion immediately after sex are believed by some to prevent pregnancies. But is there reason to believe so?
No, because it also has “no contraceptive effects.”
4. Douching after sex
Vaginal irrigation, or douching, refers to the washing or rinsing of the vagina using a douche bag, which can even be bought from online shopping sites, and look affordable. But does douching have contraceptive effects?
Doctor says none.
5. Pag-ire or contracting of vagina to get rid of sperm
Doctor says, “No contraceptive effects.”
6. Inserting vitamin C tablet inside the vagina before and/or immediately after sex
Still “no contraceptive effects.”
7. Standing up during or after sex
There are some guys who think this works because they believe gravity would somehow pull their sperm down, and therefore not fertilize a woman’s egg. But what does the doctor say?
“Using gravity to cause sperm to come out of the vagina does not have contraceptive effects as sperm are microscopic and swim upward to the uterus rapidly after sex.”
8. Taking herbs and/or pamparegla
Yes, those bottles formerly sold on the sidewalks around Quiapo Church in Manila. Do they work as contraceptives?
“None of currently available herbs are known to have contraceptive effects,” said Dr. Melgar. “Most herbs, [especially] bitter ones, are taken to induce abortion, but these abortive effects are also not supported by evidence.”
So, what works?
There is a wide range of birth control methods available in the Philippines, and Dr. Melgar affirms this. These include hormonal methods such as combined oral contraceptive pills (estrogen and progesterone), progesterone-only pills, progesterone-only injectables, combined injectables and the hormonal implant; the hormonal levonorgestrel-medical intrauterine device (IUD) and the hormone-free copper T IUD.
There is also the condom for barrier; bilateral tubal ligation (for women) and vasectomy (for men) as surgical contraception; lactational amenorrhea method, such as breastfeeding for new mothers; and the fertility awareness-based method or natural family planning, such as cycle beads, the two-day ovulation method, and sympto-thermal method.
Likhaan Center offers contraceptives such as the combined and progesterone-only pills, progesterone-only injectable, progesterone subnormal implant, copper T IUD, and condoms. They also educate patients on the lactational amenorrhea method and natural family planning, as well as refer patients for surgical contraception.
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Pros and cons of each
Hormonals, said Dr. Melgar, have very high effectiveness, even for oral contraceptives when used correctly and consistently. However, patients looking into using combined methods (estrogen and progesterone) should be screened for health conditions where estrogen effects are contraindicated, such as heart attack, stroke, migraine and hepatitis, among others.
The IUD also has very high effectiveness, although it does have its downsides. Dr. Melgar explained, “Copper T causes more bleeding and pain during menstruation. Medicated IUD causes little bleeding and no pain, but very expensive.”
Condoms also help protect against pregnancy and STI-HIV, although actual protection against pregnancy is not very high. Dr. Melgar also noted, “Men do not like to use condom.”
Lactation amenorrhea method, meanwhile, is very safe and effective. Dr. Melgar also said it is great for infant nutrition, “however, [it] [is] very difficult for women to do because of lack of support in the household or at work.”
Fertility awareness-based method or natural family planning is also very safe, but not that effective. “[It] requires strong male-partner involvement which is rare and impossible in cases of gender-based violence,” the doctor said.
Lastly, there is surgical contraception. Ligation for women and vasectomy for men are both very effective.
“Ligation is preferred by many women but availability is limited in many facilities by lack of providers and PhilHealth insurance,” she said. “Vasectomy is resisted by men because of misconception(s) that it lessens virility.”
There’s nothing to fear
Likhaan Center as a non-profit non-governmental organization, operates eight clinics in the country, mainly in Quezon City (its central office), Pasay, Navotas, Port Area Manila, Eastern Samar, Tondo, San Andres and Bulacan. What started as an initiative after graduating from the University of the Philippines College of Medicine in 1981 has now turned into a lifelong endeavor, and one that champions sexual and reproductive health and rights for all Filipinos. This September, Likhaan would be celebrating its 25th year.
Sex is a natural and important part of life, said Dr. Melgar, and practicing safe and healthy sex is vital for the mutual satisfaction of couples. Safe sex, more than helping prevent unplanned pregnancies, also protects couples from having STIs and HIV, unintended abortions or maternal complications. On the social level, safe sex prevents sexual coercion and sexual violence.
Yet, a 2010 study by Likhaan Center and the Guttmacher Institute showed that the most common reason of women for not using contraception is due to fear of its side effects. This was followed by underestimation of one’s likelihood of being pregnant, and concerns about the cost of contraceptives.
But Dr. Melgar assures the public that there is nothing to fear in using contraceptives, and these concerns are addressed by Likhaan Center’s work in its communities.
“Our contraceptive services are guided by the principles of safety, effectiveness, and women’s (and men’s) choices,” she explained. “Based on their own experiences, women are finding out that the side-effects of contraceptive use are generally minor, but that if discomfited, they have the freedom to explore and switch to other methods, and even to not use methods, if that is their decision.”
“The safety of contraceptives has been established by the World Health Organization since over 40 years ago, so that death from contraceptive use is rare,” Dr. Melgar added. “Many more women actually die from the risks of unintended pregnancy and unsafe abortion and having too many or very-closely-spaced pregnancy.”
Contraception is a matter of choice. If you plan to take it, may you be able to discern the best option for you, and here’s to hoping you pick the myth-busting, medically-approved method. JB
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