Imperfect Use of Hormonal Contraceptives Can Affect Your Emotional Well Being

How would you rate your use of combined hormonal contraceptives - are you the perfect 'student', using them exactly as you have been instructed by your health care professional or do you regularly rely on emergency contraception (Plan B or the 'morning after pill') for 'damage control'? If you are not at the 'top of the class' for your contraceptive behavior, you may also be playing swings and roundabouts with your emotions. The outcome of a study of 26,250 women, aged 18 to 49 has just been published and confirms that being inconsistent with your contraceptive regime can adversely affect your health, your schooling, your job and your relationship with your partner.
The study was carried out over a three month period in Spain where women completed a questionnaire at outpatient clinics of the departments of gynecology and family planning centers of public and private institutions throughout across the country in 2006. The lead investigator of the study, Dr Inaki Lete, Hospital Santiago Apostol, Vitoria-Gasteiz, Spain, collated information about attitudes and the psychological impact of imperfect use of hormonal contraceptives from women who used three different hormonal contraceptive methods, being the combined pill, (65%) the skin patch (12%) and NUVARING(R) (23%) (etonogestrel/ethinyl estradiol vaginal ring). Non-compliant behavior (inconsistent use of a hormonal contraceptive) was defined as missing or delays in the taking/ application/insertion or removal of the pill, patch or ring. Dr. Lete is confidant that the findings from the study will help health care professionals to "empower women to increase compliance with the prescribed contraceptive regimens."
The study found that:

• 71% of pill users, 32% of patch users and 21.6 % of ring users reported that they did not use their hormonal contraceptives properly . The emotional stress the women suffered when they 'defaulted' was described as being 'worried' and scared'

• Between 58.3% and 68.8% were 'worried' and between 16.4% and 22.6 % were 'scared' when they 'defaulted' during use

• 10 -20% of women reported that imperfect use of their current contraceptive negatively affected their work activities and their relationship with their partner and about 3% had missed days of work or school

• 40% of the pill and patch users had experienced the additional stress (and extra cost) of performing a home pregnancy test compared with 29% of those using the vaginal ring

• in ALL groups approximately 40% of women called or visited a physician, incurring further costs over and above their contraceptive prescription

• 14% of pill users, 11% of patch users and 6.3% of ring users requested emergency contraception- yet another extra cost added to the stress and inconvenience, not to mention the increased side effects

The study also showed that even though most women had used their contraceptives imperfectly and had been 'worried' or 'scared' at times, they continued to use the same contraceptive method. If you are having difficulty keeping to a consistent regime with your type of contraceptive and you still have an active sex life, it may be time to consider changing to another method of birth control or using an additional contraceptive method - if only to reduce your anxiety level.
Not using your combined hormonal contraceptives correctly not only increases your risk of getting pregnant but can give you 'pregnancy panic' attacks. Who wants to fork out extra cash for pregnancy test kits, visits to the doctor and emergency contraception (Plan B) when a little more vigilance or added protection would leave you a few dollars more for that sexy lingerie he'd love and send you to the top of a far more enjoyable class!

Contraceptive Guide to Pregnancy

Did you know that if you DON'T use any contraceptive method at all , you have an 80-90% chance of getting pregnant? OK so that was no big surprise but are you really sure you know about EVERY way in which you CAN become pregnant? If you are taking an effective oral contraceptive, like say, Alesse you will be well protected against pregnancy but it is a good idea to skim through the list below just in case you didn't come top of the class in sex ed. or you have stopped taking an oral contraceptive pill and your periods have not yet returned.

• You can still get pregnant the first time you have intercourse, whether you have an orgasm or not
• You can still get pregnant if your partner pulls out of your vagina before he comes- tiny drops of semen can 'leak' out of the penis prior to full ejaculation and those little swimmers have only one mission in mind- to get to your egg!
• You can still get pregnant if you are on your 'period' (either at the end or during the following week)
• You can still get pregnant if you have had a baby and are only partially breastfeeding (it is not advisable to take Alesse or any other brand of oral contraceptive while breastfeeding, until you have been given the 'all clear' from your doctor as hormones can pass through your breast milk so you risk harming your baby)
• You can still get pregnant regardless of the position in which you have sex
• You can still get pregnant if you douche (squirt fluid into your vagina to wash it out)- a practise not recommended.

If you are 'menopausal' and think you are at the end of your 'contraceptive career' be very careful about stopping your oral contraceptive regime- at least until your periods have been absent for 2 years or 1 year if you are over 50.
Oral contraceptives, like Alesse, need to be initially prescribed by your health care provider or doctor then you can buy them online or wherever is most convenient for you. Make sure you have a good supply (3 months is ideal) and if you're the forgetful type, set your mobile phone alarm or PC calendar at work to remind you to take a pill at the same time each day. Alesse, as you know, is an oral contraceptive that contains two synthetic hormones to stop you from getting pregnant- Levonorgestrel and ethinyl estradiol are the active, generic ingredients found in Alesse. Is Alesse 100% foolproof as a form of birth control? No, although if used correctly, Alesse, like most oral contraceptive pills will afford you close on 99% protection.
Had Unprotected Sex? Don't Panic!

If you think your contraceptive may have failed for whatever reason or you have been vomiting (therefore your estrogen level that month has not been kept high enough to prevent ovulation) - all is not lost so stay calm. As soon as you can, get a prescription for the emergency contraceptive pill.

Emergency Contraceptive Pill - NOT to substituted for your regular pill but to be taken only after unprotected sex. This oral contraceptive can be taken up to 72 hours after sex and contains a much higher dose of hormones (estrogen) than 'normal' contraceptive pills ( so the side effects are often stronger and more unpleasant too). The earlier you take emergency contraceptive pills the more effective they are. You can still get pregnant if you have taken the emergency pill but then had sex again during the same menstrual cycle.
You DO need to use protection against STD's if you have multiple sexual partners- yes, even with 'no care', long lasting contraceptive methods like IUD's and implants. The spermicide, Nonoxynol 9 does NOT protect against HIV when used with condoms.

Contraception Guide

There are many different contraception methods available, and different methods suit different people at different times of their lives. You can also ask your GP, practice nurse or family planning clinic for more information about what methods of contraception are available to you (this counts for the boys as well as the girls) and what method would be best for you to use.
Most contraceptives need to be prescribed (with the exception of condoms that are available in most shops and can be brought over the counter). Not all contraceptives will be available to you at your local doctors, however he should be able to direct you to the nearest doctors or family planning clinic that have the methods of contraception that they don't.
You can buy male or female condoms and spermicides without going to a doctor or clinic. Condoms can be brought in almost any shop (like supermarkets, boots & superdrugs are the most likely to sell them), some places also offer vending machines that sell condoms (not recommended). You can also buy diaphragms and caps at a pharmacy, if you know your size.
When you are ordering contraception, you should also research the possible side-effects that each methods carry. Ask your GP, practice nurse or family planning clinic if you need help.
Using Contraception
No contraceptive is 100% effective, and only condoms will help protect you against STI's & STD's. How effective the contraceptive is depends on how carefully and consistently you use the method.
If you don't use contraception you have an 80-90% chance of becoming pregnant.
The methods of contraception available are split into 2 main groups;
* No user failure: do not depend on you remembering to take or use contraception. These are long acting methods.
* User failure: methods you have to use and think about regularly or each time you have sex. For these methods to be effective you must use them according to the instructions given.
Some facts about pregnancy
A women can still get pregnant if;
* If it the first time she has had sex.
* If she does not have an orgasm.
* If a man pulls out of her vagina before he comes.
* If she has sex when she is on her period.
* If she not fully breastfeeding.
* If she douches (squirts fluid into the vagina). This can be harmful to women.
* Whatever position the couple sex in.
More On Contraception
Contraception and the menopause
Contraception needs to be used until the menopause. Contraception should continue to be used until a women has not had a period or any bleeding for two years if aged under 50 and for one year if over 50.
Contraception and breastfeeding
Breastfeeding can act as a very effective contraceptive when you are fully breastfeeding a baby under six months. This means you must;
* Be breastfeeding at regular intervals, day and night.
* Be giving your baby no other food or drink, so no breastfeeds are missed.
* Have no periods.
Emergency Contraception
If you have had sex without using contraception or think your method might have failed there are two emergency methods you can use.
* Emergency hormonal pills - Must be taken up to three days (72 hours) after sex. They are more effective the earlier you take them.
* An IUD - must be fitted up to five days after sex, or up to five days after the earliest you could have released an egg (ovulation).
Sexually transmitted infections
Most methods of contraception do not protect you from sexually transmitted infections.
Male and female condoms, when used correctly and consistently, can help protect against sexually transmitted infections. Diaphragms and caps may also protect against some sexually transmitted infections. Condoms that contain Nonoxynol 9 (spermicidally lubricated) do not protect against HIV.

What Is The Best Contraception As I Approach Menopause?

Woman still require contraception until they have not had a period for one year (if over 50 years) or two years (if under 50 years).
Contraception can have risks and benefits at all ages, therefore this article attempts to summarise what these are.
Combined Hormonal Contraception ('the pill') has now been said to be safe for use up to the age of 50 years, however there are many contra-indications so a medical review to discuss your personal risks would be advised. There are lower dose hormone contraceptive pills which may be of benefit to the older woman.
However, there is a evidence that the combined contraceptive pill has benefits such as it helps maintain your bone density and delays the development of osteoporosis. It also controls periods, with less bleeding and pain associated with those who take the contraceptive pill. The combined contraceptive pill can help control menopausal symptoms and tricycling (taking pill packs back to back) can provide continuous benefit.
There is a protective effect against cancers such as endometrial cancer and ovarian cancer and there may be a reduction in colorectal cancer, which continues for up to 15 years after the contraceptive pill is stopped.
The risks include a small increase in breast cancer risk and a risk of cardiovascular problems including thrombosis. This is higher in smokers and hence smokers are not recommended the combined pill after the age of 35 years old.
Progesterone Only Contraceptives: This includes a daily pill, an injection every 3 months, the levonorgestrel releasing coil or implants.
These have many advantages for the older woman. There are no links with cancer, either benefits or risks. There also appears to be no effects on cardiovascular disease or thrombosis, although there is some evidence that your cholestrol may increase. The side effect of often preventing periods is usually seen as a positive outcome and the levonorgestral releasing coil is now the treatment of choice for heavy painful periods.
Non Hormonal Contraception:
• Copper coil - this is sometimes associated with heavier periods and pain therefore has been replaced by the hormone containing coil unless hormones are contraindicated or personal preference is for a non hormonal alternative.
• Condoms - remain an effective form of contraception if properly used and also prevent sexually acquired infections so should remain the contraceptive of choice in individuals who are in short term relationships. Remember however if you are also requiring a lubricant - use water based only as an oil based lubricant ruptures the rubber.
• Diaphragms also remain a popular choice
If on hormonal contraceptives, lack of periods is not a reliable indicator of the menopause. A blood test will be required, but will only be helpful if you have stopped your contraceptive for a period of time.
HRT does not work as a contraceptive. If HRT is required in addition to contraception - the progesterone only contraceptive pill can be a useful addition. The type of HRT taken should take into account the contraceptive you are using.

Emergency Contraceptive Options

Sometimes accidents happen, condoms split, several missed pills or no contraception is used. The emergency contraceptive pill, also known as the morning after pill, offers women the ability to prevent an unwanted pregnancy. This article will focus on how emergency contraceptive pills such as Levonelle and ellaOne work, where they're available from, how they should be taken and alternatives to emergency contraceptive pills.
Where can I get it from?
In the UK, there are currently two types of emergency contraceptive pills: Levonelle and ellaOne. EllaOne is a relatively new drug and not easily available. I will focus on ellaOne later in this article. The use of Levonelle is well established and is readily available from:

• Your GP
• Pharmacist
• Family planning clinics
• Accident and Emergency

Levonelle is free when obtained from your GP, using an NHS prescription and from family planning clinics. Certain pharmacists are able to provide the emergency contraceptive without a doctor's prescription, however a charge of £26 is levied. Accident and Emergency departments should only be used as a last resort.
How does it work?
Levonelle is a progesterone based hormone (a female sex hormone). We still don't know for certain the exact mechanism of how it works. The general consensus is that it inhibits ovulation (release of an egg from the ovaries); however, it may also prevent fertilization (fusing of sperm and egg) and possibly implantation. The emergency contraceptive pill does not cause an abortion. Technically speaking, an abortion can only occur once a fertilized egg has implanted it self into the lining of the womb.
Levonelle is extremely effective when taken correctly and has been shown to reduce the risk of pregnancy down to 1%.
How do I take it?
Levonelle is not suitable for everyone; it is contraindicated in the following cases:

• Prophyria (a very rare condition)
• Severe liver disease
• Previous ectopic pregnancy
• May not be suitable in conditions such as Crohn's disease

Time is crucial when it comes to taking Levonelle. It must be consumed within 72 hours of unprotected intercourse. Ideally, it should be taken within 12 hours after unprotected intercourse. As time elapses after unprotected intercourse the effectiveness of the drug decreases significantly:

• Levonelle taken 0-24 hours after unprotected sex - 95% effective
• Levonelle taken 25-48 hours after unprotected sex - 85% effective
• Levonelle taken 49-72 hours after unprotected sex - 58% effective

Levonelle is well tolerated by most women, however some women may experience nausea and vomiting. If you vomit with in 2-3 hours of taking Levonelle then another dose must be taken. Other common side effects include headache, dizziness and breast tenderness. Less common side effects can include irregular spotting and bleeding. After taking Levonelle, if you suffer with an early or delayed withdrawal bleed, or your period is on time but is abnormally heavy, then an ectopic (implantation as occurred, but not in the womb) pregnancy must be excluded, and it is advisable to see your doctor as soon as possible.
Alternatives to Levonelle
If the time elapsed after unprotected intercourse is greater than 72 hours, or if Levonelle was not tolerated, then alternative emergency contraception must be considered to prevent an unwanted pregnancy. There are currently two options:

• EllaOne
• Intrauterine emergency contraceptive device

EllaOne (ulipristal)
EllaOne is a new emergency contraceptive which was given a license last year. Small trials including women from the UK, USA and Ireland have shown ellaOne to be effective at preventing unwanted pregnancy even after the 72 hour limit normally advised for Levonelle. This means the drug could be taken up to 120 hours (five days) after unprotected intercourse.
EllaOne is a prescription only medication. It will not be available over the counter until more is known about its long term safety profile.
The Intrauterine Emergency Contraceptive Device
The Intrauterine emergency contraceptive device, also known as the emergency IUD, is a small copper device that is inserted into the uterus (womb) via the vagina. It has the benefit of being effective up to five days after unprotected intercourse and can continue to be used as a regular contraceptive. The disadvantage is that it must be fitted, which would normally take place at a family planning clinic.
Long Term Contraception
Studies examining the emergency contraceptive found that many women went on to become pregnant in the next cycle, as they continued to have unprotected intercourse. This indicates the importance of considering long term, or continued contraception.
After taking Levonelle or ellaOne, it is wise to discuss continued contraception with your doctor or family planning clinic. Suitable methods for long term contraception may include:

• Combined oral contraceptive
• Progesterone only pill
• Progesterone injection (taken every 3 months)
• Contraceptive implant (inserted into the skin of the arm and lasts 3 years)

Sexually Transmitted Infections
It is important to point out that having unprotected intercourse not only exposes you to the risk of an unwanted pregnancy, but also to sexually transmitted infections (STIs), which are presently on the increase. You may not wish to get pregnant now, however chronic infections with bacteria, such as Chlamydia, can lead to infertility later in life as well as chronic pelvic inflammatory disease. Additionally, through unprotected intercourse with multiple partners, women can expose themselves to multiple strains of the Human papilloma virus, which increases the risk of cervical cancer. Please remember to use condoms. Keep well informed and read our article on STIs.
Further Information
To find out where your local family planning clinic is, or for more information on sexual health and contraception, visit the Family Planning Association's website (FPA). The FPA is the UK's leading sexual health charity. They aim to help people make informed decisions about sex and maintain good sexual health.

Oral Contraceptives & Condom Market - An Analysis Report

Contraceptives are used for preventing pregnancy and are mainly of two types, hormonal methods and barrier methods, also called as devices. Oral contraceptives account for a major part of the contraceptives market.
Condoms and oral contraceptives are the two cornerstones of the contraceptive market. Although condoms are a type of contraceptives but these two are distinct and totally different segments of the market. Condoms are different from other contraceptives used by females in one aspect and that is their use for safety against the STDs. No other contraceptive method is effective in these areas and so in this area condoms have an added advantage over other contraceptives. On the contrary the use of condoms by men while having sex is not that high.
The oral contraceptives market consists of branded products and the generic versions of those brands. These brands, for example the leading Yasmin brand by Bayer, are facing a threat to its market by the generic drugs in the US market.
The contraceptives and condoms market is not so much affected or driven by the economic factors like the current economic downturn and are believed to hold up well in such tough times. However, this market tends to have a moderate and consistent growth rate. This market is more based on the demographic and sociological factors such as population growth, proportion of young population, perception of people about family planning and contraceptives, especially condoms.
This report talks about the contraceptives market, highlighting the various contraceptive methods used. The condom market, a part of the contraceptive market, is discussed in detail. The various growth drivers for contraceptives and condoms are discussed, while the effect of rising generics penetration in the oral contraceptives also pointed out. The major players in the contraceptive as well as condom market are profiled along with their key strategies.

When You Need Emergency Contraception?

Emergency contraception (EC) is not the substitute for regular birth control methods or abortion but, in fact, is the "emergency" option for women to avoid pregnancy after contraception failure, sexual assault or unprotected intercourse. Emergency contraception, specially Progestin-only birth control pills like Plan B, are advised to women seeking immediate action to avoid pregnancy. Such pills are advised to rape victims and sexually assaulted women as well.
Emergency contraception pills are also known as "morning-after", "EC" or "Postcoital Contraception" in medical terms. However, "morning-after" doesn't mean that emergency contraception pills to be taken in the morning. It should be taken as prescribed.
Types of emergency contraception methods :
These are available in broadly three ways whereas two methods are in pill form and another is device known as intrauterine device. Two types of pills are progestin-only like Plan B and usual combined birth control pills (progestin and estrogen). Intrauterine device is also used as emergency contraception and suggested to women who are allergic to progestin or estrogen based pills. IUD as widely called is small, T shaped plastic device with a string attached to the end. It is inserted through cervix and placed in the uterus to prevent pregnancy. A small string hangs down from IUD into the upper part of the vagina.
How Emergency contraception pills work?
Like other birth control pills, EC works by stopping ovulation (i.e release of eggs) and preventing sperm to meet with eggs for fertilization, hence there is no pregnancy.
When to take Emergency contraception?
EC must be taken as soon as the unprotected intercourse has occurred. Progestin-only pills like Plan B contraceptive pills are available in two tablets. One pill must be taken immediately followed by next with 12 hours apart. Though EC pills can be taken upto 5 days i.e 120 hours, however, Progestin-only pills like Plan B are effective for upto 3 days i.e 72 hours.
Its effectiveness after unprotected sex can be judged as below.
- 95% effective if taken within 24 hours
- 85% effective if taken between 24 to 48 hours
- 58% effective between 49 to 72 hours
In case, more than 72 hours have passed of unprotected sex then it is highly recommended to use the IUD (intrauterine device) after consulting with your physician because after 72 hours, your contraceptive pills might be failed.
Who should seek Emergency contraception help :
Well, it is designed for emergency relief from getting pregnant. Women can take EC if
- contraception methods are failed like condom is broken or slipped off during intercourse, ring is removed or diaphragm, cap or any protection is removed.
- women think that she had intercourse during "ovulation days". These are most crucial days as the chances of becoming pregnant are very high.
- women are sexually abused, raped or forced to go for unprotected intercourse.
Being the time sensitive, two important factors will determine the effectiveness of emergency contraception success and those are
- how soon woman takes it after the unprotected intercourse has occurred.
- if she has another unprotected intercourse in the same menstrual cycle.