24 Mar 09 DIAPHRAGMS: IF YOU ARE CONSIDERING USING A DIAPHRAGM
• Women who use diaphragms have a greater risk of getting cystitis or bladder irritation than women who use other methods of contraception. One reason for this may be that the rim of the diaphragm is pressing on the outlet tube from the bladder. The diaphragm can also hold secretions and bacteria in the vagina for longer than usual and this can be the cause of infection.
• Some women don’t like having to touch their genitals, that is their labia and vagina, to insert a diaphragm, and for some women it is not culturally acceptable. If you are not comfortable about touching your genitals the diaphragm may not be the right choice for you. It is important that you feel comfortable so that you can insert it properly without feeling so concerned that it stops you from enjoying sex.
• If the diaphragm moves out of place while you are having sex, or if after sex you find that it has a little tear or a hole in it, you may want to use emergency contraception. If you think you would want to use emergency contraception if this happened to you, find out where you can get it so you will know where to go if you need to. Read the section on emergency contraception for more information. You must take emergency contraception within 72 hours of having sex for it to work.
• It’s important to have your diaphragm with you when you’re going to have sex. You will need to remember to pack it if you go on holidays. You will need to carry it with you, or insert it beforehand, if you think there’s any chance you may have sex when you’re not at home.
• Other people make inserting their diaphragm a natural and sensuous part of having sex.
• If you absolutely do not want a pregnancy at this time, then the diaphragm is probably not the right choice for you now.
• If you feel, after taking everything into account, that a diaphragm is the only choice for you, think seriously about what you would want to do if you got pregnant, so that you are prepared in case it happens.
• Oil-based products should not be used with diaphragms because they may damage the latex rubber. Products that are oil based include baby oil, hand Cream, petroleum jelly or Vaseline, massage oil, and any anti-fungal creams or pessaries that you may be prescribed if you have thrush. Some spermicides are oil based, so you should read the label to check. Things that are acidic, like Aci-jel, can also damage latex.
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24 Mar 09 MEN IN BED: INSTANT POTENCY
New injection therapy. Men have described it as miraculous. After years of living with impotence they are amazed to find that a single injection can restore their potency in an instant.
Penile injections are the latest treatment for impotence and if they are used correctly they can achieve immediate and spectacular success. All a man need do is inject himself and seconds later he will have a full erection which should last about thirty minutes.
With such rapid results it’s easy to understand how enthusiasm for these injections has grown. But now there is concern in the medical community that this enthusiasm has overreached itself and that the injections, which contain a cocktail of chemicals including a synthetic hormone, are being abused. It is claimed some clinics are using the injections indiscriminately. They are giving the injections for long-term use to men who don’t really need them and who may ultimately be harmed rather than helped by them. Penile injections carry a significant risk of complications which increases with long-term use — complications which can, paradoxically, lead to impotence.
There are basically two types of impotence — organic and psychological. Organic impotence results from physical problems such as nerve damage, diabetes or impaired blood flow into the penis. Psychological impotence is the result of an emotional block or difficulty. Some men have a bit of both.
Men with organic impotence have less to lose if they use the injections. If they develop a complication, they stop the treatment and revert to being impotent. Apart from some cell damage, they have lost nothing. Injections can be an excellent treatment for men suffering from organic impotence but should not be regarded as a long-term treatment for other sexual problems.
However, men with psychological impotence run a sizeable risk. They are physically healthy to start with, and if they develop cell damage, they may end up with actual physical impotence. The same is true if long-term injection therapy is used to treat men suffering other problems, like low libido or premature ejaculation.
Sometimes it is reasonable to use injections initially to lock-start’ the recovery of men with conditions like premature ejaculation and psychological impotence, but these must be used as an adjunct to other therapies. The injections are useful because they can show a man what is possible and help rebuild his confidence. But they aren’t a panacea for male sexual dysfunction.
They are effective in specific selected cases but men who use them need to be constantly monitored to ensure they are not developing complications. Although injections do achieve good results they are invasive: they put a little hole in the penis and there is a risk of infection and scarring. Further, they have only been in use for around ten years and no one knows what the consequences of long-term use will be. There is concern that these injections are being given too freely, without proper evaluation. They should never be prescribed for long-term use without a full history and thorough physical examination.
The rate of complications varies with the type of drug. One complication, known as priapism (inappropriately persistent erections), may occur in up to 15 per cent of men and is usually most troublesome in the early days when doctors are trying to determine the correct dose. Painful fibrotic nodules have also been reported to occur in high numbers of patients. They are related to the frequency of injections and the length of time the men have been giving themselves the injections. In more severe cases these nodules can lead to a bent or curved penis which often cannot be treated.
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24 Mar 09 THE FEMALE CONDOM: QUESTIONS
Q. Can you use a female condom and a male condom at the same time to make extra sure you don’t get pregnant?
A. No, you should not use female condoms and male condoms together because the friction is likely to make them tear, and at least one or both of them could move out of place.
Q. Can you use extra lubricant like baby oil or Vaseline with female condoms?
A. Yes it is actually good to use extra lubricant and because the female condom is made of a type of plastic, and not latex like the male condom, it is fine to use an oil-based lubricant if you want to.
Q. When I have sex the female condom keeps bunching up and getting pushed inside my vagina. What can I do? A. If that happens, put in more lubricant.
Things to think about if you are considering the female condom
• If you have a vaginal or pelvic infection you should get it treated before you use a female condom.
• You will need to feel comfortable about touching your genitals to use a female condom.
• You can use each female condom only once and then you have to throw it away.
• Female condoms are more expensive than male condoms.
• It takes a little while to get comfortable inserting the female condom. It may take a few attempts to get it in the right position, but it is very easy to insert once you get used to it.
• It can also take a little while to get used to the feel and sometimes the sound it makes during sex, which can be like a rustling noise but after a while you probably won’t notice it at all.
• Not all chemists stock the female condom, and they are not available at supermarkets yet. If you cannot buy them from a store near you, you may need to plan ahead, and send away to FPA Health for a supply.
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24 Mar 09 MEN IN BED: INTIMATE ALLERGIES
Women who are allergic to sperm. Some women are allergic to their husbands. They may love and desire them, but when it comes to sexual intercourse, they have an allergic reaction. These women are physically allergic to semen. They cannot touch it without reacting. As soon as any part of their body comes into contact with it, they have an allergic response.
At the mild end of the reaction scale, they may experience swelling and itching only in the area of contact. If they are allergy prone, their reaction may become more generalized and they can break out in hives all over or have an asthma attack. In extreme cases, semen can send women into shock. Minutes after contact they feel faint, their blood pressure falls, and they collapse. If they lose consciousness, they usually recover spontaneously. If they don’t, they need emergency treatment. Fortunately no fatalities have yet been reported.
Just as people who are highly allergic to bees carry medication with them in case of a sting, so women who are highly allergic to semen need to keep medication at hand in case of accidental exposure.
One 25-year-old woman experienced vaginal burning and stinging within five minutes of her husband’s ejaculation, symptoms which would last up to an hour. Using her husband’s fresh semen, doctor’s did skin tests on her and quickly produced an allergic response. She developed weals.
Although rare, this problem has been seen in Australia. Several such cases have been reported in the past decade. Some women are allergic to any semen and others are allergic only to a specific man’s semen. There has been one report of a woman who was not only allergic to her husband’s semen, but to his sweat, too. Further testing showed she also had a reaction to her sons’ sweat.
It is unlikely that a woman will grow out of this. Like any other allergy her reaction would probably escalate at first and then remain fairly constant. Although the reaction can be delayed, it usually occurs within five to ten minutes. Even if the exposure to semen is only vaginal, within minutes a woman who has a history of hayfever or asthma can begin wheezing, sneezing or feeling her throat swelling.
Oral sex can be particularly dangerous for such women, as exposure to semen can cause massive swelling in the throat and block off the airways.
The standard way of overcoming a semen allergy is for couples to use condoms. This solution, however, doesn’t suit everyone. Some men suffer from ‘condom impotence’. Without a sheath they are perfectly potent, but the minute one is unrolled they falter. Such impotence has been attributed to performance anxiety or fear of loss of sensation. It is also said to result from the break in stimulation necessary to fit a condom. There are also men who are allergic to latex or to the lubricant used on the condoms. They have to experiment with different brands to find one suitable.
Women can be allergic to condoms, too. Some women have been known to suffer ‘consort dermatitis’: they have allergies to both condoms and semen. Such women could try being desensitised to their husbands’ semen. This can be done with regular injections of semen extract, although this treatment is not 100 per cent successful. Taking antihistamine tablets before intercourse or using a vaginal medication can also help reduce allergy. Others have tried reintroducing contact after long periods of abstinence, but this can be dicey. As a Royal Society of Medicine report says, ‘avoiding contact with semen for prolonged intervals by sexual abstinence or condom usage has lessened the degree of symptoms in some patients but has allowed progression to anaphylaxis (shock) in others’.
So how do couples with this allergy problem have children? One method is to wash the sperm free of the seminal fluid and then place it in the woman’s uterus. Another method involves collecting the woman’s eggs, fertilizing them invitro and then implanting them.
Although women can be physically allergic to their husbands, it seems men can always tolerate their wives. No one has reported anything to the contrary, yet!
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24 Mar 09 THE MALE CONDOM:
How do condoms work? A condom forms a barrier that stops sperm getting into the woman’s body. That is why it is called a barrier method of contraception. When a man ejaculates or comes, the semen, that is the fluid that contains sperm, comes out of the penis into the tip of the condom and collects there. Because it doesn’t go into the woman’s body, the sperm cannot join with an egg to start a pregnancy. There is also much less chance of passing on a sexually transmitted infection (STI).
How effective are condoms? Condoms are about 90 percent effective. That means that if the partners of 100 women used condoms as their method of contraception for a year, about 10 of those women would become pregnant. People sometimes say they use condoms as their method of contraception, but what they don’t say is that they do not use a condom every time they have sex. The effectiveness rate is obviously higher for condoms if you actually use one every time you have sex, and you put it on before you have any penis-in-vagina sex. It is also higher if you use condoms correctly every time, taking care when you put it on and take it off, and using a water-based lubricant because this reduces the risk of the condom breaking. You should only use each condom once and then throw it away, otherwise there’s a much greater risk of pregnancy.
Why would I want to choose condoms?
Condoms not only reduce the risk of pregnancy, they are the only method of contraception that can also protect you against sexually transmitted infections (STIs) including HIV/AIDS. You may want to use condoms if you have a new sexual partner, or more than one sexual partner, or if your partner has sex with other people. Condoms may be a good choice if you don’t have sex regularly so you don’t want to use something that affects your body all the time.
There is no legal age limit for using condoms. And there is no need to see a doctor to get them. They are not expensive and there are no serious medical side effects to using condoms.
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