Barrier Methods of Birth Control: Condoms

  

Condoms -- sometimes referred to as "rubbers" -- are a barrier method of birth control. Usually made of latex (though alternatives do exist for those with latex allergies), a condom comes in a tin foil package, rolled up like the image above. To use, a partner must unroll the condom onto their erect penis (or you could do it for them!). Many people like this method of birth control because it's cheap (condoms are about $1 each and can often be obtained for free), it doesn't require a doctor's visit, there are no hormonal side-effects, and this is the ONLY birth control method that will also protect you from sexually transmitted infections. They often come pre-lubricated, but they're also available with no lube and with spermicidal lube.

Barrier methods of birth control prevent pregnancy by containing all pre-ejaculate and semen. If no semen gets into your vagina, pregnancy can't happen! The condom also protects you from sexually transmitted infections by covering the penis and keeping semen out of the vagina, anus, or mouth.

Condoms come in all sorts of colors!

Like all birth control methods, condoms must be used effectively to keep you safe. Each year, 2 out of 100 people whose partners use condoms will become pregnant if they always use condoms correctly. That's not bad at all! But, each year under typical use, 18 out of 100 people whose partners use condoms will become pregnant. The effectiveness rate of condoms drops dramatically based on whether or not you put it on correctly.

The only thing that's rather troubling about the condom is how often folks don't put it on correctly. Thanks to people in the public school system that think giving you proper sex ed will turn you into Satan-worshipping deviants, most of you won't/didn't get a health class putting-a-condom-on-a-banana demonstration. And even if you did, it never hurts to review. So let's try to learn something.

What's the right way to put on a condom?

Make sure you're not putting it on inside-out.

   

• Open the package --  with your nails/fingers. Many people try to open condoms "sexily" by using their teeth, but don't do that. You run the risk of breaking the condom before you've even put it on! For this same reason, you should also avoid using scissors.
• Make sure the rolled up ring is on the outside (see photo above). If you don't do this you may accidentally put your condom on inside-out! 
• Place the condom onto the head of the penis while pinching the tip. Make sure you do this BEFORE the penis touches the vulva. During sexual excitement, the penis sometimes secretes something called pre-ejaculate (or "pre-cum") which sometimes contains sperm and can lead to pregnancy. Pre-cum can also put you at risk for STIs. 
• While still pinching the tip of the condom with one hand, use the other to unroll the condom. The tip of the condom, also called a "reservoir tip", is designed to collect semen. Pinching it while you unroll the rest of the condom helps keep it gathered at the head of the penis so it can do its job. Pinching the tip also makes sure it doesn't get air in it -- if there's an air bubble in the condom, the friction of intercourse can cause them to burst and break the condom. 
• Unroll the condom to the base of the penis.
• Have fun!

For the visual learners, Planned Parenthood has a video which demonstrates the proper way to put on a condom. 

How to safely remove a condom:

• Pull out before the penis is soft. If you lose your erection while still penetrating your partner, the condom may come off inside their vagina/anus.
• Make sure you don't spill the semen on/anywhere near your partner's genitals. Hold the condom to the base of your penis while pulling out to prevent this. 
• Throw it away! People on television and in movies are often shown flushing the used condom down the toilet, but don't do that. It can clog the toilet. It's a better idea to tie the condom in a knot like a balloon so semen doesn't leak out, then wrap it in toilet paper and toss it into the trash. 

Important things to keep in mind:

• Condoms can only be used with water-based lubricants! The bottle will usually state whether or not it is water-based. K-Y and Astroglide are often recommended. Anything oil-based can damage the latex in your condom and make it less effective! This also rules out using anything like vegetable oil, coconut oil, Crisco, or petroleum jelly.
• If your condom breaks or slips off and pregnancy is a concern for you, take Emergency Contraception ASAP. If you were unsure of the STI status of your partner, you should also go to a health clinic to get tested. 
• Even if you're on a hormonal method of birth control to protect you from pregnancy, you should still use a condom to protect you from STIs.
• You can use spermicidal lubricant -- a type of lube with a chemical in it that kills sperm -- along with a condom to make it more effective in preventing pregnancy. However, it's recommended that you do this very sparingly, because spermicide has been known to irritate the skin of the vagina/penis,  occasionally causing sores inside the vagina, which then increase the likeliness of an STI. Spermicide also increases the likelihood of a urinary tract infection by contributing to bacterial growth in the vagina.
• Condoms should also be used during oral sex to prevent the spread of STIs -- this is the purpose of flavored condoms. However, those cannot be used for vaginal intercourse. 

If STIs aren't a concern for you (ie; you're in a relationship where you know for a fact that everyone involved has been tested and is free of sexually transmitted infections, and you trust your partner(s) to be honest with you) and you don't want to stop in the heat of the moment to grab a condom, you may want to get a form of hormonal birth control to prevent pregnancy -- such as the Implant or the IUD.

Many people don't want to use condoms because they think it "ruins the sensation" of sex. While it does decrease sensitivity a little, there's no reason you can't turn that into an advantage -- for example, a decrease of sensitivity for the penis may help your partner last longer during sex. Some people argue that it "ruins the romance", but if you're really going to let a thin bit of latex between your bodies "ruin" it for you, even at the risk of your safety, maybe you're not mature enough to be having sex. Never ever let a partner bully or beg you into not using a condom after you've asked them to. If someone blatantly refuses to do something that keeps both of you safe, they're not a good partner and they're not worth having sex with.

And finally, don't let embarrassment stop you from buying condoms! I know it can be awkward, but many places are getting those nifty "self check-outs", eliminating the need to interact with a cashier. Even if the store you're purchasing from doesn't have those, there is nothing embarrassing about having safe sex -- in fact, you should be proud, because it means you're taking responsibility for your health. 

Four Things That You Shouldn't Put In Your Vagina, But Probably Do

This one might surprise you!

1. Soap. Would you wash your eyes out with soap? No, of course not, because your eye cleans itself. It uses its own moisture to flush things out. You probably don't use soap when you clean your nose, either; it also uses its own moisture to clean itself. Well, this may come as a surprise to you -- but your vagina does that, too! A vagina is a self-cleaning organ. Healthy vaginas have their own slightly acidic pH balance, which maintains a certain level of good bacteria called "probiotics" (yeah, the word "bacteria" has an unpleasant connotation, but not all of it is bad!).  If the pH balance in your vagina is disrupted, it causes the wrong sorts of bacteria to thrive -- and then you can say hello to itchy, inflammatory, uncomfortable things such as yeast infections and urinary tract infections. Soap has a tendency to completely wreck the natural pH levels in a vagina, causing all the aforementioned unpleasantness. The ONLY thing you need to do in the shower to keep your fun bits happy and clean is to rinse them with water! Just water and a wash cloth!

Advertising will try to make you feel like your vagina is "gross" if you don't use one of these. Don't listen to them. 

2. Douches. I've always thought "douche bag" was an appropriate insult, because douches are unhealthy, irritating, and should not be let anywhere near a vagina (you know, just like some people). A "douche" is a small bottle or bag filled with a perfumed liquid that comes with a tube and that tube is used to squirt said liquid into the vagina. Like soap, douching can upset the delicate pH balance of a vagina, making you more susceptible to the aforementioned unpleasant infections. Since it squirts things into the vagina, it can also push bacteria upwards and introduce infections that way. Research has found that people who douche have a 73% higher risk of getting Pelvic Inflammatory Disease, which is an infection of the uterus, Fallopian tubes, and/or ovaries. Yikes! Advertising for douching products like to play into our insecurities about our vaginas, making us feel like we can only be "fresh" if we buy their stuff. They make us feel like our private bits will be "gross" if we don't give them our money. But let me put this as delicately as I can: it ain't supposed to smell like a flower. It is entirely normal for a vulva to have a bit of a musky scent. The scent of your vagina is actually a very valuable indicator of its health; if it's suddenly a lot stronger than usual, or otherwise different than it normally is, it can mean something is going on. This is another reason douching can be particularly dangerous: if you're pumping your private bits full of flowery perfumes and sweet scents, you're not going to notice when your natural scent changes!

Good to eat, but not good for your fun-bits.

3. Sugar. Okay, yes, you'd think this one would be obvious -- but whipped cream counts as sugar and you'd be amazed at how many people slather it all over their junk during sexual foreplay without a second thought. Yet again, this is a thing that can upset your vagina's pH balance and cause infections -- those things sure are picky, aren't they? If you want to incorporate sweet things into your sexy times without making your vagina angry, try spreading it on other parts of your body instead. Just keep it above your waist, eh?

Good for oral sex, bad for vaginal intercourse

4. Flavored Condoms. Flavored condoms are intended for use with oral sex to prevent sexually transmitted infections. And they serve their purpose pretty well on that front! However, they should not be used for PIV intercourse. The first reason is probably pretty obvious: like we've already discussed, vagina + sugar = bad. However, there are plenty of sugar substitutes out there, and the flavored condom you have may not even contain any actual sugar -- but that still doesn't mean you can use it for PIV sex. Anything scented can usually upset the pH balance of a vagina and cause infections -- douches, scented tampons, pads, etc -- and many flavored condoms are also scented to match whatever flavor they are. So, keep 'em out of that particular hole.

The Vaginal Ring (A.K.A. "NuvaRing")

Yes, it seems weird, but this thing will stop you from getting pregnant!

The vaginal ring -- more commonly referred to by its brand name, NuvaRing -- is a small, flexible ring that you insert into your vagina for three weeks at a time to prevent pregnancy. Many people like this method because it's cheap (about $15 with prescription), it's effective, the ability to become pregnant returns quickly after you've stopped using it, and there's no need to stop in the heat of the moment to grab protection.

The vaginal ring is a hormonal birth control method. It contains the same hormones as birth control pills do -- estrogen and progestin. This works to prevent pregnancy in two ways:

• preventing ovulation; ie, keeping the ovaries from releasing an egg (if there's no egg, there's nothing for the sperm to fertilize)
• thickening the cervical mucus, making it difficult for the sperm to swim and preventing them from reaching the eggs

I feel like the vaginal ring is one of those commonly misunderstood and ignored birth control methods, which is really a shame, because it's quite effective. With perfect use, less than 1 out of 100 people using the vaginal ring will get pregnant within a year. With typical use, 9 out of 100 people using it will get pregnant within a year. Not bad!

How do you use it ?

The vaginal ring is easy to insert. First, wash your hands with soap and water. Next, take your ring and squeeze it together between your fingers (like the photo at the top of this article). Then, gently push the ring into your vagina -- the exact positioning of the ring doesn't matter, so don't worry about that.

Insertion

There's no need to remove the ring during sexual intercourse, using the bathroom, or anything else. Once it's in, keep it in. 

After you've inserted the vaginal ring, you leave it inside your vagina for three weeks. After three weeks have passed, you take it out, and then you leave it out of your vagina for one week. Three weeks in, one week out. To remove the vaginal ring, simply reach into your vagina and hook the ring onto your finger, then gently slip it out:

Removal

After three weeks have passed and you've removed the vaginal ring for your ring-free week, wrap the ring inside of its original tin foil and then throw it in the trash. This is important, because used rings can still sometimes contain hormones and you don't want any children or animals to take it out of the trash and play with it. It also reduces the chances of hormones seeping into any soil or water supply. After one week of not wearing the ring, you insert a new one.

The ring-free week is usually when you'll have your period. You might still have some bleeding when it's time to insert a new one, which is normal. But -- and this is very important -- the new ring must be inserted on the same day of the week as when you inserted the last one.  

Got that? Let me say it once more: insert your new ring on the same day of the week that the previous one was inserted during your last cycle. If you put it in on a Thursday last time, you better put it in on Thursday this time too. If you don't do this, you might get pregnant. I suggest marking the days on a calendar to help you remember. Said calendar should look something like this:

Leave your ring in for three weeks, out for one week,  then get a new ring, leave it in for three weeks, you see where I'm going with this?

Some people use the ring continuously so they get to skip out on their period. That is, instead of having a ring-free week, they just immediately replace their old ring with a new one. This is something you probably want to discuss with a doctor before deciding to do. If you use the ring continuously, it's normal to have spotting or bleeding for the first six months or so. 

What happens if the ring slips out of your vagina or you make a mistake while using it?

Ah, mistakes happen. The world's an imperfect place. Pregnancy can happen if:

• the ring slips out of your vagina and isn't replaced within three hours
• you don't keep the ring inside your vagina for the full three weeks
• the ring is left in your vagina for longer than three weeks 
• you forget to put a new ring in on time after your ring-free week

If the ring slips out of your vagina, just wash it with lukewarm water, and put it back in as quickly as you can. If it was outside of your body for less than three hours, that's all you have to do. If the ring was displaced for longer than three hours, use a back-up method of birth control for seven days.

If you left the ring inside of your vagina for longer than three weeks, what you do next varies depending upon how long it's been.

If you've left it in for up to four weeks:

• Remove the ring
• Take a ring-free week
• Insert a new one after your ring-free week

If you've left it in more than four weeks:

• Remove the ring
• Try to remember if you've had vaginal intercourse more than four weeks after you inserted the ring -- since the ring only protects you for three weeks, you may be pregnant. You may want to take a pregnancy test. 
• When you restart with a new ring, use a back-up method birth control method for a week. 

If your ring-free time lasts longer than one week, insert a new ring and use a back-up birth control method for a week.

If you need to use a back up method while using the vaginal ring as your primary method, you shouldn't use a diaphragm, a cervical cap, or a sponge. Having the ring in may prevent these from being properly placed in your vagina. If you need a back-up method, use a condom or spermicide (or both). You can also use emergency contraception (A.K.A "the morning after pill", or Plan B) to prevent pregnancy for up to five days after unprotected vaginal intercourse. This is a great option if you had vaginal intercourse before you realized your ring was not in place or had been in place too long.

It's important to keep in mind that the vaginal ring does nothing to protect you from STIs. Unless you are in a relationship where you know for a fact that everyone involved has been tested and is free of STIs, you should still use a condom when having sex.

Helpful tips and reminders:

• Always wash your hands thoroughly before inserting or removing your ring!
• Since the ring can slip out, it's not a bad idea to check on it now and again. A good time to do this is after having vaginal intercourse or after you've strained during a bowel movement (since the pushing can push it out of your vagina)
• Be mindful during sexual activity -- you don't want your partner to accidentally pull your ring out while fingering you

Many people who rely on the vaginal ring love it. It's easier than having to remember to take a pill every day,  you only have to think about it twice a month, and it allows for spontaneous sex because you don't have to pause the action to put anything in place. Like other hormonal birth control methods, it often lead to lighter, shorter periods over time. Similar to birth control pills, the vaginal ring can also be used to control acne and  lessen menstrual cramps.

Obama Won, But We're Not Done Yet

The 2012 presidential election is over and, regardless of your reaction to the outcome, the world hasn’t been magically transformed into an accepting, peace-loving utopia. I think we can all be relieved to say good-bye to all of the political ads, but the fact is we still have a lot of work to do.

One presidential election being over is really no reason to stop being vocal about politics. I think so many of us tuned out for a couple of years after the 2008 election, then were surprised when things didn’t go exactly as we wanted to (even though they went pretty damn well).

On Election Day, I saw a lot of my young adult friends on social media mocking elections, politics, and the concept of actually giving a shit. When exactly did it become cool not to care about politics, about the future of the world we live in? And now that the election is over, so many people I know are “so excited to stop seeing political statuses on Facebook” and are happy that life can “go back to normal.” While we can certainly stop frantically advocating for our candidate and nervously awaiting the results, we should still be concerned, informed, and vocal about politics. The issues are all still there. Why are we more excited to see poorly Instagramed photos of shitty take-out, pictures of peoples’ pets, and arguments about sports rivalries than political conversations that deal with the futures, well-being, safety, and rights of everyone in this country? Why can’t a constant investment in the direction of our nation and its place in the world be “normal?”

I am so happy about the outcome of this election. Not only was the only viable candidate who supported my rights as a queer woman re-elected for President, but we saw many victories all over the country. But I’m not excited for Facebook or Tumblr or Twitter to “go back to normal,” nor am I really looking forward to most of my day-to-day interactions with friends to drop politics from the conversation. While I was getting tired of those political ads and truthfully did a lot of face palms, I really loved this election year because so many people actually cared, and cared so much.  I wish more people genuinely cared all year, every year.

And if political posts on social media really bother us more than hearing about what kind of fancy coffee our friends bought today, if acting like being invested in this country’s future is too earnest or mainstream of us, I think it’s time to re-examine our priorities.

All of the social issues are largely still there and we can’t expect that Obama’s presidency will solve all of our remaining economic problems while we, many of us so passionate and so vocal in his favor these past months, fall silent. Yes, this election has been grueling; it’s been taxing and nerve-wracking and honestly pretty scary for a lot of us. I’m not asking that we keep up the pace from that homestretch sprint for the next four years. But keeping Obama in office is really only ensuring that we are more capable of continuing in the right direction as opposed to moving backwards, not a guarantee that everything will work out without our help.

We still have a lot of work to do.

An Alternative to Tampons: The Menstrual Cup

Many people think that they only have two choices when it comes to their periods: pads or tampons. This simply isn't so! The menstrual cup is a bell-shaped container made of medical-grade silicone that collects menstrual blood rather than absorbing it like a pad or a tampon. It's often referred to by its brand names, the Diva Cup or the Moon Cup. It comes in two sizes: a smaller one for people who have never given birth and a larger one for people who have.

The menstrual cup comes in two sizes, small and large

                                                   

  Why use a menstrual cup?

It's safer than pads and tampons. The menstrual cup does not absorb fluids, therefore eliminating the risk of Toxic Shock Syndrome (TSS). TSS is caused when you leave a tampon in for too long; the blood it has absorbed starts to grow old and gather bacteria, which can thrive and grow quickly in warm/wet atmospheres (you know, like a vagina).  Not to mention that pads and tampons have been known to contain chemicals such as bleach, which can irritate the skin and has been linked to various uterine problems.

Once you've gotten the hang of inserting it, you don't even realize it's there. As with anything new, it takes a bit of getting used to -- I'm sure it wasn't very graceful the first time you tried using a tampon, either -- but once you've figured it out, the menstrual cup is extremely comfortable. If it's put in correctly, you won't feel it at all. Alternatively, tampons have been known to cause "micro-tears" (small cuts) inside the vagina. What did you expect, shoving rough, dry cotton up into a soft, wet mucous membrane? Micro-tears are often the cause of the vaginal discomfort that people experience during and immediately following their menstrual cycle.

It's good for your wallet. The menstrual cup is re-usable. They cost about $30-$40 upfront (currently on sale for about $20 at Amazon!), but then you don't have to spend money on pads or tampons! Think of the money you'll save! The menstrual cup can be used for up to ten years if you properly take care of it and it usually pays for itself within the first couple months of use.

It's good for the planet. Again, the menstrual cup is re-usable. The average person uses something in the neighborhood of 12,000 to 16,000 tampons or pads in their lifetime. Used tampons and pads often end up in landfills or improperly disposed of in toilets to block up our sewage systems. A menstrual cup can be used for up to ten years -- that's ten years of trash not being thrown into the environment!

It's more convenient. The menstrual cup can be safely worn for up to 12 hours -- whereas tampons can only safely be worn for about 8 -- meaning less trips to the bathroom during the day. There are no strings or anything else that show outside of your body, making it ideal for sports and swimming. You never need to carry any extras with you (no more frantically searching your bag for a new tampon or pad!), nor do you need to worry about TSS. There's also very little chance of leaks when the menstrual cup is properly inserted.

How do you use it?

   

Inserting a menstrual cup isn't too terribly different from inserting a tampon. First, wash your hands. Then fold your menstrual cup (there are different methods of folding, such as the "U" fold and the "Push Down" fold, shown in the picture above) to make it smaller. Hold the folded menstrual cup in one hand, then use the other hand to gently spread your labia. Preferably while squatting or standing with one foot on the floor and the other on a toilet or bath tub, slowly push the folded cup into your vagina -- this should be done at about a 45 degree angle; your vagina is angled, it's not straight-up inside your body.

The cup should pop open and unfold inside your vagina. This causes a suction-like seal, so it won't leak. Unlike a tampon, you do not need to push the menstrual cup as far inside your body as you can, it can be worn low in the vagina. Push it in until you're comfortable -- how high or low your sweet spot is can depend upon how low your cervix happens to be and that varies person to person. 

Once it's inserted, make sure the cup is unfolded so blood doesn't seep out around it. You can do this by running one finger around the base of it -- it should be round or oval. If it doesn't feel like it's open, you can grab the stem and give the cup a small turn, and this will usually do the trick. 

The "stem" -- the bit of ribbed silicone on the bottom of the cup, shown in the photos above -- can be used to find your cup when you want to remove it. You can use scissors to trim it to whatever length you're most comfortable with. 

To remove your menstrual cup, reach into your vagina and, using your index finger and thumb, pinch the bottom. This breaks the suction and makes it easier to get it out. Then, gently and slowly as to not spill any of the fluid, ease it out of your vagina. It's recommended that you try this at home the first few times as opposed to a public restroom, since doing it incorrectly can result in a mess. Finally, dump the fluid into the toilet, re-fold your cup, and re-insert it. 

  For the visual learners, this super informative video demonstrates the entire insertion and removal process. 

Many people are intimidated by the size of the menstrual cup and worry that it's too large to be used comfortably. But really, when folded, it's roughly the same size as a standard tampon:

   

What are the downsides?

It takes practice. When you're an inexperienced user, you're more likely to insert your menstrual cup incorrectly, which means you might experience some discomfort or leakage. It's okay, though, you'll get the hang of it! If you're new at this, you might want to wear a thin pantyliner when you go out to avoid staining your underwear/clothes. 

Some people just cannot wear them comfortably. Even if you're following the instructions religiously, some people just don't mesh well with menstrual cups. We're all shaped differently. Some of us have a particularly low cervix or a very small vagina that doesn't allow the use of a cup. If this applies to you and you still want to avoid all the horrors of cotton pads and tampons, I recommend looking into cloth pads. Some people also report that the cup puts extra pressure on their bladder, causing frequent urination. Again, everyone is different. 

Some other things that are important to note:

• You gotta keep it clean! Some menstrual cup makers sell a special pH balanced cleanser to wash your cup in at the end of your cycle, but this isn't necessary -- just boil your cup in a pot of water to kill any germs. Don't use soap! Soap is generally unhealthy for your vagina and can upset the pH balance in there, causing irritation and yeast infections. 
• Wash your hands before removing or inserting your cup. 
• Some say that menstrual cups and IUDs cannot safely mix because the suction caused by a menstrual cup may cause the IUD to expel or that the wearer may accidentally grab their IUD strings when attempting to remove the cup. However, there actually isn't any evidence to support that claim.