News Highlights
Uninformed teens resort to anal sex to avoid pregnancy, oblivious to STI risks
Few teens who practice anal sex use condoms, and some of the teens use anal sex as a method of preventing pregnancy, unaware that it is a risky way to get a sexually transmitted infection (STIs).
Many STIs can be transmitted through anal sex, including chlamydia, gonorrhea, herpes, genital warts, HIV, hepatitis, syphilis, and trichomonas.
A five year study followed the sexual behaviours of 350 experienced inner-city females aged 12-18 years, and the STI rates among them. Among the group surveyed, 40.7% reported sexual activity with casual partners and 86.5% with main partners—12% and 16% engaged in receptive anal intercourse, respectively.
Teens involved in casual sexual relationships used condoms more frequently than people in committed (main) relationships for both vaginal and anal intercourse.
Teens used anal intercourse as a form of contraception in 41.2% of casual relationships and 8.5% of main relationships. Little did these groups know, there is still a small chance of getting pregnant from anal sex.
Most safer sex education programs focus on vaginal intercourse, and the results of this study indicate that teens need to be educated about the risks of anal intercourse and how to reduce them. Teens are known to be at the highest risk for getting sexually transmitted infections, and women in particular have the fastest growing rates of HIV infection.
Houston AM, Fang J, Husman C, and Peralta L. More than just vaginal intercourse: anal intercourse and condom use patterns in the context of “main” and “casual” sexual relationships among urban minority adolescent females. J Pediatr Adolesc Gynecol (2007) 20:299-304.
Factors that influence college women to use the contraceptive ring
Women who have busy schedules may prefer using the contraceptive ring as a hormonal birth control method instead of the pill, a new study of female students at the University of Illinois in Chicago has found.
Alarmingly, more than half of the respondents who reported having sexual intercourse at least once a week were not using protection.
Almost all the respondents to the online questionnaire were familiar with the most commonly used contraceptive methods including the oral contraceptive pill (OCP), the patch and DMPA. Most of the respondents were willing to use or were already using the pill. Fewer students were open to using the patch (40%) or the ring (20%), though the majority of the students said they would prefer to use a method that can be taken weekly or monthly.
Women who work at least 20 hours a week are more willing to use a vaginal ring. Those interested in the ring are also more likely willing to use the patch, to accept a monthly method, to insert the device themselves, and to tolerate feeling the ring during intercourse. Students currently using the pill were less likely to be accepting of the vaginal route.
The authors advise health professionals to broaden women’s perspectives of contraceptive rings by counseling them on how to properly insert them along with other devices like tampon holders, and provide demonstrations during visits to the office.
Gilliam M, Holmquist S, Berlin A. Factors associated with willingness to use the contraceptive vaginal ring. Contraception 2007;76:30-34.
FOR HEALTH PROFESSIONALS
Women at risk for having heterosexual intercourse without a barrier method
Teaching adolescent females about using condoms may influence them to practice safe sex, unless their partners are not willing to use condoms, a study says.
People having heterosexual intercourse use condoms 19% of the time and only 21% of adolescents, the highest risk group, used condoms the last time they had intercourse.
Women need to be educated and empowered to protect themselves from STIs through the use of barrier methods. Female controlled methods need further investigation to compare their ease and frequency of use.
This study involved a self-administered a questionnaire to women ages 13-35 years. Analysis was done on the results from a subgroup of 469 high risk women who had been sexually active within 30 days of their baseline visit.
Women whose partners were unwilling to use condoms were 6-8 times more likely not to use any barrier method. Those whose partners were somewhat willing to use a condom were 3-5 times more likely not to use protection.
Women who had more frequent intercourse and women less than 20 years old who felt less skilled in condom use were also more likely to have at least two occurrences of intercourse per month without a barrier method. Women aged 20-24 years on hormonal contraceptives were 2.7 times more likely to have unprotected intercourse.
Peipert JF, Lapane KL, Allsworth JE, et al. Women at risk for sexually transmitted diseases: correlates of intercourse without barrier contraception. Am J Obstet Gynecol 2007;197:474.e1-474.e8.
Ask Sexualityandu
If you are on the pill and have sex without a condom during your seven sugar pill days, or while you are on your period, does the pill become less effective and increase your pregnancy chances, and why?
The effectiveness of the pill depends on how regularly you take it, not where you are in your cycle. You are protected from pregnancy throughout your cycle with a failure rate less than 1% for perfect use and 6% for typical use. If you miss two or more pills, especially in the first or last week of the three weeks of active pills, your risk for accidental pregnancy increases and you should consider using emergency contraception (Plan B).
My wife is 48 and has not had a period in four months and has been off birth control for 6 months. Can she still get pregnant?
There is still a chance of pregnancy before a woman is menopausal, but it isn’t high. Ovulation and menses may be irregular in the few years leading up to menopause. By definition, a woman is menopausal once she has gone 12 months without a period. There are many excellent contraceptive options for women at this stage of life to ensure that accidental pregnancy does not occur. For most non smokers, hormonal methods of contraception such as the pill, patch and ring are still safe and effective. Barrier methods like the condom, diaphragm and intrauterine devices are also excellent choices for this age group. As women enter menopause, hormonal methods can reduce symptoms like unwanted hot flashes, and can regulate and reduce menstrual flow.
Sometimes it hurts when I’m having sex with my boyfriend. I know I’m well-lubricated so that is not the problem. What is causing it and is there anything I can do about it?
There are many causes for pain during intercourse including vaginismus, the involuntary muscle spasms in the vagina, infection, insufficient lubrication, and endometriosis. There are effective treatments for all of these problems and you should ask your family doctor. The doctor may be able to determine what the problem is and treat it, or they can refer you to a gynaecologist who can help.
