How do Contraceptive (Spermicidal) Suppositories work?

They work by immobilizing the sperm by chemical actions and need to be inserted at least 5 minutes prior to intercourse. The effect lasts for an hour and usually gives protection for a single coitus. If she desires to indulge in intercourse again, she will need another suppository. Some of them are biodegradable and need not be removed after use. Instructions regarding use should be very clear and lucid. There are instances of women who have used spermicidal suppositories orally and some who have inserted them in the anus! It is best to use them under the guidance of a gynecologist.

What is an IntraUterine Contraceptive Device (IUCD)?

It is a contraceptive device which has to be inserted into the uterus.

There are medicated and non-medicated varieties available. The advantages include: the one time motivation, no systemic metabolic side effects, no interference with local sensitivity, high success rate and long duration of action. The disadvantages include increased incidence of pelvic inflammatory disease, increased bleeding, dysmenorrhoea and increased risk of ectopic pregnancy.

What are the contraindications for using an IntraUterine Contraceptive Device (IUCD)?

IUCD should not be used if a woman has menorrhagia (excessive bleeding), an abnormal uterine cavity; undiagnosed bleeding from the uterus or the vagina; pelvic infection; history of ectopic pregnancy or tubal surgery. IUCD is generally not advised for women who have not yet borne a child.

How should a Condom be used?

Though seemingly simple, a certain protocol needs to be followed when using a condom for contraception

1. A new condom should be used for every act of coitus.
2. Condoms are available in pre-tested, pre-sterilized packs and need not be tested prior to use.
3. It is to be rolled onto the erect penis just prior to insertion. Practice of delaying and putting it on just before ejaculation should be avoided.
4. It should be removed immediately after ejaculation otherwise the penis becomes flaccid and the semen is likely to spill into the vagina.
5. For removal, it is to be held on to the base of the penis, and should be withdrawn along with the penis.
6. It may be used with some spermicidal jelly to maximize its contraceptive effect.

What is Tubectomy?

Tubectomy is a permanent method of contenception by female sterilization, involving the excision of the tubes to interrupt the passage of ova. Its contraceptive measure does not leave any residual effect on the female’s sexuality.

Is Tubectomy reversible?

Yes, Tubectomy is reversible by microsurgicat techniques, but, this is more difficult than reversal of vasectomy. The success rate depends upon the method of tubectomy and the skill of operating surgeon.

Does Tubectomy affect Estrogen Levels?

No. Ligation of the tubes merely interrupts the passage of the ova thus preventing conception. It leaves the hormonal levels unchanged and has no effect on the female sexual desire.

Is there any change in sexual enjoyment after Tubectomy?

In fact, it may enhance one’s sexuality as it offers contraception without decreasing local sensitivity, it unlike barrier contraceptives.

Does the Female Superior Position prevent pregnancy?

Alas! No!

After pregnancy, many times couples report that they don’t experience the pleasure that they used to. Can this be helped?

After normal delivery often-vaginal walls become lax and the penovaginal contact reduces. Thus some people do report less pleasure. This can be helped. While doing the episiotomy, the gynecologist should take one more stitch known as husband’s stitch to ensure adequate apposition that helps in increasing the peno-vaginal contact, thus giving more pleasure.

What are the most common causes of lax vagina? How can it be prevented?

This may occur following childbirth. Proper management of labor with perineal support and an adequate and timely episiotomy can best prevent it.

What is the treatment for a lax vagina?

Kegel’s exercises for contracting the perineal muscles by holding the urine and releasing it, 20 such contractions and relaxations three times a day, may help increase the muscle tone. If this does not work, one may go in for vaginal reconstructive surgery.