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News Highlights
Popular spermicide does not offer STI protection as once thought
Studies have disproved the popular belief that Nonoxynol-9 spermicide protects people from Chlamydia, gonorrhea and HIV—three harmful sexually transmitted infections (STIs).
In fact, Nonoxynol-9 (or N-9) may actually increase the risk of getting HIV from an infected partner because of the irritation it may cause to the lining of the vagina or rectum.
The popular spermicide is contained in many contraceptive products, such as vaginal contraceptive film, vaginal foams, gels and inserts, and some condoms. Consumers may purchase these products without a prescription and without any counseling.
The Food and Drug Administration, or FDA, recently ruled that all products containing nonoxynol-9 must carry a label indicating that it does not protect against sexually transmitted infections. The warning information will include the following points that you should know:
- for vaginal use and not for rectal or anal use
- N-9 does not protect against sexually transmitted diseases (STDs) and may increase the risk of getting HIV
- do not use if one partner has HIV/AIDS or if you do not know if your partner has HIV/AIDS
- vaginal irritation may occur – stop using and consult a physician if you or your partner experience irritation
- latex condoms greatly reduce the risk of transmitting HIV and other infections
- some condoms have N-9, but ensure that you use a condom without N-9 if either partner has HIV/AIDS, multiple sex partners or other HIV risk factors
- there is no evidence that adding N-9 to a condom decreases the risk of pregnancy above that of condoms without N-9
FDA issues warning for nonoxynol-9 products. (Food and Drug Administration).
Contraceptive Technology Update (March 1, 2008)
How often do teens discuss contraception and STIs before having sex the first time?
The more a student learns about safer sex practices, the greater the chances that he or she will have a discussion about contraception or sexually transmitted infections (STIs) with a partner before sexual intercourse happens.
A study of U.S. students in grades 7-12 examined the factors that affect discussions teenagers have or don’t have about contraception and STIs before engaging in intercourse. Surveys and in-home interviews were conducted one year apart with over 1,400 students who had their first sexual intercourse between the first and second interviews.
Females discussed STIs and contraception prior to their first sexual intercourse more often (53%) than males (45%). The chance of discussing these subjects before having sex increased when participants knew more about condoms.
Having this talk also has a lot to do with how you communicate with the last people you want to think about during a sexual encounter—your parents. The odds of talking with a partner about STIs and contraception prior to engaging in sex increases when students generally have more open communication with their parents, even about subjects unrelated to sex. Previous research has shown that teenagers who discuss these issues with their partners are more likely to use methods of contraception and practice safer sex, thereby decreasing their risk of unintended pregnancy and infection with an STI.
Those who were older at first sex, had participated in more dating activities, and had longer relationships were more likely to discuss contraception or STIs.
The authors suggest that role playing may be helpful in increasing adolescents’ level of comfort discussing these often uncomfortable subjects.
Adolescents’ Discussions About Contraception or STDs with Partners Before First Sex. Ryan S, Franzetta K, Manove J and Holcombe E. Perspectives on Sexual and Reproductive Health. 2007;39(3):149–157.
FOR HEALTH PROFESSIONALS
Women may be getting labial reduction surgery for the wrong reasons
A few women who think their external genitalia have an abnormal appearance are having surgery to reduce the size of their labia. Much like other parts of human anatomy, the appearance of the labia varies from one woman to another, and this changes with puberty and age. Diseases can also affect the appearance of the labia and vulva, but they are uncommon.
Investigators interviewed six patients of labia reduction surgery and looked for common themes in their experiences. These women had all been unsatisfied with their labia appearance and perceived it to be abnormal or “weird”, despite the fact that some of them acknowledged that variation between people is natural. They perceived themselves to be abnormal without having a specific idea about what normal is. These perceptions were sometimes triggered or reinforced by media or other people, such as peers, mothers, and healthcare professionals.
Some patients have unrealistic expectations about labial reduction surgery, and surgery may not be the right solution for them. There are limits to what it can provide for a patient, and some women will still be unsatisfied with their appearance. Two of the women who participated in this study were unsatisfied with their surgery results and chose to have a second procedure. Women who were sexually active hoped for an improvement in their sex lives, and some even hoped to improve or salvage their relationships. But sexual interest and participation is closely linked to self-image. Counseling may be more helpful than surgery, but it is not widely available and many women are reluctant to try it. It is important that girls and women are educated about the natural variation of anatomy and symmetry.
Bramwell R, Morland C, Garden A. Expectations and experience of labial reduction: a qualitative study. BJOG 2007;114:1493–1499.
This May marks the third annual Run Against HPV, an event created by the HPV Awareness Organization, to raise funds and promote the awareness and prevention of the virus that has become the leading cause of cervical cancer and the world’s most common sexually transmitted infection.
Join the HPV Awareness Organization on May 10 in Toronto or May 17 in Montreal. The run will feature live music, a BBQ and prizes. Participants can choose to walk 2.5km or run 5km and those who raise $100 in donations will have their name entered in a raffle for a grand prize. All proceeds from the Montreal event will go to Sainte-Justine’s Hospital Foundation for an HPV awareness and prevention program.
Participants can register right up until the day of the event.
For more information or to register visit www.hpvawareness.org
Ask Sexualityandu
I suffer from epilepsy and want to take birth control pills. Can I take any brand with my meds (Tegretol and Frizium)?
No, not just any brand will work for you. Some anti-epileptic medications affect the metabolism of the birth control pill. Tegretol (carbamazepine) and Dilantin (phenytoin) both increase the breakdown of the estrogen in the pill. If you are on these medications, you need to take a pill containing a higher dose of estrogen, 50 micrograms of ethinyl estradiol, rather than the standard low-dose or very low-dose pills. Dilantin levels also need to be monitored. Contraceptives that do not contain an estrogen, like Depo-provera or an intrauterine device are also reasonable options if you are not set on a pill.
If I take the pill each morning but at different hours will it still protect me from pregnancy?
Yes, but the more regularly you take the pill, the more reliable it will be in protecting you from pregnancy. The most important days to be on time are in the week after your pill-free or placebo pill week. If the 7 day hormone-free interval is lengthened the risk of failure will be increased. Failure rates with perfect use—implying taking the pill at the same time daily and not missing any pills—are around 0.1%. In contrast, with typical use—accounting for less regular use and missed pills—failure rates are around 3-8%. If a pill is missed and taken late, then take it as soon as you remember, even if that means taking two at the same time. If this occurs during the first week of active pills you should consider using a backup method of birth control, such as condoms, for the next seven days. You may also need to take emergency contraception.
Is it normal for a woman to discharge a clear fluid when experiencing an intense orgasm?
Yes, there are glands which lubricate the vagina that will often secrete small amounts of fluid during sexual excitement or orgasm. But some women do not experience female ejaculation.
I recently received antibiotics for a throat infection and I was told that my birth control pill would not be as effective – what should I do?
This is commonly quoted as an interaction with any antibiotic, but the only antibiotics that have been proven to change the effectiveness of the birth control pill are Rifampin and Grisiofulvin, which are not commonly used. If you are being treated with antibiotics for an infection that is causing nausea and vomiting and you are unable to keep your pill down, this can decrease the pill’s effectiveness. If there is any concern about missed pills then it is best to use a backup method like a condom for two weeks after the illness is over.
