Contraception for Young People

Condoms can prevent pregnanciesCondoms can prevent pregnancies

What is birth control for teenagers? What are contraceptives?

‘Birth control’ is a term that describes ways to stop a woman or girl from becoming pregnant. Birth control can mean a wide range of things – from ‘contraceptives’ (used to reduce the chances of a woman becoming pregnant) to other ways of avoiding pregnancy, like not having sex.

Making decisions about sex and birth control

If you don’t want to have a baby, there are two main options – either don’t have sex, or if you are going to have sex, use contraception.

What is meant by ‘having sex’?

Well, here we’re talking about having sexual intercourse, where a man inserts his penis into a woman’s vagina. There are other forms of having sex – like oral sex, for instance – but the only one that can get a girl pregnant is vaginal sexual intercourse.

You might be thinking ‘yeah ok, I already know that girls get pregnant through sexual intercourse’. But are you sure that you really know the facts about pregnancy? There are a lot of myths out there. Despite what you may have heard, a girl can become pregnant:

  • The first time she has sexual intercourse.
  • Even if she has sex before she’s had her first period.
  • Even if she has sex during her period.
  • Even if a boy pulls out (withdraws his penis) before he comes/ejaculates.
  • Even if she has sex standing up.
  • Even if she forgets to take her pill for just one day.

Take our pregnancy quiz to make sure that you really know what causes a girl to get pregnant!

Not having sex

The only 100% effective way to avoid having a baby is to not have sexual intercourse, also known as ‘abstaining from sex’. Many young people around the world choose this option. For some, this means not having sex until marriage. For others, it can mean different things, like waiting until they’ve found a stable partner who they feel comfortable with. You need to decide what’s best for you personally – don’t feel pressured into having sex just because others are. It’s important to feel that you’re ready before you start having sex.

“Don’t feel pressured into having sex just because others are.”

Some people believe that you shouldn’t start having sex (be abstinent) until you’re married. People also have different views about having sex in marriage; some think you should only have sex if you want to have a baby, whilst others think that once you are married, it’s ok to use birth control if you still don’t want a baby. Many religious groups have strong views on the issue of sex and marriage.

A lot of people, on the other hand, don’t think that there’s anything wrong with having sexual intercourse when you don’t want a baby, and many don’t believe that you have to be married, or even in a serious relationship, before you start having sex. It’s good to think about where you stand on this issue.

Having sex and using contraception

As much as abstinence is the right route for some people, a lot of teens don’t want to wait to have sex until they’re ready to have a baby. Puberty brings with it a lot of sexual feelings, and many choose to have sex for the first time during their teenage years. If you do choose to have sex (and you should only have sex when you’re sure that you’re ready), make sure that you use contraception. There are many types of contraception for teenagers, and you should choose one that suits you and your relationship.

Abortion (termination of pregnancy)

Some women and girls don’t want to have a baby, but become pregnant because they’ve had sex without using contraception, or because the contraception that they’ve used has failed for some reason. In these situations, women may decide to have an abortion. This is where a woman becomes pregnant, but the embryo or foetus (unborn baby) is removed, stopping pregnancy.

As with birth control in general, there are many different arguments about whether abortion is right or wrong, and whether it should be allowed. If you have sex, you need to consider how you feel about this issue, and how your life would be affected if you had to make such a decision.

It is important not to confuse arguments about whether abortion is right or wrong with facts about the medical procedure. Different countries have different laws about abortion, and in many countries it is illegal. In many places where abortion is legal, it is a safer medical procedure than childbirth, and having a safe abortion does not affect your future ability to have children. 1 Where abortion is illegal and not performed in a medical setting, it can be very dangerous.

Contraceptives for teenagers

Are there many different methods of contraception?

Yes. Contraceptives work by preventing a man’s sperm from fertilising a woman’s egg, and this can be done in several different ways.

There are two main types of contraception:

  • Barrier methods – which physically prevent sperm from swimming into the uterus and fertilising the woman’s egg
  • Hormonal methods – which alter a woman’s hormonal cycle to prevent fertilisation.

Other types of contraception, which are generally not used by young people, include natural methods such as only having sex at certain times of the month (these are often not effective enough to prevent pregnancy), and sterilization, which is a permanent surgical procedure.

The intrauterine device (IUD) and intrauterine system (IUS), also known as ‘the coil‘, are generally not used by young people although in some countries, such as the UK and Nigeria, they are now considered suitable for all age groups.

How do you know which one to choose?

Different methods of contraception have their individual advantages and disadvantages. There’s no single ‘best’ method of contraception, so you have to decide which is most suitable for you. Whatever your situation, there should be a contraception option that works for you. For many people, barrier methods of contraception are best, because they not only prevent pregnancy, but also prevent HIV and other sexually transmitted infections (STIs) being passed on during sex.

Where do you get contraceptives from?

It depends which type of contraceptive you’re looking for. Barrier methods such as condoms and spermicides are widely available from drug stores and other shops in many countries. They’re also available from many healthcare providers. Hormonal methods are only available on prescription from doctors. You can also buy some contraceptives online.

Barrier methods of contraception

There are three main barrier methods of contraception used by teens: the male condom, the female condom, and spermicides in the form of foams or gels.

The male condom

The male condom is the only method of contraception that boys can use. It’s really just a rubber tube. It’s closed at one end like the finger of a glove so that when a boy puts it over his penis it stops the sperm going inside a girl’s body. An advantage of using male condoms is that a boy can take an active part in using contraception – it’s not just the girl’s responsibility.

The female condom

The female condom is not as widely available as the male condom and it is more expensive. It is however very useful when the man either will not, or cannot, use a male condom. It’s like a male condom, except it’s bigger and worn inside the vagina.

It’s a good idea to practice with condoms before having sex. You can get used to touching them, and it might help you feel more confident about using them when you do have sex.

Spermicides

Spermicides are chemical agents that both kill sperm and stop sperm from travelling up into the cervix (the lower part of the uterus, or womb, where babies develop). Spermicides come in different forms including creams, foaming tablets, gels and foam (which is squirted into the vagina using an applicator). Young people who use spermicide mostly choose foam.

Spermicides are not very effective against pregnancy when used on their own, but are very effective if used at the same time as a male condom. When used together, the male condom and spermicide can be a great combination for effectively protecting against both pregnancy and sexually transmitted infections such as HIV.

Some condoms also come lubricated with spermicide (Nonoxynol 9). A spermicidal lubricant aims to provide an additional level of protection if some semen happens to leak out of the condom. This can help to reduce the likelihood of pregnancy, but regular use of Nonoxynol 9 can cause an allergic reaction in some people resulting in little sores that can actually make the transmission of HIV and other sexually transmitted infections more likely. Nonoxynol 9 is only a suitable spermicide when both partners are HIV-negative. It should only be used for vaginal sex.

Hormonal methods of contraception

There are two main types of hormonal contraception which can be used by teens: the contraceptive pill, and the injectable hormonal contraceptive. If used properly, both are extremely effective in providing protection against pregnancy – but they provide no protection at all against sexually transmitted infections. For very good protection against both pregnancy and sexually transmitted infections like HIV, a hormonal method should be used at the same time as the male condom.

In some countries, contraceptive patches (that stick to the skin) and rings (that go inside the vagina) are also available.

The contraceptive pill (sometimes known as the birth control pill)

  • What does ‘going on the pill’ mean?People often talk about being ‘on the pill’. This means they are using the oral contraceptive pill as a method of contraception. This has nothing to do with oral sex, and just means that the contraceptive is in pill form which is taken orally (swallowed).
  • How does it work?The pill contains chemicals called hormones. One type of pill called ‘the combined pill’ has two hormones called Oestrogen and Progestogen. The combined pill stops the release of an egg every month – but doesn’t stop periods.The other type of pill only has Progestogen in it. It works by altering the mucous lining of the vagina to make it thicker. The sperm cannot then get through, and as the sperm can’t meet the egg, the girl can’t get pregnant.
  • What do you do?Usually a girl has to take one pill every day for about three weeks. She then takes a break for seven days while she has her period, before starting the cycle again (or instead, she may take ‘sugar’ pills for those seven days, i.e. pills that don’t actually have any affect, but which are taken purely so she keeps in the routine) for seven days.It’s very important not to forget to take these pills. If this happens, protection against pregnancy is lost. The Progestogen-only pill also has to be taken at the same time every day.
  • How effective is the pill?It’s a very effective method of contraception if it is taken correctly. If the pill is taken exactly according to the instructions, the chance of pregnancy occurring is practically nil. But if a girl forgets a pill, or is very unwell, its effectiveness is reduced. Another disadvantage of the pill is that it does not provide any protection against STIs. For very good protection against both pregnancy and STIs, the birth control pill should be used at the same time as the male condom.

Injectable Hormonal Contraceptive

  • How do you use it? How does it work?The most popular form of this type of contraception, Depo-Provera, involves the girl having an injection once every twelve weeks. The injection is of the hormone Progestogen. The injection works in the same way in the body as the Progestogen only pill, but has the advantage that you do not have to remember to take a pill every day. It does however have the same disadvantage as the hormonal pill, in that it provides no protection against STIs. 2

The Contraceptive Implant

  • What is it?The ‘implant’ is a newer form of contraceptive, which has become available in some countries, such as the UK. It is a small tube, a little over an inch long, which is inserted under the skin on the inside of a girl’s arm.
  • How does it work?The implant works in a similar way to the contraceptive pill, but instead of taking a pill every day, hormones are steadily released into a girl’s body from the device. This is seen as an advantage, particularly for girls who have trouble remembering or don’t like having to take a pill every day. However, the implant can cause unwanted side effects, and like the other hormonal contraceptives, the implant does not protect against STIs.

The morning after pill

If a girl has had unprotected sex, but doesn’t want to have a baby, one option is ‘the morning after pill’ – an emergency contraceptive that can prevent pregnancy, when taken after sex. The name is actually a little bit misleading, as it doesn’t necessarily have to be taken ‘the morning after’ – it can work up to 72 hours after you’ve had sex. However, it’s most effective when taken within 24 hours of sex, and the sooner you take it, the better.

Morning after pill (Postinor being the most popular brand) is available over the counter in Nigeria and it costs below ₦300 ($2).

In a lot of countries you can get the morning after pill for free, as a prescription from your doctor or healthcareprovider. In some – including the USA, Scotland, England and Northern Ireland – you can also buy it over the counter at pharmacies. In Wales, it is available free at pharmacies.

Although the morning after pill can be an effective way to avoid pregnancy if you have had unprotected sex, you shouldn’t rely on it, or use it regularly. It’s not as effective as other methods of contraception, and can have side effects. What’s more, it won’t protect you from HIV or other sexually transmitted infections.

Contraception and HIV

Some evidence has suggested that girls/women who have the hormonal injection are at an increased risk of HIV infection. It also suggests a rise in the likelihood of HIV transmission to her partner(s). 3 4

But, unprotected sex may have been the reason for the HIV transmission; remember to always use condoms, even if you are on contraception! Only condoms will prevent HIV and STI transmission!

For more specific guidance on what type of contraception to use, see this HIV & Contraception tool.

– Culled from Avert.org | Averting HIV and AIDS 

Young People: What are your Sexual Reproductive Health Needs

 

Youth Discussing Sexual Reproductive Health

Youth Discussing Sexual Reproductive Health

Jessica (not real name) walks into a clinic to see the doctor after she had not seen her period for some weeks. A laboratory test after, it was discovered that she was pregnant. A  medical review of her history showed that she was also pregnant 6 months earlier. 

She procured abortion for that pregnancy 6 months earlier (unsafe abortion) and now back with another pregnancy.

She is just 19 years old.

Reading this, a question pops into my head, will this teen have been better informed of the benefits of Sexual Reproductive health education? How many such girls exist in our communities? How do we help them?

These questions brought my mind again to the importance of Sexual Reproductive Health and how investing in it will help the most important age group of any country.

Sexual Reproductive Health is that aspect of health that deals with issues surrounding the reproductive system of human beings. It is an essential component of young people’s ability to understand their sexual identity and a very important aspect of their development.

A focused approach to improve one’s Sexual Reproductive Health will go a long way in ensuring well-adjusted, responsible and productive members of the society. We have been approaching it from the angle of what we think young people need, what about approaching it as a response to needs assessment community by community. This will involve NGOs working in different areas using different approaches but still in line with W.H.O’s guideline.

So reader, WHAT IS YOUR SEXUAL REPRODUCTIVE HEALTH need?

You can answer in the comment section, tweet or DM us @glohf, send an email to info@glohf.org

Share with friends, siblings and yes, enemies 🙂

 

We count down to this years World AIDS Day celebrations. Are you in Abuja and you want to volunteer? Shoot us a mail at info@glohf.org.

Thanks

#BreastCancerAwarenessMonth The Pink month and the Breast

I love breasts!
Not new right? We all do. Still, I just had to let that out. I love them so much that I get hypnotized just by… well… *sigh*
That is not why we are here. We are here because of the enemy- breast cancer. Knowledge is power so let us arm ourselves.
Who is our friend?
The Breasts. The breasts are very important organs that find function for both motherhood and sexuality. Breasts are one of the things that put the ‘FE’ in FEMALE. Though some guys have breasts too, commonly known as’ man boobs’ (salute to Ricky Rozay #boss), the breast is more associated with the female gender.
Anyways, let’s get to business, the breast exists both in males and females though rudimentary in males. It consists of a hemispheric shaped area with the nipple sitting on the summit – the areola. As Kon from the Bleach anime would say:  it’s the shape of happiness. The appearance of the breast begins a new phase in a girl’s life and a lot of changes happen to the breast from the first time it buds till the last breath of the owner.
From infancy to just before puberty, there is no difference between the female and male breasts. With the beginning of female puberty, however, the release of oestrogen (a hormone), causes the breasts to undergo dramatic changes which culminate in the fully mature form. This process, on average takes 3 to 4 years and is usually complete by age 16.
On average, there are 15 to 20 lobes in each breast, arranged roughly in a wheel spoke pattern emanating from the nipple area. This is responsible for the tenderness in this region that many women experience prior to their menstrual cycle. In preparation for pregnancy each month, the breast feels lumpy, increases in size, becomes painful, firm, engorged and sensitive.
The breasts are least engorged 7-10 days after the beginning of menstruation, when it is best to perform breast self-examination (BSE).
About 80 – 85% of normal breast tissue is fat during the reproductive years. Ligaments called Cooper’s ligaments keep the breasts in their characteristic shape and position and support breast tissue. In old age and during pregnancy, these ligaments become loose or stretched, respectively, and the breasts sag.
Now we know about our friend – the breast, let’s examine the enemy.
What is breast Cancer? 
Cancer is a group of diseases that cause cells in the body to change and grow out of control. Most types of cancer cells eventually form a lump or mass called a tumor and are named after the part of d body where the tumor originates.
Breast cancer begins in breast tissue, glands for milk production, called lobules, & the ducts that connect the lobules to the nipple. The remainder of the breast is made up of fatty, connective, and lymphatic system. Most masses (tumors) are benign; that is, they are not cancerous, do not grow uncontrollably or spread, and are not life-threatening
How common is the enemy? 
Breast cancer is one of the leading female cancers in the world. In Nigeria and other developing countries, it is the leading cancer in females. It’s a disease that has ruined lives, families, caused depression and mental health issues.
A woman has a 1 in 8 chance of developing breast cancer at some point in her life.  It is the commonest cancer in Nigeria.
Who is at risk? 
  • Sex: breast cancer is more common in females though there are cases of breast cancer in males
  • Age: breast cancer is more common in ages over 40yrs though it’s starts earlier more often in the black folks (between ages 19-34yrs)
  • Genetic factors – Positive first degree family history
  • Hormonal factor: Early menarche and late menopause
  • Nulliparity ->  especially never pregnant above age 35
  • Use of hormonal contraceptives – Combined oral contraceptives for >3yrs continuously
  • Hormone replacement therapy
  • Obesity
  • Alcohol, Tobacco smoking
Please note that there is usually interplay of risk factors for breast cancer to develop. However, there are strong risk factors which when present,require pro-active self-assessment. The strongest risk factor is the genetics (family history of the disease). if an individual’s mother has/had/died from breast cancer, there is a high probability that she can have it, even at a young age. if you have a positive family history of breast cancer, a monthly breast exam (Between day 7-10 of your menstrual cycle) can be that stitch that will save you.
Breast cancers can be in-situ or invasive. In situ are confined within the ducts or lobules where they originated. Most breast cancers are invasive, or infiltrating – started in the lobules or ducts of the breast but have broken through walls to invade the surrounding tissue. Microscopic analysis of breast tissue is necessary for a definitive diagnosis of breast cancer type (insitu or invasive). The seriousness of an invasive breast cancer is influenced by the stage of the disease; that is, how far it has spread when it is first diagnosed.
How do we identify and overcome the enemy? 
Breast cancer typically produces no symptoms when the tumor is small and most are treatable (even curable). Therefore, it is very important for women to follow the recommended screening guidelines for detecting breast cancer at an early stage, before symptoms develop.
When breast cancer has grown to a size that can be felt, the most common physical sign is a painless lump. Less common signs and symptoms include breast pain; persistent changes like thickening or redness of d breast’s skin and nipple abnormalities. Other symptoms include spontaneous discharge (especially if bloody), nipple erosion, nipple inversion, or tenderness.
It is important to note that lump/pain (or lack thereof) does not indicate the presence or the absence of breast cancer.
Any abnormality in the breast should be evaluated by a doctor as soon as possible.
Now, Arm yourselves…
How to conduct a Self breast Examination (SBE 101)
Step 1
Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips
What you should look for:
Breasts that are their usual size, shape, and color
Breasts that are evenly shaped without visible distortion or swelling
Dimpling, puckering, or bulging of the skin
A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)
Redness, soreness, rash, or swelling
Step 2: 
Now, raise your arms and look for the same changes mentioned above.
Step 3
While you’re at the mirror, look for any signs of fluid coming out of 1 or both nipples (watery, milky, or yellow fluid or blood
Step 4 
Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast
Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together
Use a circular motion. Cover the entire breast from top to bottom, side to side-from your collarbone to d top of your abdomen and from your armpit to your cleavage. Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts.
For the skin and tissue just beneath, use light pressure.
Use medium pressure for tissue in the middle of your breast.
Use firm pressure for the deep tissue in the back
When you’ve reached the deep tissue, you should be able to feel down to your ribcage
Step 5 
Finally, feel your breasts while you are standing or sitting
Cover your entire breast, using the same hand movements described in Step 4
Asides the much advocated self breast examination, mammography is another reliable screening method and should be done every two years in women over 40yrs.
People with family history of breast cancer should seek physicians’ advice on appropriate time to have it done.
Early detection is key in the management of breast cancer.
If you discover anything unusual in your breast, seek professional help immediately.
If unfortunately a cancer was detected, follow your physicians advice. Don’t ignore it. Even if you are a very spiritual person, please combine your prayers with  their medical advice.
If, unfortunately, the breast has to be removed for you to live, I advise that you allow it. If you delay, it might get to a time when there is no choice but to take it off.  Please be wise in making decisions. You can always opt for a silicon breast implant. You should know that silicon implants feels good to both touch and taste (based on errm… experience *cough* *cough*)
Phewww! OK so that’s it! Breast cancer is a monster of sorrow, so ladies please be cautious and do breast examinations monthly. We have lost too many breasts and their owners to this monster.
Before I go…
Let me share this story with you…there was this 24 year old, fine, sexy, sweet girl who was diagnosed of stage 1 breast cancer in the left. At that stage, she could have had that breast removed and she would have most likely been fine. She opted for spiritual healing. She came back about a year later with stage 3 disease. At this time, removal alone could not help. In fact, there was no cure again at this stage. Now she has to deal with the pain of chemotherapy, hair loss and other issues associated with the management of the disease. A stitch in time could have saved her from all this. 
If I could rub a magic lamp and a genie came out to grant me wishes….my first would be for breast cancer and all other cancers to disappear.
Ladies, please, for the love of breasts, do this
And this
So that we can all keep smiling. We don’t want to lose any one else to the enemy.
Peace!
– Awoyokun M.D. (@awomike)