Doin’ It Well

New to Whom?

Over the past year, you may have begun hearing about Implanon, a new form of birth control. Actually, America is not as cutting edge as we’d like to think. Implanon received FDA approval last year, but this method of birth control has been used in Europe and other places since 1998.  About 2.5 million women use this method worldwide.

Implanon is a progestin-only form of birth control. This is good news because it is an option for women who cannot use or do not want to use a birth control method containing estrogen (when they are breastfeeding for example). 

A soft, flexible rod that is about the size of a matchstick, Implanon is inserted by a trained health care provider into the underside of a woman’s non-dominant, upper arm. Insertion takes about one to two minutes and is painless. A local aesthetic may be used.

Once inserted, the hormone in Implanon is slowly released into the body and provides pregnancy prevention at a rate of 99 percent.  Pretty good, considering it lasts for three years and there is no maintenance needed. Once a woman has Implanon inserted, she doesn’t need to think or worry about pregnancy prevention again for three years.

Anatomy Lessons

Just to review: progestin prevents pregnancy by stopping ovulation (release of an egg), thickening the cervical mucous, which makes it more difficult for sperm to get through, and thinning the lining of the uterus.

Fertility returns once Implanon is removed; and for those who change their minds about getting pregnant before the three years are up, they can have Implanon removed whenever they want.

Spare the Rod

Reading about this method may remind you of its distant relative, Norplant, which was taken off the market a few years ago. Norplant consisted of six plastic rods inserted into the upper arm and provided pregnancy prevention for five years. Healthcare providers experienced difficulty removing Norplant in some patients due to the length of time it was left in place.

Because Implanon is only one rod and is inserted for only three years, the problems experienced with Norplant should be avoided. Only clinicians who have completed the insertion and removal training for Implanon can order the rods to offer patients.

Locally, Women’s Health Practice and Planned Parenthood are both offering Implanon.  It’s pricey because the cost for three years of contraception is paid upfront. Cost ranges between $750 to $1400, and additional visit fees may apply.  Call each facility to inquire about payment plans or sliding scale fee options.

Side effects may include…

Some side effects of Implanon are similar to other hormone methods of birth control, particularly progestin-only methods, and may include weight gain, acne (acne may improve), depression, menstrual changes, headaches and mood swings.

You can feel the Implanon rod by palpitating the skin of the inner arm, but it is not noticeable to the naked eye. So you won’t be called out as an Implanon user when walking around downtown or through the quad.  But either way, use it with pride!

Remember, Implanon, as with all forms of hormonal birth control, does not protect against sexually transmissible infections, including HIV. So condoms are still a must for those who are sexually active.

My body, my choice

As we mentioned, Implanon’s discrete placement means that women can use it without others necessarily knowing. This means that – unlike some other forms of birth control – it may be possible to use Implanon without the knowledge of roommates, parents, or even sexual partners. Implanon allows a woman to be in charge of her own fertility.

We at Doin’ It Well believe that reproductive and sexual health decisions are personal, and making them requires that we have the freedom to exercise our choice, and also that options are made available. And let’s be clear: reproductive choices do not squash the choices of other people; they allow everyone to make the individual choices that are right for them.

Although Implanon’s cost may make it an impractical method for some, increased options are always positive. At the same time, we have a responsibility to fight for affordable and accessible sexual health options for all people, including working-class folks. Choices for everyone will keep us all doin’ it well.

Oops!

Finally, we want to send a belated “Thank You” to RM who noticed our misspelling of Dr. Jocelyn Elders’ name. Our apologies to the good doctor, and thanks to our eagle-eyed readers!

Sex 411 Implanon Resources:

• Planned Parenthood: (217) 359-8022
• Implanon Patient Labeling & Consent Form: http://www.plannedparenthood.org/birth-control-pregnancy/birth-control/the-implant.htm
• Women’s Health Practice: (217) 356-3736

Kim Rice and Ross Wantland are professionals in the fields of human sexuality and violence prevention. Email them at buzzdoinitwell@yahoo.com.

Teens can play a powerful role in standing up for their health needs and educating each other. Locally, the Teen Awareness Group, a group of trained teenage peer educators, provides individual and group presentations about topics like birth control, STIs and healthy relationships to local schools and organizations. The impact is powerful: peers who would not otherwise receive this information are educated on options regarding decision making around sexual activity, birth control and medical care. They are taught skill building techniques to help with their refusal skills and assertiveness and are equipped to ultimately make decisions that are right for them.

With supervision, training and room to apply this information to their own environments, the peer educators become highly effective in their roles. In addition, teen educators are incredibly knowledgeable about how informed their peers are on sexual health issues; they are very aware of what kind of education needs to happen. This kind of teen-led model is really important if we are going to provide sex education that is both medically accurate and ultimately useful for those receiving it - teens.

Figuring it out

As advocates for accurate sex education, we are often confronted with questions about what kind of sex education is appropriate for children and adolescents. Generally, there is a fear that sex education - usually within junior high or high school - would be too advanced, morally inappropriate or replace the role of the parent. There’s also a dual assumption: “Children I know aren’t going to have sex, and those who are having sex aren’t children I know or care about.” Therefore, the question of sex education seems moot; it doesn’t impact our lives.

For those of us who were adolescents once, we should know better! Although some teens are not sexually active, most teens are experimenting sexually in some way. In addition, all children and teens are sexual individuals. Unfortunately for most of us, we had to figure out sexuality without assistance from educators, parents or other adults. How awesome would it have been if we were provided with information that would have helped us understand sex and make decisions that matched our values?

According to the Illinois Caucus for Adolescent Health (ICAH), 83 percent of Illinois residents believe that students in this state should receive information about birth control and sexually transmitted infection prevention. Almost 90 percent of Illinois residents believe that teens should not be sexually active, but they should know how to practice safer sex. In another study, ICAH found that 66 percent of sex education teachers do not teach about how to use condoms. Over half of these teachers didn’t even provide information about where to find birth control or sexual health-related resources.

Teens speaking up

“Adults” have fought for quite awhile over what is appropriate sex education for adolescents. Just recently, abstinence-only education - which is what it sounds like: abstinence and more abstinence - received an increase in funding from Congress. (You may remember the recent report released by the government that found that abstinence-only education was not an effective form of sex education.)

However, the voices that we haven’t been hearing from (mostly because adults aren’t listening) are the voices of teens. Teens should be dictating what their health curricula teaches them, if for no other reason than because these classes are specifically for them.

For the past three years, the Campaign for Comprehensive Sex Education (CCSE) has been working with community leaders, parents, teens and school representatives to promote medically accurate and comprehensive sex education in local schools. Last year, the Urbana School Board approved a health curriculum which drew heavily upon existing comprehensive sex education curricula.

For the fall, CCSE is planning to host a sex education resource fair to give parents, teachers, children, adolescents and other interested individuals an opportunity to hear what sex education could look like in CU, resources for talking with kids about sex and information about how we can all advocate for age-appropriate, comprehensive sex education in our community.

Teens we need YOU!

Do you enjoy our column? Are you interested in sexual health? Are you bored this summer? Then join us in sex education initiatives happening here in CU!

CCSE is in the beginning stages of planning the comprehensive sex ed. resource fair for the fall. Because comprehensive sex education affects teens, you are a necessary voice in this group. Join us at CCSE’s upcoming planning meetings; meet new people; learn more about sexuality; and help us plan the sex education resource fair.

Sex 411: Be a part of comprehensive sex education for CU!

• Planning meetings for CCSE will be held on July 2 and July 18 at 5:30 p.m. in the 2nd floor meeting room at Planned Parenthood of East Central Illinois - 302 E. Stoughton, Champaign. All are welcome.

• For more information on CCSE, contact Jen Cunha at jcunha2@uiuc.edu

Kim Rice and Ross Wantland are professionals in the field of sexuality and violence prevention. Write to them at buzzdoinitwell@yahoo.com

In honor of Father’s Day, Doin’ It Well thought it would be a good idea to address how fathers can be actively involved in a positive way in their daughters’ sexual development. A father (and other men who are primary caretakers to kids) has a huge responsibility of raising his daughter and may share a special bond with her as one of the earliest men in her life. Because of this, fathers have an important role in helping their daughters understand sex.
 

The Current Script
We’re all familiar with how differently girls and boys are raised when it comes to sexuality, sex education and gender roles. Boys are given condoms, told not to get anyone pregnant and, in general, have later curfews. Girls are told to avoid sending the “wrong message” and that they should be firm against sexual pressure from boys.

What strikes us about this script is it completely denies female sexual desire. It’s also really condescending to girls (they need to be protected … by men). Of course all parents want to protect their children, but when it comes to sexuality, this plays out very differently for girls. Also, this sets the stage for how women begin to view themselves as sexual people.

Take the example of “Purity Balls.” The intention of these events is to strengthen the relationship between a father and his daughter, and to encourage abstinence until marriage. A girl attends a dance with her father as her date, and vows to remain abstinent until marriage - for herself and for her father. As one father put it: “[In] today’s day and age, if the daughters are sexually active before they’re married that ceremony really is meaningless because the father’s not giving anyone away.”

Another example of how girls are taught that men “protect” them from sexuality and are also the guardians of all things sexual is a recent cell phone commercial. A father sits with a young man while his daughter gets ready for a date. The father lets the gentleman caller know that his picture/number is in his daughter’s cell phone. The father threatens, “It’s almost like I’m watching you, all the time,” which is clear code for “Don’t try anything with my daughter.”

In both of these examples, the message is that sexual drive for a teenage boy is normal and that the girl’s father will protect his daughter from it. These messages reinforce the idea that girls need men to protect them from boys’ sexual desire and to a lesser degree, their own sexuality. It also places an emphasis on a female’s sexuality as property and that her sexual “innocence” defines her worth.
 

What a Girl Needs
We have to wonder: why don’t fathers actually talk to their daughters about their romantic and sexual desires, feelings and emotions, and help her make sense of them? It would be awesome to see dads sitting down with their daughters before a date and asking them if they have questions about hand holding, kissing, or sex.

Simultaneously, helping both girls and boys understand sexuality when they’re children requires respect and patience. Some of us may shudder at the thought of our father-figure talking to us openly and honestly about sex. So fathers need to respect that children may not want to talk about this, and instead help them find an appropriate person to talk to. Sex education - when done right - is not about being salacious or creepy; it is about respecting our daughters as sexual beings who deserve whatever support or guidance we can give them.

Girls are denied their sexual desire from the moment they enter puberty. It’s not surprising that 10 or 15 years later, they enter sex therapy and state, “I just don’t desire sex as much as my husband.” We’re not suggesting that low desire is solely the result of early influences on how girls are expected (or not expected) to experience their sexuality, but we believe it plays a role. And we think it can be changed.

Dads can normalize their daughters’ sexual feelings as natural and wonderful and they don’t have to be acted upon unless she chooses. Dads can give their daughters the comfort level and skills to talk about sex, which would then make it easier for the daughters to bring the topic up with their partners. Fathers can provide information to their daughters about anatomy, reproduction, sexual desire, STIs, safer sex, birth control and emergency contraception, so they are equipped with all the information to become a sexually healthy adult. And while he’s at it, he can talk with her about his values about love, sex and relationships. It’s up to you, Dads!
 

Sex 411
Check out this great resource for dads and daughters: dadsanddaughters.org. They have suggestions on how to empower girls, how to talk to them about sexuality, body image and a range of other topics.
 

Kim Rice and Ross Wantland are professionals in the field of sexuality and violence prevention. Write to them at buzzdoinitwell@yahoo.com

Dear Kim & Ross, If one … partner (in this case a man in an opposite sex couple) is allergic to latex, are there any other options that would protect against HIV when it comes to penetrative sex?  I don’t think there are, but I thought you might be the one to ask…

A

Dear A,

That is an excellent question. Latex is a milky-substance derived from the rubber tree, and many everyday items contain some latex, including condoms or latex barriers (“dental dams”). Approximately 1-5% of the population has a latex allergy. The most common symptoms of a latex allergy include a mild rash and itching  As with most allergens, repeated exposure may increase the reaction, so it is important to recognize the symptoms early and get them checked out by your medical provider. If you experience itching or swelling in the genital, oral, or anal areas after sex while using a latex condom or barrier, you could have a latex allergy. At the same time, these symptoms could be a sign of an STI.  Either way, the sooner you talk with your doctor, the sooner they can help you figure this out.  

For male condoms, there are two types of non-latex condoms. Lambskin condoms, although effective at preventing pregnancy, are not effective at preventing STI transmission, including HIV. Lambskin condoms are porous, and while the pores are not large enough for sperm to get through, STIs are able to permeate.

Because some people are allergic to latex, the condom industry used polyurethane – a clear, odorless plastic – to develop two types of condoms: female and male. Polyurethane seems to be the best bet for a barrier that helps prevent STI transmission & pregnancy.

The Good News and the Bad News

Although twice as expensive, polyurethane condoms have many advantages over latex condoms. They are thinner, transmit heat better, and they don’t have the rubber odor of latex condoms. Oh, and did we mention that they are more resistant to sun-damage and they can be used with oil-based lubricants? Additionally, polyurethane technically is as good of a barrier at preventing pregnancy or transmission of STIs.

The bad news is that there is inconsistent data as to whether they work as well as latex condoms. The FDA requires that makers of polyurethane condoms inform consumers that latex condoms should be used unless there is a latex allergy. Most research has shown that polyurethane condoms have a slightly higher risk of slippage or breakage during sex. Because polyurethane is not as elastic as latex, the male condoms may not fit as snugly, leading to increased slippage. However, we should stress that polyurethane male condoms are only slightly less effective – in normal use – than latex condoms. Latex and polyurethane condoms are still the only birth control methods that help protect against HIV.

Live the Reality

Reality makes the female condom, which is essentially a polyurethane sheath placed inside the vagina or rectum. The open end has a large ring which remains outside of the body, keeping the condom in place. During sex, the penis only comes into contact with the inside of the female condom. Additionally, the female condom can be inserted up to eight hours before intercourse.  It can be a little intimidating to figure out how to use a female condom, but when used properly, it provides protection against pregnancy and HIV/STIs. Be sure to use enough lube, otherwise it can be a little noisy. Because all female condoms are made of polyurethane, they can be used by individuals who have a latex allergy. And although called the “female” condom, it can be used for anal sex between two men!

Double Trouble

As we were doing research, we found that in addition to polyurethane condoms, some experts recommended that a male partner could wear two condoms, one latex and one lambskin. The idea is that the two condoms could be worn so that a latex condom is still used AND the latex doesn’t come into direct contact with the allergic individual. Doin’ It Well is hesitant to recommend this method. Wearing two condoms can cause friction between the condoms that makes both of them more likely to break. Contrary to popular belief, two condoms do not work better than one!

Buying Polyurethane!

In a quick survey of area supermarkets and drug stores, most of the drug stores carry polyurethane male condoms. Although female condoms are supposedly available over-the-counter, they were not available at any of the stores we went to. The female condom is available at Planned Parenthood for those who are interested in using them.

Sex 411: If I’m looking for a non-latex barrier…

• Trojan Supra
• Durex Avanti
• Reality Female Condom
• Non-microwavable plastic wrap or cutting a polyurethane condom down one side can provide an effective, non-latex “dental dam.”

Kim Rice and Ross Wantland are professionals in the field of sexuality and violence prevention. Write to them at buzzdoinitwell@yahoo.com