For centuries, men and women have been trying to prevent the inevitable result of having sex, but only in the last fifty years have attempts at preventing pregnancy become relatively successful.

Abstinence, or not having sex, remains the most effective method of preventing pregnancy. But, for teens that choose to have sex condoms and birth control pills are the simplest and most common methods of contraception available. Other more exotic and more permanent methods are also available, and all have their pros and cons.

It takes "two to Tango", "two to make a thing go right", and it definitely takes two to make a baby! For anyone who has heard the "Birds and the Bees" talk, you'll remember that men and women have children by means of sexual reproduction. A male sperm, which contains the father's DNA, and a female egg,which containing the mother's DNA, are both needed to form the fertilized egg that grows into a baby. During sexual intercourse, the male releases millions of sperm into his female partner's vagina, and then the race is on! Each sperm races around to find the egg that is waiting to be fertilized. Since most women release only one egg per month, most sperm will not complete their task.

Once a single sperm meets an egg, they combine to form a fertilized egg, or zygote. This is the moment of conception, the Eureka!moment when two become one. No more sperm will be accepted by the egg,and the fertilized egg begins to grow within the female's body. It will be another 5-7 days before the fertilized egg attaches itself to the woman's uterus (or womb) and the woman becomes pregnant.

So why use contraception? The most obvious reason is to avoid or delay pregnancy. Many young women and men are interested in having sex long before they want the responsibility of having a baby. Women also have far more opportunities for education and careers than they ever have before, and may want to delay having a child until they have completed their education, started their career, or have met their "perfect"partner. Still others, both men and women, may not want to have a baby at all.

Just as important, some forms of barrier contraception may also protect you from acquiring sexually-transmitted infections(STIs), such as HIV, Chlamydia and Gonorrhea. Preventing STIs protects your from life-threatening infections like HIV, Syphilis and Hepatitis,and may also protect you from future infertility and/or chronic infection.

The Canadian website, Sexualityandu.ca,lists at least 17 different forms of contraception available.Individual birth control methods can be broken down into five categories: barrier, hormonal, chemical, natural, and permanent. The choice is yours to make.

BARRIER CONTRACEPTION methods include the male condom, the diaphragm, the sponge, and the recently invented female condom. All of these methods work to prevent the meeting of male sperm with the female egg, some more effectively than others. The male and female condoms form a near-impenetrable latex barrier, keeping male sperm on the man's side and the female egg on the woman's side...never to meet.

Only the male and female condoms are effective at preventing most STIs,including HIV and Chlamydia, because of the impenetrable nature of latex What about the birth control pill, a.k.a. the oral contraceptive pill (or simply, "The Pill")? This form of contraception falls into the HORMONAL category, along with injectable contraceptives, the birth control patch and the vaginal birth control ring. Normally, specific hormone levels in a woman's body signal for an egg to be released from the ovaries two(2) weeks before her next menstrual cycle, giving her body the monthly opportunity to become pregnant. These hormone-based birth control methods use synthetic hormones (similar to the body's estrogen and progesterone hormones) to trick a woman's body into not releasing an egg. If no egg is released from the ovary, then no pregnancy can take place.

Keep in mind, however, that no birth control method is perfect, not even the Pill. Although very effective when taken correctly, many women have difficulty remembering to take the Pill on a daily basis. If it is forgotten too many times in one month, a fertilizable egg may still be released, allowing for pregnancy.

Remember, the Pill doesn't protect you from STIs Newer methods of hormonal contraceptives may be easier to remember than taking the Pill everyday. An injectable contraceptive (Depo-provera®)is given by needle injection once every 12 weeks. A woman still needs to remember to take the injection, but only 4-5 times a year. Other hormonal choices include the contraceptive patch that is changed on the skin once a week, and the contraceptive vaginal ring that a woman keep sin her vagina for 3 weeks of the month. Like any drug, all hormonal contraceptives have potential side-effects that may or may not be well tolerated.

CHEMICAL CONTRACEPTIVES contain chemicals that act to kill male sperm before they can find the female egg. These chemicals are known as spermicides.They are only partially effective at preventing pregnancy, and may actually increase your risk of HIV if used without a condom. The IUD(or intrauterine device) is a medical device inserted into a woman's uterus that also helps to kill sperm inside the uterus and inhibits implantation of a fertilized egg. Although not permanent, one IUD maybe left in a woman's uterus for 3-5 years as an effective contraceptive.

For individuals unwilling to use other forms of contraceptives, NATURAL CONTRACEPTION is a riskier method of avoiding pregnancy. One method is to avoid having sex during the time of the month when a woman is most fertile, when her egg is released. Another natural technique is for the man to with draw his penis from the woman's vagina prior to ejaculation (releasing of his sperm). Neither method is very effective, but may be better than nothing.

Lastly, there are surgical forms of PERMANENT CONTRACEPTION available. The most common surgeries are tubal ligation in the female and vasectomy in the male. In either surgery, the tubes used to transport the egg or sperm are cut or surgically blocked to prevent future pregnancy. These permanent methods are typically used by families who do not want anymore children.

Whatever form of contraception you choose,make sure that you talk with your sexual partner about the risks of pregnancy and sexual infections before you have sex. And if your partner isn't mature enough to discuss these topics, are they really the person you want to be having sex with?

For more on birth control:

www.sexualityandu.ca

For more on abstinence:

www.silverringthing.com

Dr. Donald MacQuarrie is currently finishing a medical residency in Family/Emergency Medicine at the University of Western Ontario in London, Ontario. He was born in Halifax, Nova Scotia, raised in Fredericton, New Brunswick, and with his wife currently owns a home in Halifax. With no children and his wife still in Nova Scotia while he's in Ontario, their current contraceptive method of choice would appear to be abstinence -the silver ring thing.

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