Contraception and Protection (Kinda the Opposite of Conception) PSA

Chapter 10 Contraception and Protection (Kinda the opposite of conception) PSA

• ADVANCE NOTICE: SCREENING OF “HERSTORY OF PORN” • In one sense, this is a regular class video, like all of the others which I show throughout the semester. In another sense, it is different. This video is very graphic, with many explicit sex scenes and close-ups of genitals, including many erect and ejaculating penises. Some explicit language is used. The current topic is pornography, and the sale and commercialization of sex, so this video is very appropriate. It was made by Annie Sprinkle, a very intelligent woman who freely chose to enter the realm of pornography. It is literally “Herstory” of her twenty-five years in the industry. It is a documentary, not a pornographic film. However, it includes clips of the best (and the worst) of over 150 of the adult movies which she has made. These not only document her personal history, and some of the changes that she has made, but they also illustrate several changes in the pornography industry in general. One thing is abundantly clear: Annie loves sex, and she loves making porn. She has no shame about her sexuality, and is currently doing a one- woman live show in which everyone is invited to view her vulva and witness her orgasm. She views her life as a wonderful journey. This is not the only view of porn, by a long shot. There are many people who feel that porn has ruined their lives. There are many who believe that porn is degrading to women (and to men), and/or that it encourages sexual violence or perversion. But be aware that Annie’s video is a celebration of porn. It is one view out of many possible views, but it is one that I feel we should at least consider. • I am giving this advance notice, so that you will not be completely shocked and surprised to just walk in one day and see this video. If it is against your personal or religious views to watch any pornography for any reason, then please exercise your right to stay home that day. If you come to class and start to be too upset, please feel free to close your eyes from time to time, or to leave the class. This is always your right. Remember that most of us have been brought up with a pretty negative view of sex and sexuality, and most of us have a lot of guilt over some aspects of this topic. Many of us have had negative sexual experiences in our lives as well. Note: We will not have small group discussions after this video, primarily because it is a long video. • ADVANCE NOTICE: SCREENING OF “HERSTORY OF PORN” PSA • Specific warning list. Most occur in very short film clips. (May not include everything.) • Lots of explicit sex scenes; heterosexual people having sexual intercourse • Lots of graphic close-ups of both male and female genitals • Lots of “cum-shots”; ejaculating penises • Group sex; switching partners • Shaving pubic hair • Masturbating with a toothbrush; masturbating with a sausage • Double penetration • Bondage; leather, whips, and chains; S & M • Anal penetration of a man with a huge dildo • “Hot amputee action” • Anal beads • Tampons • Woman dominating a man • Real piercing of the labia • Simulated “rainbow shower”; vomiting fantasy • Anilingus • Paddle and spanking • “Penis torture” • Simulated rape sequence • Vibrator and clitoral orgasm • Sex toys • Sex as a spiritual experience; Tantric sex; medibation (meditation/masturbation) • Double genitals of a FTM transsexual • Lesbian sex (Annie says she “became a lesbian” and this is real for her) • Mirror exercise and use of a speculum • Woman using a strap-on dildo with another woman • Annie’s “crygasm” • If you do decide to view the movie you should access the Canvas Assignment before class to PSA print the questions or access it during the class by computer to take some notes on the questions. They are more detailed than previous video questions.

• If you decide to NOT view the movie access Canvas to see the alternative to Herstory of Porn writing exercise. Historical and Social Perspectives • Evidence of contraception since the beginning of recorded history – Ancient Egypt – dried crocodile dung next to the cervix

– 6th Century Greece – eat uterus, testis or hoof of a mule

– 17 Century Europe – vaginal sponges soaked in solutions

– 18th Century Italy – Cassanova – lambskin condom U.S. Contraceptive Efforts • 1870s (Anthony) Comstock Laws – Secretary of the NY Society for the Suppression of Vice – Enacted laws prohibiting mailing of contraception information – Abstinence considered to be the only acceptable birth control • 1915: Margaret Sanger – 1915 – opened a clinic which illegally taught diaphragm use – Wrote, “The Woman Rebel” publishing birth control info – Arraigned for violation of the Comstock Laws – Fled to Europe Chief Justice Earl Warren Served from ‘53 – ‘69

U.S. Contraceptive Efforts • U.S. Supreme Court Rulings – Griswold vs. Connecticut, – Challenged Comstock laws, 1965 • Rarely enforced since the 50’s • Estelle Griswald opened a Clinic in 1961 • Arrested and fined $100 • Challenged up to the Supreme Court • Removed state control of legality of birth control by married couples as a matter of Right to Privacy • Constitution does not have a provision on Privacy – Eisenstadt vs. Baird, 1972 • Removed state control ”””” by single people ””””” • Resulted in a 9% drop in birth rate among 15-20 yo women Contemporary Issues on Contraception • 99% of US women have used contraception at one time • May need contraception for 30+ years • Worldwide contraceptive usage increases annually • Increase in contraceptive use among US teenagers – 85% Males/78% F used contraception at first intercourse – Still - too high a rate of teen pregnancies, births, abortions Contemporary Issues on Contraception • Allows planning for wanted children • Better physical health of mother and child – Fewer children, spaced further, fewer abortions • Insurance coverage of contraceptives increases over time • Reduced population growth, 1970~3.5 bil, 2015~7 billion – 63% use world wide (6% in Nigeria, 70% in China) • Wide diversity of views among cultures and religious groups – GOP tends to spend less on public BC, Dems more Nirmala Palsamy was named one of several, “Heroes of the Planet” by Time magazine in honor of her work to educate women about family planning and birth control in India. Sharing Responsibility for Contraception “It Takes Two” • As an individual – Ask about birth control before intercourse • “Uh, hmm, before we go there, uh, do you have protection?” – Always be packing • As a couple – Read and discuss options together – Attend a class or clinic together – Share expenses Choosing a Birth Control Method

• Find the one that is: – 100% effective – Completely safe – No side effects – Reversible – Separated from the actual act of foreplay and sex – Inexpensive – Easy to obtain – Usable by either sex – Not “memory” dependent Choosing a Birth Control Method

• Consider effectiveness and cost

• Consider ease of use and side effects

• Characteristics of ineffective use

• Be familiar with several types

But, does not prevent STI’s Contraceptive backup: be prepared and have emergency contraception on hand for when: Your primary form is unavailable or when using a new form of contraception that requires time to work: New use of BCP After forgetting to take BCP When combining BCP with other meds Early after IUD placement When you just plain want to be sure FYI Hormone-Based Contraceptives 4 Basic Types of The Pills Prevent ovulation 1) Combination pill – most common – Estrogen/progestin at a constant dose 2) Triphasic pill – – E/P in fluctuating doses 3) Extended cycle – 3 months between placebo pills – E/P at a constant dose – Seasonale

Create a cervical mucus plug, reduce ovulation frequency and thin the uterine lining 4) Progestin-only pill » Constant dose, no estrogen If you miss a pill, take it right away. Go back to your normal schedule.

If you miss two pills, call your doc AND use a back-up contraception method until you start a new cycle.

If you discontinue the pill start another contraceptive form right away

+ = Other Hormone-Based Contraceptives • Vaginal ring – estrogen/progestin – In the vagina for 3 weeks then 1 week off • Transdermal patch – E/P – Wear a skin patch for 3 weeks, 1 week off • Injected contraceptives – progestin only – Once every 12 weeks • Contraceptive implant – progestin only – Inserted under the skin for 3 years Barrier Methods

• Male Condom – most common first intercourse contraceptive – Sheath fits over erect penis – Used for over 15,000 years – “Rubber” production began in the 1800’s – The only method that also reduces STI transmission – Colored, flavored, ribbed – Lubed or dry – 5 years shelf life – Best used BEFORE penetration – May wish to retract foreskin 1st (a) the end of a plain-end condom needs to be twisted, leaving space at the tip, before it is unrolled over the penis. (b) a condom with a reservoir tip does not need to be twisted. • Male Condom – Good lubrication is important – Grasp condom base BEFORE withdrawal – Wrap in a tissue and toss, NOT into the plumbing Planned Parenthood video

Barrier Methods • Female Condom – Worn internally by a female – “Pretty good” for reducing STI’s • NOT as good as a male condom for reducing STI’s Vaginal Spermicides • Can be purchased in pharmacies without a prescription • Types – Foam – Sponge – Suppositories – Creams – Contraceptive film (VCF)

Cervical Barrier Devices – since 18th century

• Diaphragm

• Cervical cap

• FemCap

• Lea’s Shield

• ALL + spermicide

Intrauterine Devices

• ParaGard/Mirena • Most common reversible contraception in 3rd world • Very high satisfaction rate in US, 80% • Affect sperm motility and viability • Thicken cervical mucous • Alter endometrial lining • Impair tubal motility Thread + IUD can be expelled or migrate. Check the thread after each menstrual period.

Thread Emergency Contraception

• Slipped condom • “Ooops” sex • Missed BCP • Get hammered, then nailed • Forget that long term BC has run out • Not packing, but suddenly you should have been • Using a “natural method” poorly • Rape Emergency Contraception • Hormone Pills – Birth control pills best taken within 24 hours (95%), but OK up to 120 hours (<75%) of unprotected intercourse – Plan B, Next Choice – Ask any pharmacist • but you may need to ask more than one – Some may be reversible up to 72 hours • If you change your mind • Non-Hormone pill – Ella, up to 5 days but Rx only • Copper-T IUD – Most effective form of EC – Inserted up to 5 days after unprotected sex – But, mostly for a woman who will now continue with the IUD

Fertility Awareness Methods • Standard days method – No sex from days 8-19 of menstrual cycle, “Fertile Window” – Most effective natural method – “Cycle Beads” no sex on white • Mucus method – 1.5” stretch

• Calendar method – Avoid the “Fertile Time” • Basal body temperature method – AM temp drops before, rises after ovulation – But, sperm live several days – Marked in (0.1O) tenths, 0.5O is significant Sterilization • Most effective method (except abstinence) • Leading method in U.S. and the world • Pretty permanent, not EASILY reversible – So, reasonable consideration by singles or couples is needed • Little to no effect on sexual desire/performance Vasectomy

Tubal ligation

Essure/Adiana, a tiny coil that is used in female sterilization.

Inserted into uterine tubes through the cervix. Three months later the tubes are closed by tissue growth. Unreliable Methods of Birth Control • Nursing – Amenorrhea is common for a brief period after birth while breastfeeding – 80% ovulate before first period • Douching • Withdrawal – Difficult to judge when to withdraw – Anxiety may lower pleasure – Cowper’s gland fluid may carry sperm – Any sperm on vulva may travel into vagina/uterus New Directions in Contraception

• Males – Progestin/Testosterone implant or injection – Reversible vasectomy in clinical trials

• Females – Spray on contraceptive – Non-hormonal methods • Contraceptive vaccine, vaginal ring, spermicide – Spermicide to protect against STIs End.