I'm trying to find some reliable information on two related subjects. First, what is the optimal effectiveness of condoms as a birth control method (I'm not concerned with preventing the spread of STD's, since the couple in question is STD-free and monogamous). In most studies, the stated effectiveness of condoms has been skewed lower by several factors which competent users can eliminate.

So, by optimal, I mean the following conditions:

1. The condoms are latex.

2. The condoms are a reliable brand with good quality control (e.g. Trojan).

3. The condoms are full-thickness (as opposed to "super-sensitive" skinnier models).

4. The users use the condom properly; i.e. they apply it before any genital contact, leave space at the tip, roll it all the way down, and remove it properly immediately after intercourse, also avoiding any petroleum-based lubricants.

5. I'm concerned only with preventing pregnancy, not STD's, so you don't have to worry about any organisms smaller than sperm penetrating the condom.

In ideal circumstances, isn't latex impermeable to sperm? If so, then the failure rate of latex condoms, when used properly, should be a purely a function of the quality control of the manufacturer, right?

I would appreciate any reliable information anyone can pass on about this, along with references to text or on-line sources, if possible.

Second, I would like some non-biased information about the health risks and negative factors associated with taking birth control pills. I say non-biased because the American medical system has an unfortunate history of perpetuating gross negligence, misinformation, and abuse in women's health issues, and I tend to mistrust information from male-dominated medical institutions and research organizations.

Again, I would appreciate any reliable information with references to text or on-line sources, if possible.

Of course, the real question here is this: If an STD-free monogamous couple is in a very serious relationship (i.e. will probably lead to marriage, and then children, within two years), and they already plan to use condoms before marriage, is it really worth the health risk for the woman to use birth control pills, just to gain some extra measure of protection against a premature pregnancy?

At the risk of opening the floodgates, I would also welcome any intelligent opinions on this general question, but I am especially interested in some hard numbers on the first two questions.

The information on Planned Parenthood jives well with what I remember seeing in other places, such as the Physicians Desk Reference (unfortunately, the PDR doesn't seem to have this info in their online version and my copy is not at hand).

As the site says, in a year, 14 out of 100 women who use condoms as birth control will become pregnant, but the number drops to 2 of 100 with perfect use. This is not exactly a failure rate as it doesn't take into account breakages that do not result in pregnancy. It is also not a per-condom or per-use statistic. It also notes (as does the PDR if memory serves) that using spermicides (which many condoms have included) will increase the effectiveness. The PDR says the same, and notes that no solid data (at the time my version was published ... about 5 years ago) on exactly how much the increase is was available.


Planned Parenthood also has information about a number of other birth control methods. This part of the site has info about 'the pill' and it's benefits and risks.

[This message was edited by methos5000 on 05-21-03 at 08:42 AM.]

I agree, Planned Parenthood has the most excellent information about all types of birth control.
If you are using the condoms correctly, I believe they have a success rate of about 98%. The 2% is usually for condoms that break or slip during intercourse.
Also, latex condoms DO protect against disease as well, which is great. If you are only concerned with pregnancy prevention, you could look into lambskin condoms, which are more natural but do NOT protect against disease.
Spermicides certainly increase the effectiveness, but new studies are indicating that the spermicide may also break down the latex of the condom -so don't use old condoms! That, and some people are allergic to spermicide.
By all means, look through the site Methos referenced. They have all the information you could ever need about birth control.

As for risks, the only real risk associated with condoms is that you'll be allergic to it. The risk of pregnancy and disease is always there if you are having sex at all, no matter how you are protected.

Thanks for the info, folks. I checked out the Planned Parenthood site, and it had some great info about condoms. For example, I knew that you're supposed to pinch the air out of the space at the tip of the condom, but I never knew why it was so important (friction against air bubbles causes most condom breaks). Information like this helps make condom use much more effective.

Here's another site I found from the Center for Disease Control which has some great information, including correcting some common myths about condoms: Basic Facts About Condoms. This site and the Planned Parenthood site both mention an interesting study that dramatically confirms the effectiveness of condoms in preventing the spread of AIDS as well.

Yes, condoms certainly help prevent the spread of AIDS. That's kind of the whole point of condoms. I figured studies had been done, but I always thought the information was common knowledge...
Another good reason to pinch the end of the condom: when the male ejaculates, if there is no "reservoir tip" to catch the ejaculate, it will likely overflow around the top of the condom, or possibly even burst the condom (it does come out at, what, thirty miles an hour, they say?).
That CDC site is excellent as well. Full of info. I learned all of that in health class, but it's great that it's out there because people need to know how to protect themselves.

It's good to know the next generation is getting a good education; when I was in high school, the whole subject of sex education was still somewhat controversial (early 80's), and a lot of the studies on condoms and STD's we have now hadn't been done yet. Even today, though, there is still a lot of misinformation out there, and I don't know if the kind of specific information we've been discussing here is common knowledge.

A lot of students who are exposed to this information in middle school or high school don't really take it seriously until it's too late. I think it's great to be living in the Internet Age, and have so many wonderful information sources instantly available, including this site, which is the best question-and-answer forum I've seen on the Internet. I only wish more people would take advantage of the Internet to educate themselves and think more critically.

since we are talking about monogomous and committed couples here, i recommened you look into natural family planning. you may know it as the method supported by the catholic church. however, that is not the top reason why i use it, besides i´m a baptist, not catholic. don´t let that scare you from it though.
i used to be on the pill and after a while it very often gave me migraines. there are many reasons not to take the pill: it it linked to brest cancer, cervical cancer, liver tumors, blood-clotting defects, heart attacks, brain hemmorraing, depression, even temporary or permanent INfertility, not to mention it´s rather pricely per month.
i use it personally and love it! you can look under www.ccl.org
http://www.ccli.org/advantages/index.phtml
it is true that the majority of women do not know their bodies and have no idea of telling when they are ovulating and when it´s ok to have sex (i mean, assuming they are avoiding pregancy). when learned and the woman is not lazy about it or uninterested, it is about 98% effective and has absolutely no side effects.
there is a lot to say against the pill, a lot that the medical world doesn´t really seem to advertise. i don´t understand why they don´t endorse the NFP method, but they don´t for the most part. not only is it a method of accurately avioding or achieveing pregnancy, it is a very useful tool in your own personal health. for example, women who have very irregular cycles are often that way due simply to their diet or even the amount of light in their bedroom at night while they sleep. instead they go to the doctor who has no idea why her cycles is so irregular and he simply prescribes the pill- "your worries are over"
i would be glad to answer any more questions you have about it, there is a lot more i could say, you can email me to the address in my profile.

Yes, there are risks with any form of birth control, and some women should certainly not take the pill. But that is up to the woman and her doctor.
As for natural family planning, I have to say I don't put much stock in it myself. It takes an awful lot of knowing about your body, and bodies can be quite quirky.

The risks you mentioned are certainly real, but for the most part they affect older women with other medical conditions, women who smoke or are overweight. That is why the pill is certainly not for everyone, and not for anyone forever. But I have been using it for eight years with no ill effects.
I have not heard of the pill causing infertility, though the whole point of taking the pill is to not be fertile... Where did you get that information?
Yes, it can get pricey, but good insurance companies cover it, and if you qualify you can get it for free or at a reduced rate through Planned Parenthood (which already has it cheaper than anywhere else).

The important thing is to be educated, whether you put that education to use or not.

elexina,
i got all the information from my natural family planning book. i image you could also find it on their website as well, or i can fax it to you if you´re interested.
your body is most likely not as quirky as you think. if it is, there is probably a problem/reason for it. the basic nfp method is not complicated at all. you simply have to learn the couple of usually very obvious basic characteristics.

hassia,

It's nice to get a different point of view on the pill. This is exactly the type of information I was looking for, since I still believe most of the "common knowledge" about the pill is from biased sources. The pill may work fine for a lot of people (or at least it seems to in the short run), but I think women should think twice before altering their body's natural hormones. It's something the male-dominated medical field is all too eager to recommend.

There are more natural alternatives to the pill, both for birth control and for hormone therapy. I still need to do my own research on this before I can discuss specifics, but in the mean time, it's good to hear different sides of the issue from other people. Thanks for the input!

hi silent,
thanks, that feels good.
i would be happy to fax or email you a few pages from the book if you're interested. otherwise you can contact the ccli. i am glad to have been of service. i just wish more people knew about nfp.

Well, I said I was going to do more research on this subject and I have. I found an obstetrician/gynocologist named Uzzi Reiss who specializes in natural hormone therapy. It turns out that the hormones used in birth control pills, and most other hormone therapy prescribed by many doctors, are unnatural hormones in that they aren't chemically the same as the hormones in a woman's body.

All the studies that have found cancer and other serious side effects from birth control pills and other hormones are based on artificial hormones. Natural hormone therapy (i.e. using hormones identical to those made naturally in the human body) has never been shown to have these effects.

The only side effects from natural hormone therapy are short-term effects from over or under-dosing which are easily corrected by monitoring for symptoms and adjusting the dosage; these are the same symptoms that a woman would experience without any supplementation at all as her hormones become unbalanced due to changes in her life and her body. So natural hormone therapy is merely an attempt to bring the body back into balance by adjusting the levels of natural hormones that are already present.

Contrast this with birth control pills and other artificial hormones which are pushed by the pharmaceutical companies (and by most doctors) because they have unnatural chemical compositions which can be patented. Sure, they mimic some of the effects of natural hormones, but at what cost?

We hear a lot about increased risk of cancer, but did you know that progestin (one common progesterone-substitute used in birth control pills) also causes constricted arteries, significantly increasing the chance of heart disease? And that heart disease kills far more women than all cancers combined?

And with all the influence and pressure that the pharmaceutical companies exert on the FDA and the medical industry, who knows what side effects may go unannounced in the latest, greatest artificial hormones?

It turns out that strictly from an evolutionary perspective (and please don't interpret this as social commentary), women's bodies were designed for reproduction, as in having several kids starting from an early age. So any woman who doesn't follow this evolutionary design tends to get unbalanced hormones. Birth control pills can throw their bodies even further off balance.

This is not to say that women are doomed to be either be baby factories or be plagued with hormonal imbalances. Rather, any woman who doesn't have children, only has one or two, or waits a long time to have her first child, is more likely to have unbalanced hormones and is more likely to benefit from natural hormone therapy. With this therapy, she can live any lifestyle she wants and still have balanced, healthy hormones.

So, bringing this back to birth control, the birth control pill is an inherently unnatural drug for two reasons: one, it contains artificial hormones; two, it alters a woman's body to make her not get pregnant, exactly the opposite of what her body was designed for. Ultimately, this will probably unbalance a woman's hormones and cause serious long-term health problems.

There are other, far safer methods of birth control than this. If you are a woman, and you're using or considering using the birth control pill, please reconsider! I would strongly recommend reading Dr. Uzzi Reiss' book at the link I'll post below. I've already read this book cover-to-cover myself, and I gave it to my fiance to read.

She had been taking birth control pills in a previous relationship, and I asked her not to take them again until I could do more research. After reading Dr Reiss' book, I asked her not to take the pill, because I wouldn't want any woman I care about doing that to her body.

And yes, we are the couple I was talking about above. I'm telling you this so you can know how serious I am about this information. Please don't take the pill or let someone you love take it until you check out this basic info:

Advanced Nutrition and Hormone Based Gynecology

And here's the Amazon.com site for the book. Note, I'm not making any profit from plugging this book (and I'm not a big fan of Amazon.com's corporate philosophy). I'm listing the Amazon.com site because it also includes numerous 5-star reader reviews, so you don't just have to take my word for it:

Natural Hormone Balance for Women

silent,
you are missing the point. a person should neither alter his/her hormones, nor add to them! you don't need hormones -natural or artificial- to have effective birth control. besides, where does this guy even get these hormones? are they man-made? are they animal?
did he suck them put of dead people?

Euwwwwwwwww Hassia!

Suck from Dead People??

Just because the hormones are chemically the same as human hormones doesn't mean they come from humans. They can still be synthesized from other substances (certain plant extracts in this case), but the final product is chemically identical to human hormones. Unlike artificial hormones, many human hormones can be easily synthesized from natural substances, which means they can't be patented, and pharmaceutical companies can't get a monopoly on them.

Besides, people today are already unnaturally out of balance, from exposure to all the elements of the modern world. Using electric lights at night disrupts the circadian rhythm. Eating refined starches and sugars disrupts the body's natural insulin and blood sugar levels. I could go on and on, but the point I'm making is that the natural state you're talking about preserving hasn't existed for hundreds of years.

From an evolutionary perspective, natural hormone therapy is not unnatural. It's our modern environment that's unnatural, because human bodies haven't had time to adapt to it. Most people, men as well as women, are probably already hormonally unbalanced to some degree, and natural hormone therapy is simply an attempt to restore that balance, using the patient's natural reactions as feedback to find and restore the optimal hormonal levels.

Working with doctors who know the signs of balanced and unbalanced hormones, most patients quickly find a natural hormone therapy regimen that restores their natural balance, improves their energy, their mood, their general health, and slows their aging process, with no adverse side effects. So how could this be a bad thing?

As for family planning, it's much more effective when a woman has an extremely regular menstrual cycle, which is another benefit of natural hormone therapy, so I don't see how these two ideas conflict. Whether a woman is trying to get pregnant, or using family planning to avoid it, natural hormone therapy can help her by making her more regular, and healthier to boot.

[This message was edited by silenteuphony on 09-16-03 at 11:48 PM.]

I was on the pill for many years. The nice thing about taking the pill is you know EXACTLY when your cycle is going to start. This includes the benefit of shorter cycles and less pain. Taking certain birth control pills also helps women with acne to have clear skin.The risks of taking the pill after age 35 are much higher.One of the hardest parts of the pill... is remembering to take it. (my only problem with the pill )

Something you need to consider when you take the pill is the reaction it has with other medicines. St. Johns Wort, penicillin and a variety of other medications can cause the pill to be less effective.

I think it is very smart for you to research all of your options. You will be able to make an informed decision that is right for you.