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How To Get Birth Control: Choosing the Right for You

August 30, 2021 by Eve Leave a Comment

Accessing effective birth control may be one of the most important turning points in women’s lives. But birth control campaigners believe that still millions of women in the U.S. live in ‘contraceptive deserts’, meaning, women who could get pregnant but cannot get basic services to plan or avoid pregnancy.

Information is key to changing this, and we’re going to share with you the different kinds of birth control and how to get birth control that suits your body and lifestyle.

Key Takeaways

How you get your birth control depends on what type you need.
The best method for you depends on your lifestyle and sex life.
Have an honest conversation with yourself and a professional about intercourse to decide what’s best for you.
If you have more than one sexual partner, you will need a method to protect you from STDs, such as condoms.
Hormonal options, such as the shot, the patch or birth control pills, can have side effects. That is why they require a consultation with a doctor or nurse.
The most reliable methods of birth control for preventing pregnancy, such as the implant and the IUD, can only be accessed through a doctor.

How To Get Birth Control

How you get your birth control will depend on the type you would like to use, but many require an appointment and prescription. All birth control options should be available at a doctor’s office or Planned Parenthood clinic. A lot of methods are now also available online (especially for repeat prescriptions) and some you can buy in pharmacies.

Your options for access may also be affected by your insurance plans.

Local Pharmacy for OTC Methods

All barrier and topical methods, i.e. condoms, caps, and spermicide are available over the counter. They can be sourced from your local pharmacy or grocery store without prescriptions or appointments. Some brands of emergency contraception can be picked up at the drug store too.

Below is a complete list of over the counter contraceptives and some information:

Condom: A thin tube of latex stretched over the penis during intercourse to protect against STDs and conception.
Cap or diaphragm: A circular dome of latex that is inserted into the vagina before intercourse, preventing sperm from reaching the cervix.
Female condom: Condoms for women are latex tubes that are inserted into the vagina before intercourse.
Spermicide: A gel that is used during intercourse to kill sperm, also found on condoms.
Birth control sponge: A small sponge that is soaked in spermicide and inserted into the vagina before intercourse, preventing pregnancy.
Emergency contraceptives: The ‘morning after pill’, if you have had unprotected intercourse in the last 72 hours, stops conception.

How effective do you think condoms are at protecting against HIV?

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50%

90%

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condoms

Condoms are more than 90% effective against HIV

With a prescription from a doctor, you may also be able to get birth control pills or progesterone shots at a pharmacy, depending on what state you live in.

Your Doctor

Your doctor can offer you advice about all types of available birth control and can make an assessment on which option might fit your age, weight, health, and hormones, with the fewest adverse effects.

When consulting with a doctor or nurse about the best birth control for you, expect to discuss these important points:

Do you have particularly heavy or painful periods that you would like to manage with hormonal birth control?
Is it realistic for you to remember to take a pill at the same time every day?
Is it realistic for you and your partner to use a barrier method (cup, condom or diaphragm) every time you have intercourse?
Do you want to have children at some point in your life or soon?
Do you have casual intercourse and need protection from STDs?

Based on their assessment, the doctor or nurse will recommend a hormonal or non-hormonal type of birth control and tell you about costs.

Hormonal methods slightly increase the risk of blood clotting, especially if you have high blood pressure or certain underlying health conditions, which is why it is good to check in with a health professional [1].

The doctor or nurse may also give you a pelvic examination and should check your blood pressure, weight and BMI. During your first appointment, be prepared to be asked about some personal topics, like:

Are you sexually active?
How many sexual partners have you had in the last 12 months?
Have you had unprotected intercourse?
Have you ever had a sexual health check?
When was your last period?
Do you have any underlying health conditions, such as high blood pressure or diabetes?
Have you had any STDs before?
Have you been pregnant before?
Do you have any signs or symptoms of STDs?

Planned Parenthood

Planned Parenthood is a non-profit family planning service provider that operates in all states across the U.S. They have sexual health clinics that can be accessed at affordable prices and with all insurance plans, where you can book an appointment with a doctor or nurse. You can locate the nearest Planned Parenthood health office online via their website or give them a call.

Is It Safe To Get Birth Control Online?

Yes, birth control can be safely bought online. However, it is best to first have an appointment with a gynecologist or nurse, especially if it is your first time getting contraceptives.

Online birth control platforms, such as Nurx, now offer telemedicine—contraception to order. They sell various types of birth control, with delivery, and offer online prescriptions at low costs, but are not to be substituted with your regular health care.

Take a look at our Nurx review to see what other people think about the online birth control service or if you have questions.

Prescriptions are provided by the online private company following a medical review and consultation, based on the information you give them.

Keep in mind, online services are not meant to replace primary health checkups. Medical professionals say there is more to getting a prescription than simply inputting basic health information.

Once you are confident about your reproductive health, and you have found a birth control method that suits your body—ordering your contraception online may be a convenient way of accessing it.

How To Get on Birth Control

The best place to start, especially for a longer-term method, would be with a visit to the doctor’s office or an appointment with a sexual health nurse or doctor at a clinic. There you can have questions answered about birth control and get a health and reproductive health check-up, followed by a prescription.

Pick the Best Method for Your Needs

Some women like to control their menstrual cycles with hormonal methods like the pill due to heavy periods and bad PMS. Hormonal treatments can stop a woman’s periods altogether, which can be seen as a blessing for those who have struggled for years with their premenstrual symptoms.

Other women may find stopping their periods invasive and prefer their natural hormones and cycle. In which case, non hormonal birth control methods are more suitable.

Hormonal birth control has been known to create mood swings and is sometimes linked to depression [2]. Birth control pills may not be suitable for all women, particularly those who are overweight, who smoke, or have high blood pressure, due to a slightly increased risk of cardiovascular problems [3].

Condoms are essential for safe intercourse, especially if you have different sexual partners. However, condoms may not suit couples who require a more reliable and long-term method.

If you feel you can communicate with your partner during intercourse and share some of the responsibility of birth control, there may be more options available to you, such as the fertility awareness method. If male birth control options interest you and your partner, they would also be worth considering.

Consult a Doctor for Non-OTC Methods

You will need a prescription to access non-over-the-counter methods including birth control pills.

Getting a prescription usually involves an appointment with a doctor or nurse. It is safer to talk with a medical professional and get a check-up, especially if you haven’t done so before or for more than six months. They can also advise you on what birth control is covered by which insurance plans.

You can discuss what method of birth control might suit you best and how to use it, before getting a prescription to try it or ordering it online.

Non-Over-The Counter-Methods that should be available to you are:

The contraceptive pill: A daily pill containing the hormones progesterone or oestrogen (depending on the type) to stop ovulation.
The shot: An injection of progesterone taken once every 12 weeks to stop ovulation.
The patch: A sticky patch on the skin that releases hormones into the bloodstream and is replaced weekly.
Vaginal rings: A small plastic ring that is inserted into the vagina and releases progesterone and oestrogen into the blood.

The implant: A tiny straw-like implant is placed under the skin in your arm where it releases hormones for up to three years. It has to be fitted by a doctor or nurse.

IUD, intrauterine device: A small ‘t’ shaped piece of plastic or metal that sits just inside the uterus. There is also a non-hormonal type, which also has to be fitted by a doctor or nurse.

How To Get Birth Control Pills Without a Prescription?

It is not generally possible or recommended to use the birth control pill without a prescription in the U.S. Doctors give prescriptions following an appointment or you could speak to a doctor on an online platform.

How To Get Birth Control Delivered

Websites such as Nurx, Prjkt Ruby, Simple Health and the Pill Club offer free delivery of various types of birth control. Nurx delivers and provides services in 33 out of 50 states and has some pretty good reviews.

You can visit their websites to assess which company might work best for you, but first, be sure to read all about the best birth control delivery services here.

FAQ

A few of your most common birth control questions answered!

Can You Buy Birth Control Pills Over the Counter?

In most states, you can pick up birth control pills from the pharmacy, but first, you need to get a prescription. Because of this birth control pills are not technically an over-the-counter method.

How Can I Get Birth Control Refill Without Doctor?

When you have your ongoing prescription, you do not need to worry about seeing a doctor to get your refill each time. However, it is a good idea to review your birth control choice with a doctor every six months to one year and get a health care screening, regardless of what method you use.

Does Insurance Cover Birth Control?

Yes, since the Affordable Care Act, most insurance plans must cover all methods of birth control free of charge, by law. However, some plans only cover certain brands of birth control pills or generic versions. Your health care insurance provider can tell you which brands of birth control they pay for.

How To Get Birth Control Without Insurance

If you do not have insurance, you can still access many methods of birth control at the pharmacy when you have got a prescription. You may have to pay a fee for the appointment, or depending on your income, you could qualify for government care such as Medicaid that would cover the costs.

How Much Do Birth Control Pills Cost?

Depending on your insurance and benefits, as well as the brand that you use—birth control pills can cost between $0-$50 per month.

How Do You Ask for Birth Control?

The first step would be to book an appointment with your regular doctor, a gynecologist, at your local health office or Planned Parenthood center. They can help you to get a prescription that’s right for you. They can also offer you all types of birth control including the IUD, the implant or shot, as well the contraceptive pill.

Can I Get Birth Control Without My Parents Knowing?

All health providers are bound by terms of confidentiality, meaning they cannot talk to your parents about your medical record or your sex life.

However, if you are using your parent’s insurance plan and are concerned about how much information is available in the family, it is worth checking the insurance provider account to see what shows up on the itemized list. You can also inquire with them about the possibility of keeping information that is sensitive to you, private.

How Long Does It Take To Get Pregnant After Stopping Birth Control?

You can get pregnant as soon as you ovulate after stopping birth control. Even if you miss one pill, you are at risk of getting pregnant for the following week. Fertility studies show that around half of women who stop birth control get pregnant within the first 3 months and most women get pregnant within 12 months after discontinuing birth control [4].

Conclusion

Accessing birth control may seem a little intimidating to begin with. Online options may seem like an easier or friendlier option and have received some great reviews. However, always remember that they are not meant to replace your primary health care provider.

Ensure that you are fully informed on your choices to get the best contraceptive for you and your lifestyle. With all methods of birth control, accidents can still happen, so be flexible and ensure you know what to do in an emergency, such as the best place for you to source emergency contraception.

References

National Research Council (US) Committee on Population. “Contraceptive Benefits and Risks.” Contraception and Reproduction: Health Consequences for Women and Children in the Developing World., U.S. National Library of Medicine, 1 Jan. 1989, www.ncbi.nlm.nih.gov/books/NBK235069/.
Lewis, Carolin A, et al. “Effects of Hormonal Contraceptives on Mood: A Focus on Emotion Recognition and Reactivity, Reward Processing, and Stress Response.” Current Psychiatry Reports, Springer US, 7 Nov. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6838021/.
Shufelt, Chrisandra L, and C Noel Bairey Merz. “Contraceptive Hormone Use and Cardiovascular Disease.” Journal of the American College of Cardiology, U.S. National Library of Medicine, 20 Jan. 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC2660203/.
Girum, Tadele, and Abebaw Wasie. “Return of Fertility after Discontinuation of Contraception: a Systematic Review and Meta-Analysis.” Contraception and Reproductive Medicine, BioMed Central, 23 July 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6055351/.

Sex After Hysterectomy: How Long After a Hysterectomy Can You Have Sex?

August 30, 2021 by Eve Leave a Comment

Our reproductive organs and sex lives make up an essential part of self-image, affecting the way that we connect with ourselves. The removal of a sexual organ is a huge transition both physically and emotionally and could affect your identity. On the other hand, there’s more to life than sexuality alone, and it could be that your hysterectomy just saved yours.

But what’s next? What can I expect from my body now? How will my sex life be affected? In this article, we convert science into no-nonsense advice to answer a few common questions about sex after hysterectomy.

Key Takeaways

Many women’s sex lives are not negatively impacted by hysterectomy and report increased sexual desire and pleasure post-surgery.
The type of surgery you undergo and the extent to which your sexual organs have been removed impacts how much a woman’s sex life is affected.
If you have a reduced feeling towards sexual activity, you can try new ways of stimulation to reach orgasm. Many of the effects after surgery are temporary and will improve with time.
If you experience pain, notice bleeding, or feel you are not ready for sex, talk to your partner and a professional.

How Long After a Hysterectomy Can You Have Sex?

All types of hysterectomy are major surgery, and it is not recommended to have sex or insert anything into the vagina for at least six weeks after the operation. As with recovery from any operation, you should be good to yourself and go for regular follow-up appointments with your doctor.

Different levels of hysterectomy produce different hysterectomy side effects in both the short and long term, especially sex drive [1].

Total Hysterectomy

Total hysterectomy is the most common type of surgical removal. It removes the whole uterus, including the cervix. It could also involve having the ovaries removed and fallopian tubes, but usually, they remain in place [2].

Radical Hysterectomy

Radical hysterectomy means removing the uterus, the top part of the vagina, and the cervix and tissue surrounding it. It could also involve removing the ovaries and fallopian tubes. This type is most likely to affect female orgasm due to the shortening of the vagina [3].

When the ovaries are removed, there can be an onset of menopausal symptoms due to the body no longer producing the hormones estrogen and progesterone.

Partial Hysterectomy

In a partial hysterectomy, or subtotal hysterectomy, the top part of the uterus is removed, and the cervix remains intact. This type is the least likely to have an adverse effect on a woman’s sex life, as the cervix is often synonymous with sexual pleasure during penetration.

Post Hysterectomy Sex: What to Expect

During climax, female orgasms involve noticeable uterine contractions. Having no uterus means that sex and orgasms feel different to before. However, there is a good body of evidence suggesting that many women actually enjoy their sex lives more after hysterectomy [4].

Pre-surgery symptoms in women with reproductive health conditions can involve a lot of pain and discomfort. Following the operation, many women feel relief from this, meaning that their sexual activity increases. They may therefore experience a higher sex drive and more intense orgasms.

Desire and Feelings About Sex Will Vary

While some women experience increased sex drive and improve sexual sensation after hysterectomy, post-op feelings towards sex vary greatly. Some women have less interest in sex because they feel less desirable or experience changes in their hormone levels that negatively impacts their sex lives.

Coming to terms with the changes may also cause stress or relationship problems that affect sex life.

Overall, though, studies show that up to 75% of women have a positive post-op experience, reporting that their sexual functioning improved after hysterectomy [5].

Be Safe

Take good care of yourself, especially if you are recovering from a hysterectomy. There is no better time for safe sex. Barrier protection methods are the only types of contraception that protect you from bacteria and sexually transmitted infections. See more on the effectiveness of condoms and for a guide on how to use female condoms.

Start Slow

A common adverse effect of hysterectomy that causes reduced sexual sensation is vaginal dryness. Finding new ways of sexual function and satisfaction is important in this case.

To increase arousal and increase clitoral stimulation, it is a good idea to source a good water or silicone-based sexual lubricant for your dry vagina and ask your partner to start slowly. Indulge in more foreplay and oral sex to get you started and experiment with new toys.

As recovery progresses, many women find that their natural lubrication returns; however, to begin with, more foreplay and extra lubrication can ease penetration and help to avoid pain and sexual problems.

Stop If You Feel Pain

Should you experience any pain during penetration, ensure you alert your partner and stop having sex straight away. Similarly, if you notice bleeding, stop having sex and be sure to update your physician.

Does a Hysterectomy Affect Sexuality?

Hysterectomy can cause changes in the way women feel about their sexuality, which is the most common reason for sexual problems.

According to psychological studies, premenopausal women found that becoming infertile made them feel less desirable or sexy. When women are exposed to attitudes suggesting that their ability to bear children is what makes them feminine or sexy, their body image may be affected negatively, leading to a change in sexuality post-hysterectomy [6].

This is a normal emotional side effect and can be worked on through counseling with a psychosexual therapist if it is affecting your sex life.

Questions to Ask Your Doctor About Sex After a Hysterectomy

Ensure you are fully kept in the picture by your medical provider about what to expect. Below are a few points to get you thinking:

When Can I Have Sex Again?

It is not recommended to have sex until at least six weeks after a hysterectomy. Follow the guidelines recommended by your doctor or surgeon as different surgical methods produce different healing times.

Depending on how you feel, it might take longer than the recommended healing time to be comfortable with having penetrative sex again. Be kind to yourself, and allow more recovery time if needed.

What Changes Should I Expect?

The most common side effects from a hysterectomy in the short term are pain, heavy bleeding, and vaginal discharge. Other after-effects include menopause-like symptoms such as hot flushes. As recovery progresses, these symptoms should go away.

Your periods will stop, which for different women induces different emotions. Many women feel that this is a blessing, while for others it may seem like a loss of womanhood. Post-hysterectomy, it is no longer possible to get pregnant.

Other long-term side effects can include urinary incontinence or prolapse, but the prevalence of this is low, and it depends on other factors [7]. Your doctor may recommend pelvic floor exercises to reduce these negative long-term effects. There are also available hormone replacement therapies for treating menopausal symptoms.

How Can My Partner Help?

You may need a lot of emotional support and careful intimacy following a hysterectomy to get your confidence back with your sexual relations. It is also a time, if you experience changes in your sexual sensation, for you and your partner to try new ways for you to reach orgasm. This could require care and patience from your partner.

FAQ

Hysterectomy is a sensitive topic that may create a whirl of internal questioning. Here are a few common quandaries for those who are post-hysterectomy.

Can You Have Sex Without a Uterus?

Yes. When you are healed from your operation, there is no reason not to have sex without a uterus.

Can You Have Oral Sex After a Hysterectomy?

Yes. In fact, if you are experiencing differences in arousal following hysterectomy, having more oral sex with your partner would be a great way to increase sexual satisfaction.

Is Sex Different After a Hysterectomy?

Your feelings towards penetrative sex might change. If they do, it would be a good idea to use the opportunity to experiment with new positions, extra foreplay, and new toys. You can read about outercourse for some fresh ideas!

Is Sex After a Partial Hysterectomy Different from After Full Hysterectomy?

There is likely to be differences in your sexual experience depending on the type of hysterectomy you have undergone. A total hysterectomy means the removal of the cervix. This may affect female orgasm because the cervix is known for sexual satisfaction from pressure during penetration.

Total hysterectomy can also mean getting ovaries removed, which produces hormones. When these hormones are no longer produced in the body, there can be a decrease in women’s sex drive.

Partial hysterectomy does not include removal of the ovaries or the cervix. Therefore, it is the type that is least likely to affect your sexual experiences.

Is Sex Better After a Hysterectomy?

It can be the case that your sexual function improves after hysterectomy. If you have experienced pain and discomfort from an illness before the surgery, you may be more comfortable having sex when you have healed from the operation.

Depending on your personal circumstances, you may also experience a loss of your sexual identity or hormonal changes post-hysterectomy leading to decreased sex drive.

Remember to communicate with your partner your feelings about this. Just talking about it could make you feel better. Medical professionals should also be kept in the picture, as it is possible to get hormone treatments that can offset the changes.

Is Vaginal Dryness Normal After a Hysterectomy?

Yes, vaginal dryness is a common short-term side effect post-hysterectomy that should decrease with time.

Conclusion

Hysterectomy is a major surgery that, like with any major surgery, has some serious physical side effects for women during the aftermath. Remember to be kind to yourself and take it slow, sexually or otherwise, and this is a highly sensitive time for you.

Your fertility does not have to define you, but you may still have some creeping conflicting feelings to sex after a hysterectomy. If this is affecting your day-to-day life, your relationships, and your sex life, talk to a mental health professional such as a sexologist and your partner about sex.

References

[1] Kozłowski M;Gargulińska P;Ustianowski Ł;Lewandowska R;Kwiatkowski S;Cymbaluk-Płoska A; “Sexuality of Women after Gynecological Surgeries.” Healthcare (Basel, Switzerland), U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/33050505/.

[2] “Hysterectomy (Surgical Removal of the Womb).” InformedHealth.org [Internet]., U.S. National Library of Medicine, 23 Aug. 2018, www.ncbi.nlm.nih.gov/books/NBK525761/.

[3] Danesh, Mahmonier, et al. “The Effect of Hysterectomy on Women’s Sexual Function: a Narrative Review.” Medical Archives (Sarajevo, Bosnia and Herzegovina), AVICENA, D.o.o., Sarajevo, Dec. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4720466/.

[4]Bradford, A., & Meston, C. (2007). Sexual outcomes and satisfaction with hysterectomy: influence of patient education. The journal of sexual medicine, 4(1), 106–114. https://doi.org/10.1111/j.1743-6109.2006.00384.x

[5]Rhodes JC, Kjerulff KH, Langenberg PW, Guzinski GM. Hysterectomy and Sexual Functioning. JAMA. 1999;282(20):1934–1941. doi:10.1001/jama.282.20.1934

[6]Iżycki, D., Woźniak, K., & Iżycka, N. (2016). Consequences of gynecological cancer in patients and their partners from the sexual and psychological perspective. Przeglad menopauzalny = Menopause review, 15(2), 112–116. https://doi.org/10.5114/pm.2016.61194

[7] I;, Bohlin KS;Ankardal M;Lindkvist H;Milsom. “Factors Influencing the Incidence and Remission of Urinary Incontinence after Hysterectomy.” American Journal of Obstetrics and Gynecology, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/27593942/.

10 Types of Outercourse That Can Improve Your Sex Life

August 18, 2021 by Eve Leave a Comment

Any time the word ‘sex’ comes to mind, many people automatically assume this means penetration. Outercourse (non-penetrative sex) is a credible alternative to penetrative sex that you can try out today. Not only is outercourse easy to learn, but it is also as enjoyable as sexual intercourse.

Let’s look at various forms of outercourse that you can practice, its benefits and risks below.

Key Takeaways

Outercourse is any sexual activity that does not involve penetrative intercourse. Abstinence and outercourse are not the same things.
Only you can define what outercourse means to you.
There are over 10 different types of outercourse couples can explore.
Outercourse has many benefits, and you can choose to practice outercourse with your partner for any reason.
Some types of outercourse have risks associated with them. You can contract STDs or HIV if you fail to use proper protection. Although remote, there’s still a risk of pregnancy involved.

What Is Outercourse?

Outercourse is any sexual activity that does not involve intercourse [1]. It can mean different things to different people. While for some outercourse is anything that isn’t penis-in-vagina penetration, for others it means no penetration of any kind. Penetration can also mean using fingers or sex toys.

Many people choose outercourse as an alternative way to get intimate with their partners. It’s often a safe method for preventing pregnancies and the spread of sexually transmitted diseases (STDs).

There is no standard definition for outercourse. Only you and your partner can draw those boundaries, and only you can define what it means to you.

Outercourse vs Abstinence: Are They the Same Thing?

Outercourse isn’t the same thing as abstinence, although in both cases you avoid any sexual act that involves penetration [1].

In simple terms, abstinence refers to an individual’s decision to avoid all forms of sexual acts. Abstinence may allow some outercourse depending on the individual.

There isn’t a cut-and-dry definition for abstinence as well. You have the freedom to decide what it means for you.

How To Have Outercourse: 10 Outercourse Ideas

Let’s look at some ways you can explore and enjoy outercourse with your partner.

Talk About Fantasies

Talking about your fantasies with your partner can exponentially increase sexual satisfaction and spice up your sex life [2][3]. A little dirty talk is an excellent way to practice outercourse and build intimacy.

Stick to Just Kissing

Kissing is another simple form of outercourse. Don’t write off its potency. It’s an amazing way to build intimacy and has many health benefits [2][4]. You can discover what turns both you and your partner on by kissing other parts of their bodies besides their lips.

French and deep kissing are some exciting non-penetrative sex ideas you can add to your sexual repertoire.

Massage

A sensual massage can be quite satisfying for couples who want to explore each other’s bodies [2][5]. You can set the scene using mood lighting and rose petals. Scented candles also help set the mood for a massage.

You can tell each other which body parts you love getting rubbed and explore different sensations at the same time.

Use Sex Toys

To some couples, sex toys are a valid outercourse option. With virtually hundreds of different types of toys in the market, you and your partner can enhance your sex life by using them for genital stimulation [2].

A classic sex toy example is the vibrator. You can use it to stimulate your partner’s clitoris or head of the penis, helping your partner have an orgasm and reach deep sexual satisfaction.

Dry Humping

Dry humping involves sexual activity that can stimulate a person’s sexual organs without penetration. A good example of this sexual activity is intergluteal sex [2].

As a couple, you can grind each other’s bodies for pleasure. Also, you can test out different sex positions and role play. Besides that, you can grind to the rhythm of your favorite song and add a bit of dirty talk to spice it up.

Mutual Masturbation

Masturbating together can also produce an orgasm for both of you [2]. You can use this opportunity to show your partner where you like to be touched and what feels good. Besides that, you can add kisses and talk dirty to each other for added pleasure.

Manual Stimulation

You can take turns in pleasing each other to orgasm using clitoral stimulation, fingering or hand jobs. Manual stimulation can be deeply pleasurable to people who enjoy it [2].

To keep things spicy, you can use different lubes on your partner to see what sensations they enjoy the most.

Oral Sex

Giving your lover a good blowjob or cunnilingus can be extremely pleasurable [2]. You can explore their genitals with your mouth and tongue, using different strokes and motions to see what they enjoy the most. You can also combine oral sex with kissing and nipple stimulation for even more variety.

Anal Sex

This sexual act is deeply pleasurable, and yes, it involves some penetration [2]. People of all genders can find anal penetration to be pleasurable, including gay and heterosexual couples. Anal play creates an exciting opportunity especially for couples that want to try out new penetrative sex ideas and toys.

Anal play can go hand in hand with other activities such as kissing, oral sex and mutual stimulation to produce maximum pleasure.

Experiment with BDSM or Other Fetishes

You can also experiment and enjoy kinky activities that involve spanking, bondage, humiliation play and other forms of BDSM activities [2]. Most of these activities do not involve penetration. Having a fetish for a person’s armpit is perfectly fine!

You can discuss and plan kinky activities with your partner, including a safe word for when any of you need to stop. You can also combine BDSM with a sex toy, talking about fantasies and enjoying mutual masturbation.

Outercourse Benefits: Why Do It?

Is outercourse worth the trouble when you could just have ‘real sex’ instead?

Well, yes. In some circumstances, outercourse can be a valid alternative for sexual intercourse. Anyone can practice outercourse, regardless of your sexual orientation or gender [3]. Besides that, you can also practice outercourse even if you’ve never had sex before.

Here are some reasons couples can consider for outercourse:

If you or your partner aren’t ready for sex.
Outercourse also works in case you aren’t interested in sex with your current partner.
If you want to learn new things and mix it up a little, you can experiment with outercourse.
If you haven’t brought condoms or are taking birth control.
If you want to avoid pregnancy or you’re tracking your fertility.
If your partner has body dysphoria, a painful health condition or trauma that prevents penetration.
If you want to understand your body (or your partner’s body) more.
Outercourse can act as foreplay. You can use sex without penetration to prepare for sexual intercourse.
If you want to bond and build more trust with your partner before intercourse.
If you want to have safer sex and avoid the risk of contracting STDs.

Outercourse Risks

Many types of outercourse are safe. However, some of them bear health risks to you and your partner. Here are some examples:

Anal and oral sex involves contact with your partner’s genitals and the exchange of bodily fluids. Outercourse of this kind carries the same risks as vaginal sex. You can contract many of the same STDs as sexual intercourse if you don’t use protection [3][7].

Use barrier methods like condoms, dental dams or gloves to prevent contact with genital fluids [9]. Here is more information on how to get birth control and how to use non hormonal birth control.

Even where you don’t swap fluids, the risk of STD transmission remains. Skin-to-skin contact can still spread HPV and herpes.

Although remote, there is some risk of pregnancy. Sometimes during mutual masturbation and sexual stimulation, semen (cum) comes into contact with the vagina. To prevent pregnancy, you can use other forms of birth control besides condoms [8].

If you want to enjoy having outercourse with your partner without having to worry about STDs, get tested regularly. Also, avoid genital contact and contact with each other’s sexual fluids where possible.

FAQs

Here are answers to some questions you may still have about outercourse.

Can You Get Pregnant from Outercourse?

Outercourse is nearly 100% effective at preventing pregnancy. Non-penetrative outercourse prevents pregnancy by avoiding vaginal sex. Kissing, dry humping, oral and anal sex can’t cause pregnancy.

There remains a remote chance pregnancy can happen but under accidental circumstances. Although you may not have had vaginal sex, if semen accidentally comes into contact with the vulva, sperm can make its way up your vagina and fertilize an egg [8].

This can only happen if:

Semen accidentally drips or wipes into the vaginal opening.
A sex toy or fingers with wet semen come into contact with the vagina during sexual acts like mutual stimulation or sex toy play.
Semen drips into the vulva from the anus after anal sex.

To eliminate this risk, avoid all contact with semen and pre-ejaculate. Where possible, use spermicides after such an accident occurs. You can also learn how to do the pull out method to avoid spilling semen.

Can You Get STDs from Outercourse?

While outercourse has the lowest risk of transmission, you can still get STDs from it. Some types of outercourse that require any form of penetration carry the same risk of STDs as vaginal sex, anal and oral sex without using barriers [8]

To reduce these risks:

Practice outercourse without penetration. Avoid anal and oral sex.
Ensure that you and your partner test for STDs regularly.
Seek treatment and recover fully before resuming your sexual activities.
Wear protective barriers like condoms, dental dams and latex gloves when performing oral and anal sex. Here is more information about the effectiveness of condoms in birth control.
Stick to one partner or abstain from any risky sexual behavior.
Where possible, avoid genital contact and keep sexual fluids away from each other.

Non-Penetrative Sex and HIV

Non-penetrative sex is safe sex, especially where you and your partner don’t spill sexual fluids. Kissing, massage, fantasies, kinky fetishes and other options that do not involve penetration are unlikely to spread HIV from one person to another [6].

However, where anal and oral sex are involved, use a condom. Keep sexual fluids away from each other and your risk of contracting HIV is minimized.

Can I Have Non-Penetrative Sex After a Miscarriage?

Yes, you can have non-penetrative sex after miscarriage.

If you and your partner want to get intimate soon after a miscarriage, you can begin with outercourse. Doctors recommend you wait at least two weeks after your bleeding has stopped before any penetration, including tampon use [8].

Outercourse provides some sensual options to try out with your partner before you can go back to having normal sex.

Conclusion

Outercourse is a thrilling way to change your sex life. However, it’s essential to remember that it still bears some risks of STDs, HIV and pregnancy. Ensure to use protective barriers and birth control methods to keep yourself safe.

After a miscarriage, take your time to get back into sexual intimacy with your partner. Give your body and mind time to heal from the loss before going back to your normal sex life. Until then, enjoy some stimulating outercourse to help you warm up.

References

“University Health Service.” Abstinence | University Health Service, uhs.umich.edu/contraception-abstinence.
Blunt-Vinti, Heather, et al. “Show or Tell? Does Verbal and/or Nonverbal Sexual Communication Matter for Sexual Satisfaction?” Journal of Sex & Marital Therapy, vol. 45, no. 3, 2019, pp. 206–217., doi:10.1080/0092623x.2018.1501446.
Bakaroudis, Maria. “Outercourse: Exploring Nonpenetrative Forms of Pleasurable Safer Sex.” American Journal of Sexuality Education, vol. 9, no. 3, 2014, pp. 381–397., doi:10.1080/15546128.2014.944736.
Wlodarski, Rafael, and Robin I. Dunbar. “Examining the Possible Functions of Kissing in Romantic Relationships.” Archives of Sexual Behavior, vol. 42, no. 8, 2013, pp. 1415–1423., doi:10.1007/s10508-013-0190-1.
Barreto DM, Batista MVA. Swedish Massage: A Systematic Review of its Physical and Psychological Benefits. Advances in Mind-body Medicine. 2017 Spring;31(2):16-20.
Patel, Pragna, et al. “Estimating per-Act HIV Transmission Risk.” AIDS, vol. 28, no. 10, 2014, pp. 1509–1519., doi:10.1097/qad.0000000000000298.
Cobb, J C. “Outercourse as a Safe and Sensible Alternative to Contraceptives.” American Journal of Public Health, U.S. National Library of Medicine, Aug. 1997, www.ncbi.nlm.nih.gov/pmc/articles/PMC1381109/.
“How Soon Can I Have Sex after a Miscarriage?” Bakersfield Pregnancy Center, 30 Apr. 2020, wehelpyou.org/how-soon-can-i-have-sex-after-a-miscarriage/.
“Condom Fact Sheet In Brief.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 4 June 2021, www.cdc.gov/condomeffectiveness/brief.html.

The Pull Out Method—How To Pull Out and Is It Safe?

August 17, 2021 by Eve Leave a Comment

More technically known as the withdrawal method or coitus interruptus, the pull out method is a form of birth control. You don’t have to buy anything, and there aren’t any pills. It does require some self-control and, perhaps more importantly, trust.

In short, during intercourse, the man removes his penis from the vagina before ejaculation. The majority of sperm are transported with ejaculation, so in theory, withdrawing should lower the chances of pregnancy. In practice, it’s difficult and has a number of downsides, not least a vulnerability to sexually transmitted infections.

Key Takeaways

The withdrawal method:

Has a failure rate of about 20%.
Doesn’t protect against STDs.
Is best used with another method of birth control.
May not increase sexual satisfaction.
Relies on man’s ability to pull out.
Can be a source of anxiety.

What is the PullOut Method?

This technique is one of the most straightforward birth control methods. Before the moment of his climax, the man removes his penis and ejaculates outside the vagina.

Withdrawal is considered a natural or traditional form of birth control. It’s also a non-hormonal form of birth control, which is practiced all over the world.

The pull out method is often used when another form of contraception isn’t available, or there is some cultural objection to birth control methods.

How Effective Is Pulling Out?

Withdrawal is as simple and basic as it comes, and best of all, it’s free. Unfortunately, it’s not super effective to prevent pregnancy.

When medical professionals talk about the effectiveness of different forms of contraception, they may speak about ideal use and typical use. Ideal use means the way it theoretically should be done, without any mistakes.

Typical use is the real-world use, often less than ideal. This is particularly relevant to the pull out method, relying as it does on one partner’s ability to pull out at the right moment [1].

If you were to use the pull out method perfectly as your primary method of birth control, it would fail to prevent pregnancy 4% of the time [2]. On the other hand, in a one-year term, typical use of the pull out method will result in pregnancy 20% of the time. Compare that to the effectiveness of condoms, which can be as much as 90% effective.

The wide difference between ideal and practical use indicates the difficulty of using the withdrawal method. Additionally, the sperm content of pre-ejaculate means that even when performed perfectly, pregnancy is still possible [3].

How Often Does Pregnancy from Pulling Out Occur?

When having sex without any form of contraception, an unplanned pregnancy will result about 85% of the time. The 20% failure rate of the pull out method isn’t so bad by comparison. However, that still may be gambling with higher stakes than most people are comfortable with.

A big portion of the failure rate is due to contraceptive failure when the man was unsuccessful in pulling out at the right moment. If the man has a harder time with that aspect, the chances might increase by a lot.

Despite being used so often, the withdrawal method isn’t considered a reliable way to avoid pregnancy.

It might also be worth noting that one potential advantage, greater sexual pleasure, may not actually result from the pull out method [4]. When surveyed, women generally preferred to use a condom. Some men preferred the withdrawal method, but others did not.

How Effective is Pulling Out and Birth Control?

The withdrawal method is commonly used with other birth control methods. That can mean a couple of different things.

First, it might mean that you use the withdrawal method with a second method of contraception at the same time for extra protection. One common combination is withdrawal and the fertility awareness method, in which the woman’s fertility is tracked.

Alternatively, many people use another method of contraception when they can but fall back on the pull out method when there isn’t anything else available. Most people know how to get birth control, but they may not want to ruin the moment. Otherwise, they use other contraceptive methods, such as condoms or the pill [5].

It’s difficult to judge the effectiveness of using a combination of contraceptive strategies involving withdrawal. The risk of pregnancy is probably lower than using withdrawal by itself, but without some statistics, it’s difficult to judge.

Pull Out Methods Pros and Cons

While withdrawal isn’t as reliable a method of contraception as some, it does have a few advantages.

Pros

Cons

How To Pull Out Correctly

Learning how to pull out in time is a skill, and it can be developed like one. Once you know what you’re doing, it is a lot easier.

One key component is accurately gauging how close the climax is, so you can pull out in time at the right moment. That may just require some experimentation until you learn what that feels like. Otherwise, there are a few tips that can make pulling out more effective.

Be Consistent

This means picking a moment to pull out consistently. Once you’re familiar with your own progression of arousal, find a moment that is the right one for you to pull out. Focus on finding that moment and pulling out every time.

Urinate Before Sex

Most sexually active men have experienced this at one point or another. The feeling of pressure that indicates a need to urinate can feel very similar to the build-up to climax. Urinating first means there won’t be any confusion and mistiming as a result.

Ejaculate Away from the Vagina

The thing is, evolutionarily sex is meant as a way to make babies, whatever other meaning it has gained. As a result, both a man’s and a woman’s body do their best to make sure that is what happens. While sperm normally can’t survive outside the body, it’s not unknown for pregnancy to be caused by ejaculation landing on the vaginal opening.

Just make sure that you move your penis away vagina before ejaculating, and it shouldn’t be a problem.

Use an Ovulation Calculator

While unprotected sex can result in pregnancy at any point, a woman may be more likely to conceive at certain points of her cycle. The fertile window, as it’s called, are the few days leading up to and including the day of ovulation.

An ovulation calculator is a form of the fertility awareness method. Using one, you can track a woman’s fertility. Alternatively, outercourse is another method of contraception that can be used on fertile days.

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ovulation calculator

When used correctly, an ovulation calculator can reduce the chance of conceiving over the course of one year

Use Other Forms of Birth Control

While there is a chance of pregnancy even if the male partner pulls out, that can be reduced by using other methods of birth control. We’ve already mentioned the fertility awareness method, but other options include:

Spermicides.
A birth control sponge.
A cervical cap.
IUD.

Ensure Both Partners are STD-Free

The withdrawal does not protect against sexually transmitted diseases in any meaningful way. There are much better ways of producing your sexual and reproductive health. While kids might not be part of the plan in the short term, if you want to have that choice open to you down the line, your reproductive health should remain a priority.

What To Do If the Pull Out Method Fails

As withdrawal is one of the least reliable contraceptive methods, it’s not unusual for it to fail. When it does happen, there are a couple of birth control options available to reduce the chances of pregnancy.

Emergency Contraception

There are two types of emergency birth control that are usually used [6].

The first is the morning after pill, usually a medication called levonorgestrel [7]. It’s a single pill that can be used up to 72 hours following unprotected sex. It’s more popular, but can result in:

Nausea.
Vomiting.
Tiredness.
Other side effects.

The second type of emergency contraception is a copper IUD. It’s not hormonal and generally has few side effects. It also can be used up to five days after unprotected sexual activity. However, it has to be inserted by a doctor and is considered less convenient.

FAQ

Can I Get Pregnant Even if He Pulls Out?

Yes. There is a small amount of sperm in pre-ejaculatory fluid, so it’s possible to become pregnant even if the male partner withdraws in time.

How Does the Pull Out Method Fail?

The pull out method usually fails to prevent pregnancy in one of two ways. The first is the result of sperm in pre-ejaculate fertilizing an egg. The second occurs when the withdrawal is mistimed.

What Are the Chances of Getting Pregnant During Ovulation Using the Pull Out Method?

It’s difficult to judge the risk, as there are a variety of factors at play. The failure rate of the pull out method is about 20%. However, the chances of getting pregnant rise dramatically during ovulation.

Conclusion

Withdrawal may not be terribly reliable, but it is much more effective than no birth control method at all. To most doctors, a good birth control method also provides some protection against sexually transmitted diseases, which the pull out method definitely does not.

As a result, it’s important to be careful when using the withdrawal method. It may be best used with someone you know to be free of STDs.

References:

Posted under Health Guides. Updated 7 February 2020. +Related Content. “Contraception: Success and Failure Rates of Contraceptives.” Center for Young Women’s Health, 7 Feb. 2020, youngwomenshealth.org/2009/11/03/success-and-failure-rates-of-contraceptives/.
Gynecology, Department of Obstetrics &. “Use of Withdrawal and Unintended Pregnancy Among Females… : Obstetrics & Gynecology.” LWW, Sept. 2013, journals.lww.com/greenjournal/Fulltext/2013/09000/Use_of_Withdrawal_and_Unintended_Pregnancy_Among.16.aspx.
Killick, Stephen R, et al. “Sperm Content of Pre-Ejaculatory Fluid.” Human Fertility (Cambridge, England), U.S. National Library of Medicine, Mar. 2011, www.ncbi.nlm.nih.gov/pmc/articles/PMC3564677/?_escaped_fragment_=po.
Tadayon, Mitra, et al. “The Relationship of Male Condoms and Withdrawal Contraceptive Methods with Female Sexual Function and Satisfaction: a Cross Sectional Study.” International Journal of Reproduction, Conception, Obstetrics and Gynecology, 1 July 2016, ma-rc.ajums.ac.ir/_ma-rc/documents/%D9%85%D9%82%D8%A7%D9%84%D8%A7%D8%AA/94/The%20relationship%20of%20male%20condoms%20and%20withdrawal%20contraceptive.pdf.
Nguyen, Nghia, et al. “Correlates of Use of Withdrawal for Contraception among Women in Vietnam.” BMC Women’s Health, BioMed Central, 29 Apr. 2020, bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-020-00957-z.
Gemzell-Danielsson, Kristina, et al. “Emergency Contraception.” Taylor & Francis, 25 Feb. 2013, www.tandfonline.com/doi/abs/10.3109/09513590.2013.774591.
“Levonorgestrel: MedlinePlus Drug Information.” MedlinePlus, U.S. National Library of Medicine, medlineplus.gov/druginfo/meds/a610021.html.

Hysterectomy Side Effects, Procedures and Recovery: What You Should Know

August 7, 2021 by Eve Leave a Comment

Hysterectomy is one of the most common operations performed on women, with around 600,000 American women going through the procedure each year.

A hysterectomy can be a life-saving operation in critical cases. However, it is essential for you to make an informed decision as the procedure is associated with very severe hormonal changes.

Here, we will discuss the procedural details of a hysterectomy and answer the common questions about the procedure side effects.

Key Takeaways

In most cases, hysterectomy is done to cure fibroids in the uterus, pelvic inflammatory disease, and cancer.
The process can be radical, total, or partial depending on the areas of the reproductive system removed along with the uterus.
Abdominal hysterectomy is the most critical procedure, whereas laparoscopic and vaginal hysterectomy has lesser risks.
Women stop having menstrual periods after hysterectomy and can not get pregnant. The removal of the ovaries along with the uterus results in surgical menopause.
Recovery time can be between 4 to 8 weeks depending on the surgical process and the health condition of the patient.

What Is a Hysterectomy?

The primary purpose of the procedure is to remove a woman’s uterus, often due to heavy periods caused by fibroids. The uterus is a muscular and hollow organ located in the pelvis where the egg is fertilized and the human embryo develops during pregnancy.

The type of hysterectomy performed depends on the condition of the patient. In a total hysterectomy, both ovaries and fallopian tubes are removed with the uterus. After a hysterectomy, the patient will no longer have menstrual periods and will be unable to get pregnant.

Do you think the rate of hysterectomies in the US are on the rise or decline?

On the rise

On the decline

Relatively the same

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hysterectomies

Hysterectomies are actually on the decline as the health industry is finding ways to deal with most underlying conditions non-surgically.

What Is the Most Common Reason for a Hysterectomy?

The most common reason for a hysterectomy is heavy vaginal bleeding resulting from fibroids and chronic pain. Medications are unable to control these symptoms.

Reasons for a hysterectomy include:

To remove large benign fibroids in the uterus which can cause heavy bleeding, anemia, chronic pelvic pain, or bladder pressure [1].
Cancer in the reproductive organs or precancerous conditions in the cervix or endometrium [1].
Advanced stages of pelvic inflammatory disease (PID).
When the uterus drops through the cervix, in a condition known as uterine prolapse [2].
Pain or bleeding due to endometriosis, which causes the uterine lining to grow outside the uterus cavity.
Adenomyosis, where the inner lining of the uterus grows into the uterine muscles [3].

Types of Hysterectomies

There are three types of hysterectomies, which one is best for the patient depends on their condition.

Radical Hysterectomy

In radical hysterectomies, the uterus is removed along with the adjacent conjunctive tissues and some portions of the upper vagina. The pelvic lymph nodes may also be dissected, however, the ovaries and fallopian tubes remain intact [4].

Radical hysterectomy can be done through multiple surgical approaches. It is conducted through a pelvic incision or small abdominal incisions, and requires acute surgical precision to avoid heavy bleeding.

The approach taken depends on the diagnosis, age, and medical history of the patient—personal preferences are also taken into account.

Total Hysterectomy

During a total hysterectomy, the cervix and uterus are removed, ensuring there is no risk of the development of cervical cancer in the future. Sometimes one or both ovaries and the connected fallopian tubes are removed. This is called a bilateral salpingo-oophorectomy.

Partial Hysterectomy

This surgical process removes the uterus but the cervix remains intact. However, the patient may opt for the removal of the cervix to reduce the risk of cancer progression. The method of surgery depends on the stage of cancer, the patient’s age and health, and the size of the uterus.

Types of Hysterectomy Surgeries

The type of surgical procedure followed will depend on the patient’s condition. Your healthcare provider will discuss the options with you for the best outcome.

Abdominal Hysterectomy

Abdominal surgery is the most common approach used for removing the uterus and the other reproductive organs.

In the first process, a vertical incision is made between the navel and pubic hairline. Then, a horizontal cut is made just above the pubic hairline. The method is mostly used to remove uterine fibroids.

Abdominal hysterectomy results in more visible scarring and a longer recovery period. The exact surgical process can vary depending on the size and shape of the uterus and possible tumor [5].

Which type of hysterectomy surgery is most commonly used?

Vaginal hysterectomy

Abdominal hysterectomy

Laparoscopic hysterectomy

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hysterectomy surgery

Abdominal hysterectomy is the most common type of hysterectomy surgery

Laparoscopic Hysterectomy

This is a minimally invasive surgery for removing the uterus. The cervix is left intact, resulting in a shorter operating time and faster recovery period for the patient. The chances of abdominal wall infections are much lesser when compared to abdominal hysterectomy [6]. The procedure is also termed as robotic hysterectomy.

During the process, a tiny camera or laparoscope is inserted into the abdomen through a small incision below the navel. Specialized equipment is inserted from two or three smaller incisions made in the abdominal wall, assisting in removing the uterus through the vagina. The surgeon conducts the operation by observing the details on a screen.

Vaginal Hysterectomy

In this process, the uterus is surgically removed through the vaginal opening. Quite often, the cervix is also removed.

The advantage is a quicker recovery period and minimum visible scarring, with many patients able to go home on the same day after a few hours in the recovery room. Vaginal hysterectomy also has lesser risks and is a cost-effective process.

Laparoscopically assisted vaginal hysterectomy is an advanced process, however. A laparoscope with a small video camera is inserted from an abdominal incision. This provides additional aid during the surgery.

This process is recommended for women with an enlarged uterus, endometriosis, or a history of prior pelvic surgery. Such conditions can complicate a standard vaginal hysterectomy.

Due to the use of extra electronic equipment, the cost of this procedure is higher.

Side Effects of a Hysterectomy

There can be both long-term and short-term side effects of hysterectomy surgery. The side effects depend on the patient’s medical history and overall health conditions. Obesity can increase the risks of bleeding and infections after abdominal hysterectomy [7].

The reason behind the surgery is another factor leading to various complications. For example, a patient undergoing a hysterectomy for cancer treatment is more likely to encounter side effects related to the cancer that other patients won’t experience.

What Are the Short Term Side Effects of a Hysterectomy?

In the preliminary stage of recovery, patients might notice bloody vaginal discharge, pain or swelling at the incision area, and constipation. In some cases, this can be similar to tubal ligation side effects. Few other short-term side effects may occur within 30 days of the surgery. These include the following:

Blood loss leading to the requirement of blood transfusion.
Development of infections near the incision or in the lower abdomen.
Pain from damage to surrounding pelvic organs like the bladder, urethra, and also the blood vessels and nerves.
Venous thromboembolism or formation of blood clots in deep veins [8].
Numbness in the incision area or in the legs.
Side effects related to anesthesia.
Obstruction of bowel movements.

In cases where hysterectomy is accompanied by oophorectomy (removal of the ovaries), short-term side effects can include menopause symptoms such as the following:

Hot flashes
Insomnia
Vaginal dryness
Night sweats

Another aspect of hysterectomy is the emotional side effects. Since the removal of the uterus means no further possibility of getting pregnant, it can have a strong mental impact on some women. The onset of early menopause after a hysterectomy can also bring about a sense of loss.

Some studies have indicated that adverse psychiatric effects can include:

Psychosis
Depression
Agitation
Anxiety
Reduced psychosexual functioning [9].

However, recent studies have concluded that there is no direct relationship of hysterectomy with anxiety, depression, or other mental health issues [9]. Such symptoms can be related to other issues like the stress of hospitalization, fear of surgical procedures, prolonged illness, and other personality issues.

What Are the Long Term Side Effects of a Hysterectomy?

Hysterectomy can result in an increased risk of pelvic organ prolapse. Since the uterus is absent, other abdominal organs like the bowel or the bladder can push down on the vagina, requiring further surgeries.

There is also the chance of fistula formation between two organs after hysterectomy. Although rare, a fistula is an abnormal tract that can form between the bladder and the vaginal wall, or the ureter and the vaginal wall, causing urinary incontinence.

When the ovaries are removed, there can also be issues related to sex life. Symptoms can include vaginal dryness, pain during sex, and decreased sex drive in some women. These results from the change in estrogen levels.

However, preoperative sexual counseling and advanced preparation for tackling the postoperative sexual side-effects are helpful [10].

Hysterectomy Risks and Potential Complications

When the ovaries remain intact after hysterectomy, the patient can experience menopausal symptoms within 5 years, resulting from the change in normal blood supply to the ovaries.

With the ovaries removed, the production of the female reproductive hormones will stop, causing the patient to enter surgical menopause immediately.

Women entering early menopause have a higher risk of cardiovascular disease, Alzheimer’s disease, and osteoporosis [11]. This is more relevant for younger women and those reaching menopause before the age of 50. Hormone replacement therapy to replace the lost estrogen can be effective in such cases.

Hysterectomy can also lead to the development of abnormal blood fat levels and high blood pressure [12]. The risks of coronary artery disease and congestive heart failure are also shown to be higher.

Some gynecologists are suggesting women opt for nonsurgical alternative therapies for treating conditions like fibroids, endometriosis, and prolapse before choosing the surgical route.

Hysterectomy Recovery: What To Expect

Hospital stay duration depends on the hysterectomy method and your overall health condition. After an abdominal hysterectomy, the patient may need to spend a few days in the hospital to recover. Medicinal treatment continues in this period to aid in healing.

Generally, the recovery period for vaginal or laparoscopic hysterectomy is between 3 to 4 weeks. Since abdominal hysterectomy is a major surgery, the recovery period is between 6 to 8 weeks, depending on the overall health of the patient. Limit all activities during this period and follow the home care instructions provided by the surgeon.

Patients can also experience fatigue for a period of 6 weeks after the procedure. Vaginal bleeding or discharge can also be experienced for 8 weeks. Taking some precautions can help the muscles and tissues in the area heal. These include the following:

No driving for two weeks
No lifting of heavy objects
No pushing or pulling of heavier objects
No sexual intercourse.

To aid the process of recovery, the following steps are beneficial.

Light exercise in the form of walking
Proper rest and sleep
Keeping the incision area clean and free from infections
Taking all prescribed medicines in the right manner
Avoid all forms of tight clothing
Avoid activities like swimming until the scar tissue has healed completely.

Most women should be able to return to their work routine within 5 to 6 weeks. Still, strenuous activities like heavy exercise or contact sports should not be resumed without the doctor’s permission.

It is important to maintain a healthy diet and avoid smoking to help the body recover. Suffering from constipation is common after the surgery. A high-fiber diet and proper hydration should help with bowel movements.

Will I Experience Body Changes After Uterus Removal?

The main change will be the stop in menstrual periods while removing the ovaries can trigger premature menopause symptoms. Once fully recovered, you will possibly feel healthier after a hysterectomy as the primary symptoms will be gone.

There is no evidence to suggest that hysterectomy affects sex drive or increases weight after surgery. Weight gain is usually due to the lack of activity after the surgery. Some women have also found sex after hysterectomy to be more enjoyable.

However, every woman is different and some may face problems related to sexual functioning in the long run. These can include difficulty to reach orgasm, loss of vaginal sensation, and lack of vaginal lubrication. In such cases, the doctor can help with a minimally invasive treatment plan.

What To Ask Your Doctor Before Hysterectomy

It is important to ask your doctor the right questions once a hysterectomy is suggested so you can learn about the exact reasons behind its need and the changes you can expect afterward. You can also discuss nonsurgical treatments as alternatives.

Some common questions are listed below. As all patients are different, you may find some of these not relevant to you.

Why is a hysterectomy needed for me?
Which type of hysterectomy is being recommended and why is it the best option?
Can my condition improve without surgery?
Are there any surgical and non-surgical alternatives?
Since I am nearing natural menopause can it improve my condition without surgery?
What are the changes I can expect after surgery?
What are the risks involved with the process?
How long will it take to recover after a hysterectomy?
What are the chances of your complete recovery after surgery?
Will any additional treatments be required after the hysterectomy?

FAQ

A few FAQs regarding hysterectomy are discussed below.

What Effect Does a Hysterectomy Have On a Woman?

The negative effects can be both physical and mental. However, full recovery from these effects is possible. The primary positive effect is recovery from prevailing conditions like cancer or large fibroids.

What Happens to Your Body After a Hysterectomy?

Since the process removes the uterus, you will stop menstruating and will be unable to carry a pregnancy. You may also experience early menopause or similar symptoms. The removal of the ovaries during the process brings about immediate menopause.

What Are the Negative Side Effects of Hysterectomy?

There are short-term effects, such as blood loss and infection, and long-term negative effects, including pelvic organ prolapse and fistula formation.

Does Partial Hysterectomy Cause Early Menopause?

If the ovaries remain after the surgery, they will continue to produce hormones. However, the change in hormonal flow can lead to early menopause within a few years.

What Are the Side Effects of a Hysterectomy At 40?

As we have already mentioned, some research has suggested early menopause brought about by hysterectomy can lead to cardiovascular problems and osteoporosis.

Conclusion

With rapid advancements in medical technology, hysterectomy comes with lower complication rates and considerably lower expenses. Even so, it is a serious and permanent process, so make sure that it is a medical necessity for you.

Learn how the procedure is going to affect the various aspects of your life. That way you will be able to handle the changes easily.

References

Stewart, Elizabeth A, et al. “Reassessing Hysterectomy.” Minnesota Medicine, U.S. National Library of Medicine, Mar. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3804006/.
Shekhar, Chander, et al. “Prevalence, Sociodemographic Determinants and Self-Reported Reasons for Hysterectomy in India.” Reproductive Health, BioMed Central, 2 Aug. 2019, reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-019-0780-z.
“The Experts Weigh In: Is a Hysterectomy an Effective Endometriosis Treatment?” Endometriosis : Causes – Symptoms – Diagnosis – and Treatment, 11 Sept. 2018, www.endofound.org/the-experts-weigh-in-is-a-hysterectomy-an-effective-endometriosis-treatment.
Marin, F, et al. “Types of Radical Hysterectomies : From Thoma Ionescu and Wertheim to Present Day.” Journal of Medicine and Life, Carol Davila University Press, 15 June 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4197497/.
Konishi, Ikuo. “Basic Principle and Step-by-Step Procedure of Abdominal Hysterectomy: Part 2.” Surgery Journal (New York, N.Y.), Thieme Medical Publishers, 26 Dec. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6554018/.
Einarsson, Jon I, and Yoko Suzuki. “Total Laparoscopic Hysterectomy: 10 Steps toward a Successful Procedure.” Reviews in Obstetrics & Gynecology, MedReviews, LLC, 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC2673000/.
Osler, Merete, et al. “Body Mass and Risk of Complications after Hysterectomy on Benign Indications.” OUP Academic, Oxford University Press, 5 Apr. 2011, academic.oup.com/humrep/article/26/6/1512/2914011.
Swenson, Carolyn W, et al. “Risk Factors for Venous Thromboembolism after Hysterectomy.” Obstetrics and Gynecology, U.S. National Library of Medicine, May 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4418022/.
Chaudhary, S, and T K Bhattacharyya. “PSYCHIATRIC EFFECTS OF HYSTERECTOMY.” Medical Journal, Armed Forces India, Elsevier, Jan. 1995, www.ncbi.nlm.nih.gov/pmc/articles/PMC5529799/.
Bradford, Andrea, and Cindy Meston. “Sexual Outcomes and Satisfaction with Hysterectomy: Influence of Patient Education.” The Journal of Sexual Medicine, U.S. National Library of Medicine, Jan. 2007, www.ncbi.nlm.nih.gov/pmc/articles/PMC2857776/.
“Early Menopause Predictor of Heart Disease.” ScienceDaily, ScienceDaily, 4 Oct. 2019, www.sciencedaily.com/releases/2019/10/191004105615.htm.
“Hysterectomy Alone Associated with Increased Long-Term Health Risks.” ScienceDaily, ScienceDaily, 3 Jan. 2018, www.sciencedaily.com/releases/2018/01/180103101142.htm.

Fertility Awareness Method and Natural Family Planning

August 2, 2021 by Eve Leave a Comment

Birth control pills historically revolutionized the rights and opportunities of women around the world. But for anyone who has taken hormonal contraceptive treatments, you understand that there can be annoying side effects.

Natural family planning, commonly known as fertility awareness or the calendar rhythm method, has been gaining popularity as an alternative method of family planning and is excellent for those trying for a baby. In this article, we discuss what’s involved in natural family planning to help you make a decision right for you.

Key Takeaways

Natural family planning (NFP) methods are a way to track signs of fertility throughout your menstrual cycle. You have sex at specific times to either avoid pregnancy or try to get pregnant.
When used correctly, natural family planning methods are an effective way of avoiding pregnancy, especially when used in conjunction with other birth control options such as condoms or caps.
It takes 3–6 months to learn this method.
Due to it being a hormone-free method, there are no physical adverse effects, and it is a good way to understand your level of fertility or reproductive cycle.
Always use condoms as well to avoid sexually transmitted infections (STIs).
Fertility awareness based methods are a good way to get in touch with your body’s natural functioning. They can help couples who are trying to conceive.

What Is the Fertility Awareness Method?

Also known as the symptothermal method, this method means tracking the signs that show what stage you are in your menstrual cycle to either avoid getting pregnant or to increase your chances of pregnancy.

How Does It Work?

You have to keep a daily record of your fertility signals, such as your temperature and the fluids coming from your cervix, or cervical mucus. There are a few different methods to ensure you are tracking your cycle effectively, detailed in the next few sections.

Methods of Natural Family Planning

The main ways to track your fertility are the:

Calendar method.
Cervical mucus method.
Standard cycle days method.
Basal body temperature method.

Natural family planning is typically most effective if you use all of these methods at the same time. It involves gathering your own personal data for a few months to figure out when you are at your most and least fertile.

Menstrual Cycle and Ovulation

During your menstrual cycle, there are fertile days and other times of your natural cycles when you are less likely to conceive. The average woman has a 28-day cycle, within a range of 24–32 days, although some have more irregular cycles. Cycle length is calculated from the first day of your period to the beginning of the next one.

During your period, or menstrual bleeding, you are the least likely to get pregnant, while during the window of ovulation, usually around days 11–14, you are at your most fertile time.

Ovulation is when the ovaries release an egg into the fallopian tube. The egg then lives in the fallopian tubes for 24 hours, and if it goes unfertilized, does not survive. Therefore the fertility window, in reality, is very small, but the trick is knowing exactly when ovulation will occur.

Monitoring Cervical Mucus

At different times in your cycle, the mucus from your cervix changes in color and consistency. At the beginning and end of your cycle, the cervical mucus is typically white and drier, whereas during the fertile days, many women have clear, slippery mucus. The cervical mucus method simply involves being aware of what your cervical mucus looks like throughout the month.

Many women may also experience spotting when they ovulate. This is when small spots of menstrual blood appear in the middle of the menstrual cycle, signaling their fertile days.

Calendar Method

Also known as the rhythm method and calendar rhythm method, this is a way for women to track ovulation times based on their own menstrual cycle and avoid unprotected sex when they ovulate.

If you track how many days your cycle is for a few months, based on when you start your period to the next one, you can figure out how long your average cycle is, and the most likely time you have ovulated. This method alone is not very effective at preventing pregnancy and is best used together with cervical mucus and the tracking basal body temperature method [1].

Standard Days Method

The Standard Days Method (SDM) recommends that there is a 12-day fertile window during which women with regular menstrual cycles (26–32 days long) should abstain from sexual intercourse or use a barrier method, such as condom or cap, to prevent pregnancy. It is simply calculated by mapping the 12 days in the middle of the cycle, between each period [2].

Temperature Method

The temperature method, known in women’s health literature as the basal body temperature (BBT) method, involves measuring your body temperature at the same time every morning when you are resting. It should be done before you get up and before you eat or drink anything.

It is used because there’s a slight rise in body temperature after ovulation. Therefore, when you chart your temperature, look out for a rise of 0.4°F, up from the week before. If you have detected a slight rise in your temperature, it is likely that your fertility window has finished for this cycle.

On which two days prior to basal body temperature rise is the chance of conceiving the highest?

8-7

2-1

3-2

5-4

Click on your answer to reveal what studies say

Show hint

basal body temperature

The third and second days before basal body temperature rise are when the chance of conceiving is the highest

Effectiveness of the Fertility Awareness Method

Done correctly, fertility awareness methods can be an effective way to prevent pregnancy. Failure rate is only 1–2%. If, during your fertile window, you abstain or avoid sex, it is unlikely that you will get pregnant. If you are trying for a baby, the fertility awareness method would be the first step to influencing when you conceive.

Preventing Pregnancy

When tracked correctly, natural family planning methods are highly effective for avoiding pregnancy: 98–99% of women did not conceive while using the natural family planning method, according to a comprehensive fertility study [3].

However, if fertility awareness methods are not followed accurately, they can lead to unplanned pregnancy. Remember, getting the methods right takes practice and commitment!

Which contraceptive method do you think is the most effective?

Fertility awareness methods

The pill

Copper IUD

Implant

Male condom

Choose an answer to reveal which method is most effective

Show hint

contraceptive method

An implant is the most effective way of preventing pregnancy

When you have figured out when your fertile times, remember to use condoms, the cap, or diaphragm when you have sex, or at least use the pull out method. Just in case, try to keep some emergency contraception at hand too.

Keep in mind that emergency birth control is a hormonal treatment and affects your cycle. If you take an emergency contraceptive pill, you have to use barrier contraception for two complete menstrual cycles before natural family planning is effective again.

Getting Pregnant

If you are trying to get pregnant, the natural family planning method is an excellent way to get in touch with your level of fertility and knowing when to time sex, increasing your chances of conception.

Is Natural Family Planning for Me?

Benefits

There are some key benefits of natural family planning:

There are no side effects or health risks as with medical contraceptives.
It is a hormone free method and no chemicals are used, as with birth control pills or hormonal contraceptives.
With correct information, practice, and advice, most women can track ovulation.
No follow up medical appointments are needed for the technique, once you have learned how it works.

The methods give you more control over your reproductive system and involve your partner in the process, which can have benefits to the relationship and your mental health.
Natural family planning is the only type of family planning that includes both preventing pregnancy and aiding conception.
Monitoring your vaginal discharge makes you more aware of your reproductive health and may help you recognize abnormalities, such as if you have a sexually transmitted infection.

Disadvantages

For 12–16 days in the month, you have to abstain from sex or use condoms, the cap, or pull out method, which some couples can struggle with.

Fertility awareness based methods do not protect against STIs.
There is a lot of room for mistakes, if you are not tracking correctly.
The method takes a few menstrual cycles to practice for you to control it effectively. Until then, you have to use condoms or caps.
Fertility signs have to be tracked consistently every day, which is not convenient for everyone.
Your cycle can become unpredictable if you are very stressed, there is a dip in your health, or you are lactating, in which case natural family planning methods should be reconsidered.

Lactational Amenorrhoea Method (LAM)

Lactation Amenorrhoea Method (LAM) refers to the time of infertility many women experience after having a baby and is a natural method of birth control. Intensive breastfeeding for the first six months after birth can stop ovulation, which some fertility research claims to be 98% effective in preventing pregnancy. However, it has received some criticism in other studies [4].

Is LAM Reliable?

Failure rate of LAM increases the closer the baby gets to six months old, so it is a good idea to start using other methods of contraception from five months after birth. Also, if you start weaning your baby early or feed them formula milk, your milk flow decreases and the LAM method becomes less of a guarantee to prevent pregnancy.

FAQ

Does the Fertility Awareness Method Work?

Yes; however, for it to be effective in stopping pregnancy, you have to keep track of all the fertility signs and use other contaceptives or abstain from sex during your fertility window.

How Is Fertility Awareness Based Method Used?

You track your body’s natural functioning and find signals that tell you when you are fertile, then avoid unprotected sex during the time that you are ovulating.

How Many Days Before and After Menstruation Is Safe?

It depends on your cycle. You technically cannot conceive during your first few menstrual bleeding days, but just at the end or after your period there is a chance you will, read more in can you get pregnant on your period.

Conclusion

It’s difficult to find a method of birth control that’s perfect. For a hormone-free method, natural family planning could certainly be an alternative to other forms of contraception.

However, do your best to use the birth control method correctly, by following all of the guidance, especially if you are trying to avoid pregnancy! If getting pregnant is something you want, this technique will definitely be of interest to you, but if it does not work and you are concerned about your reproductive health, always refer to a fertility specialist.

References:

[1] Johnson, Sarah, et al. “Can Apps and Calendar Methods Predict Ovulation with Accuracy?” Current Medical Research and Opinion, vol. 34, no. 9, 2018, pp. 1587–1594., doi:10.1080/03007995.2018.1475348.
[2] Weis, Julianne, and Mario Festin. “Implementation and Scale-Up of the Standard Days Method of Family Planning: A Landscape Analysis.” Global Health: Science and Practice, Global Health: Science and Practice, 30 Mar. 2020, www.ghspjournal.org/content/8/1/114.
[3] Frank-Herrmann P;Heil J;Gnoth C;Toledo E;Baur S;Pyper C;Jenetzky E;Strowitzki T;Freundl G; “The Effectiveness of a Fertility Awareness Based Method to Avoid Pregnancy in Relation to a Couple’s Sexual Behaviour during the Fertile Time: a Prospective Longitudinal Study.” Human Reproduction (Oxford, England), U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/17314078/.
[4] Van der Wijden, Carla, and Carol Manion. “Lactational Amenorrhoea Method for Family Planning.” The Cochrane Database of Systematic Reviews, John Wiley & Sons, Ltd, 12 Oct. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC6823189/.