Contraceptive methods

Do Long Term Contraceptives Effect Barrier Contraception Use?

"There is compelling evidence that where good quality sex and relationships education (SRE) is available it leads to a reduction in teenage pregnancies. Yet nearly a quarter of young people rated the SRE they received at school as bad or very bad – and four in 10 young people are unsure where to find their local sexual health clinic – so the education on offer is far from standard. Imagine what today's statistics might have been if every school in the country had this vital subject on the timetable. The downward trend in teenage conceptions can only be sustained if SRE becomes a statutory requirement in all schools."

Reversible, long-term contraception such as IUDs and implants and effective contraceptives that prevent pregnancy, suitable for all ages and all women reportedly, including women who have never had children. But, we must remember that these contraceptives are not barrier methods, they do not prevent the transmission of STDs and STIs. A study has found that girls in high school that use these contraceptive methods tend not to use condoms. 

These contraceptive methods are also known as Long acting reversible contraceptives (LARCs) and are highly effective. The help to reduce the number of unintended teen pregnancies, however, it appears that those who use LARCs are less likely to use condoms, when compared with those who take oral contraceptives, use the patch, ring or injection. Hence the study was carried out on sexually active users of LARCs and users of moderately effective contraception. 

The researchers also used data from the 2013 Youth Risk Behaviour Survey which takes a representative sample of high school students. In August 2015, 2,288 sexually active female students were analysed.

The females were asked which of the following contraceptive methods they had used the last time they participated in sexual intercourse:  oral contraceptives; condoms; an IUD or implant; injection, patch, or ring; withdrawal or other method; or not sure. It also asked them if there parter had used a condom as a barrier contraceptive method too.

The survey found that of the 2,288 girls asked, 1.8% of them used an LARC; 5.7% used Depo-Provera, patch or ring;22.4% used oral contraceptives, 11.8....5 used the withdrawal method; 15.7% used no contraceptives at all; and 1.9% were not sure. The results showed that users of LARCs were approximately 60% less likely to use a condom than users of oral contraceptives.

There did not appear to be much difference in condom usage between the LARC users and injection, patch and ring users. It also showed that females using the LARCs were twice as likely to have two or more recent sexual partners compared with other contraceptive users.

The authors of the analysis concluded that the differences in using condoms could be related to their use to prevent pregnancy as a backup. It is possible that LARC users may perceive there to be no need for condoms even when they have multiple sexual partners. However, this puts them at risk of STDs and STIs. It appears that the biggest worry at the time of sexual intercourse is unwanted pregnancies, and the risk of contracting sexually transmitted diseases or infections is sometimes forgotten about. There is a definite need to remind everyone of the necesity of barrier contraceptives in not only preventing pregnancy but also in preventing STDs and STIs.

Those that use the IUD are particularly at risk of contracting STDs and STIs and should be especially encouraged to practise the use of condoms during intercourse because the presence of a foreign body in the uterine cavity increases the risk of n infectious organism gaining a foothold, whose damage can later result in medical problems including infertility and ectopic pregnancies.