There was a time when contraceptives were kept well out of sight in chemists’ shops. For a man, purchasing a supply of condoms meant either struggling to tell a shy young girl what was required in a series of broad hints or else braving a disapproving look from a matron who could not have been more threatening had she been the mother of his intended. I don’t know what it was like for a woman. But it can’t have been much better.
Today, that has all changed. In most chemists’ shops contraceptives are lined up at the front of the counter, sharing pride of place with the aspirin tablets, gripe water and vitamin pills.
Two main types of contraceptives can be bought without medical advice and have real value in pregnancy avoidance.
Firstly, there are condoms (also known as sheaths, French letters, rubber johnnies and Durex) which are used regularly by about one quarter of the couples requiring contraception. Only in recent years has the pill edged ahead of the sheath in popularity and as women in their thirties are taken off the pill the chances are that the sheath will once again move back into first place. Used properly this is an extremely effective form of contraception. One survey showed that if a hundred couples used the sheath for one year, only three or four women would become pregnant.
Secondly, there are the spermicides, chemicals which literally kill off the sperm and thereby prevent conception. Spermicides are used far less widely as a sole means of contraception as some doctors believe that they are not completely reliable.
Other contraceptives which may be bought over the counter are not worth considering. Douches, for example, which are favoured by some women can just as easily wash sperms up into the womb as wash them out of the vagina.
This form of contraception used to be compared to ‘paddling with Wellingtons on’ or ‘playing the piano with gloves on’ because of the fact that with a thick layer of rubber separating the penis from the vagina the joys of sex were rather slight. Today’s disposable contraceptives are usually thin enough to ensure that the loss of sensation is slight.
The advantages of using condoms are presumably fairly obvious; they’re useful for unpremeditated sexual encounters; they’re available for use by everyone regardless of medical history or condition; they provide some protection against venereal disease; and they’re easy to get hold of. Even if you can’t find a chemist’s shop open the gentlemen’s lavatory in the nearest public house will probably be equipped with an automatic dispensing machine (upon which there will undoubtedly be scribbled slogans like ‘buy me and stop one’ and ‘this chewing gum tastes awful’).
The disadvantages are that using them embarrasses some people and diminishes sensation for others. (Diminishing sensation helps some men who are premature ejaculators. The thin layer of rubber twixt penis and vagina helps ensure that the erection lasts longer.) They occasionally fail. To keep the risks of becoming pregnant to a minimum it is important to follow certain basic rules when using a condom. 1 A condom should always be put on as soon as the penis is erect. Sperm can leak out of the penis before ejaculation. 2 Any air at the end of the condom should be expelled as it is rolled on to the penis. If the air is allowed to remain the condom is more likely to burst (although modern condoms are so strong that you really can blow them up into balloons). If the condom does not have a teat make sure that there is some space left at the end. 3 Handle condoms with care. Sharp nails and teeth can burst them. 4 After ejaculation the penis should be removed from the vagina with the condom still in place. One partner should simply hold on to the rim of the sheath and make sure that it doesn’t slip off.
Choosing a condom
Condoms are available in many different shapes and colours these days. The only thing that doesn’t really vary is size – condoms will stretch to fit even the largest organ. You can buy condoms that are straight or contoured, dry or lubricated, smooth or rippled, transparent or coloured and thin or very thin. You can buy them with or without teats at the end to hold the sperm and you can, if you’re willing to forgo sensitivity for the sake of economy, buy very thick, washable condoms.
The most important single thing to look for when choosing a con- dom is the British Standards kitcmark which confirms that the product (or more accurately ones like it) has been tested and found to be safe and reliable. Apart from that it’s largely a matter of taste, although most experts agree that the very short ‘American tips’ which leave the shaft of the penis uncovered are not safe – they tend to come off too easily – and the particularly fancy condoms which are fitted with lots of knobs and projections designed to stimulate a woman are not safe because they may rip or burst.
The thickness of condoms is measured in thousandths of a millimetre and most sheaths fall into one of two groups. The thicker (and usually the cheaper) are 0.065 mm thick. This group includes Atlas (lubricated with a teat), ordinary Durex (non-lubricated and available with or without a teat), Dnrex Allergy (non-lubricated without a teat and designed to minimize the chances of either partner developing signs of an allergic reaction as a result of contact with the sheath – if this condom doesn’t prove adequately non-allergic, non-synthetic sheaths are available which are made from sheep’s intestines), Dnrex Gossamer (lubricated and available with or without a teat), Durex Nu-form (designed to accommodate the shape of the penis, lubricated and with a teat), Durex Unison (which is ribbed for extra stimulation), Forget-me-not (lubricated with a teat) and Two’s Company (lubricated, with a teat and available in a pack with a spermicidal pessary).
The thinner (and more expensive) group are made of rubber which is 0.05 mm thick. Brands in this group include Durex Black Shadow (made in bhek), Dnrex Fetberlite and Durex Fiesta (available in a variety of pretty colours). All these sheaths are lubricated.
In addition to these varieties there is a sheath called Durex Nu-Form ‘Extra Safe’ which has its own spermicidal lubricant. The purpose of the lubricant is, naturally, to aid penetration. A dry rubber sheath may prove uncomfortable. Making the lubricant spermicidal simply adds to the effectiveness of the protection provided. In the next section I shall discuss spermicides.
The first thing to be said about spermicides is that they should not be used without some form of mechanical protection. Spermicides may be designed to kill sperms but they are not by any means guaranteed to kill all sperms. A man with a high sperm count may have plenty left even after the spermicidal cream has killed off many millions of sperm.
So don’t use any spermicide by itself.
Spermicides are available as creams, pessaries, aerosol foams, gels, foaming tablets and impregnated soluble films. They should be put into the vagina a few minutes before intercourse (enough to allow time for them to spread around but not enough to allow time for them to leak out) and replaced at hourly intervals if intercourse is prolonged or repeated.
One of the best-known spermicides available today is Cfilm, a small square of spermicide-impregnated film which, it is said, can be placed either inside the vagina or on top of the penis. According to the Handbook of Contraceptive Practice published by the Department of Health and Social Security this product ‘is relatively ineffective and should not be advised’. So I won’t.
Apart from the fact that they are messy, that they taste nasty and that they are not very effective there isn’t anything wrong with spermicides. They should keep for about a year, but keep them in the refrigerator if the weather is hot and keep an eye on the expiry dates. If you keep pessaries in the fridge do make sure that no one makes a jelly or decorates a cake with them. It has happened.
Choosing a spermicide
Most spermicides contain a chemical called nonoxynol 9. Varieties containing this substance include C Film, Delfen Cream, Delfen Foam, Duracreme, Duragel, Ortho-crème, Rendell’s Pessaries, Staycept Pessaries and Two’s Company Pessaries. Nonoxynol 9 is mixed with benzethonium chloride in Emko foaming aerosol and Orthoforms pessaries. Other products, which include such sensual-sounding chemicals as p-di-isobutylphenoxypolyethoxyethanol and tri-isopropylphenoxypole-thoxyethanol are Antemin Cream, Genexol Pessaries, Or tho-gynol Jelly, Pre-ceptin Jelly and Staycept Jelly.