Safe Sex in the Middle East: The Best and Worst Birth Control Methods

Aside from the obvious answer to preventing unplanned pregnancy (abstinence), if you’re going to be “getting it on” with your significant other, it’s important to educate yourself about effective birth control methods. The Middle East, in particular, is rife with misconceptions when it comes to what works and what doesn’t. So, in no particular order, we’ve broken it down for you:

1. The “Pull Out Method”

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According to this method, the man pulls his penis out of the woman’s vagina right before he ejaculates. The idea, obviously, is that if semen doesn’t get inside the woman’s vagina, she can’t pregnant. When the pull out method is executed correctly, it is 96% effective. However, 4 out of 100 women who use the pull out method regularly with their partner will still get pregnant due to “pre-cum”.

Sadly, the withdrawal method is often not executed correctly. This happens when the man is inexperienced or not in complete control of his sexual excitement, at which point the rate of pregnancy occurrence rises to 27%.

So, gentlemen, as tempting as it may be to not use a condom, do not use this method unless you’re ready to bear the burden of responsibility.

Ladies, do not use this method unless you trust the man you are with completely. Unfortunately, if something goes amiss because your partner fails to control his excitement, you (the woman) will be blamed and scorned by society for his failings.

Effectiveness: 96% if done properly, 73% if done improperly

Protects against STDs? No.

2. The Fertility Awareness Method (FAM)

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Pregnancy is possible only if sperm enters a woman’s vagina during the five days prior to ovulation (since sperm can live up to five days inside the vagina), the day of ovulation, or the day after ovulation (conception is still possible for 24 hours after the egg has been released). During the other 21 days (on average) of a woman’s fertility cycle, pregnancy is not possible.

The idea behind FAM is that if a woman is able to correctly track her fertility cycle, she will know when it is safe to have unprotected sex and when she needs to abstain. The tricky part about this method is that it is built on averages, and not every woman has the same number of days in their cycle. Also, ovulation happens for different amounts of time depending on the woman – it could be shorter or longer than average. That said, several sub-methods of FAM have been devised for women to roughly calculate their fertility cycle:

The Basal Temperature Method: The woman’s fertility cycle is calculated by measuring the fluctuation of body temperature throughout the month.

The Cervical Mucus Method: The woman’s fertility cycle is calculated by observing changes in vaginal discharge throughout the month.

The Calendar Method: The woman’s fertility cycle is calculated by tracking menstruation dates for 8-12 months and mathematically predicting likely days of ovulation.

Effectiveness: 88% if done properly, 76% if done improperly

Protects against STDs? No.

3. Condoms (Male)

Usually made out of latex, condoms are worn around the penis. They must fit properly (guys, don’t buy magnums unless you need it – it’s irresponsible as hell, and your penis will look tiny  swimming around in all that loose rubber) in order to be effective as a method of birth control. If the condom slides off during sex or breaks, you might as well have never used one in the first place.

Effectiveness: 98% when used properly, 82% when used improperly

Protects against STDs? Yes.

4. Condoms (Female)

A pouch is inserted into the vagina to prevent sperm from entering. However, female condoms are difficult to find in the Middle East and women face stigmas when purchasing any kind of birth control, compounding the problem and putting women a situation where they are limited in their ability to negotiate their own terms for safe sex.

Effectiveness: 95% when used properly, 79% when used improperly

Protects against STDs? Yes.

5. Diaphragm (used with Spermicide)

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A small cup is inserted into the vagina forming a barrier to prevent sperm from entering the cervix. To be effective, you should place 1 teaspoon of Spermicide inside the cup’s dome. The diaphragm must be inserted BEFORE sex and left in the vagina for 6-8 hours after the man’s last ejaculation.

If well cared for, a diaphragm can be reused for up to two years. However, they are difficult to find in the Middle East.

Effectiveness: 94% effective when used properly, 88% when used improperly

Protects against STDs? No.

5. Chemical Birth Control Pills (Female)

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This is one of the most popular birth control methods today, and also one of the most effective when used correctly. The idea is that by taking certain female hormones you prevent ovulation from occurring, and without the release of an egg there can be no pregnancy. However, for pills to be effective, they must be taken at the same time every day and you cannot skip days. There is little room for error.

Effectiveness: 99.9% effective when used properly, 91% effective when used improperly

Protects against STDs? No.

6. Intrauterine Device (IUD)

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This T-shaped object is inserted surgically into the uterus for the purpose of altering sperm movement so that sperm cells cannot reach the egg. The advantage of an IUD is that its low-maintenance (it can last up to 12 years), you can’t “do it wrong”, and it’s easily reversible. The disadvantage is that you must get the device inserted by a healthcare provider, but in Cairo many health centers will perform the procedure for a low cost.

Effectiveness: 99% effective

Protects against STDs? No.

7. The “Morning After Pill”

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If a woman has unprotected sex or believes that one of her contraceptive methods may have failed, within 72 hours (the sooner the better) she can take the “Morning After Pill”, which is a progestin that prevents ovulation from occurring. It is essentially a super-dose of the same female hormones you find in regular birth control pills.

Unfortunately, the Morning After Pill is scarce in the Middle East. Most pills on the market will be imported from Europe and won’t be available in regular pharmacies. However, if you are in a desperate situation, there is an alternative: You can go to a pharmacy and pick out any pack of regular progestin-only birth control such as Microlut, that has “levonorgestrel” as its main ingredient.

For example, Plan B (one of the most popular brands of morning after pill), contains two levonorgestrel pills (.75 mg each) for a total of 1.5mg. Take 50 Microlut pills (.03 mg levonorgestrel each) at once to get the equivalent emergency contraception. For more info about equivalencies, visit this database by Princeton University.

Effectiveness: If taken within 24 hours, 95% effective. If taken within 72 hours, 89% effective.

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