Withdrawal and emergency contraception

18 May 2020

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Welcome back to the Marie Stopes blog!

We have discussed some interesting things so far involving a wide range of topic from post-partum menstruation to how to discuss with your partner about abortion.

Today we’ll be exploring another important topic. In contraception talk, we will be focusing on one of the first techniques of family planning known as The Withdrawal Method.

Weighing the benefits and failures

So, what is the withdrawal method? It’s the act of withdrawal of the penis before ejaculation as to prevent the sperm in the semen from entering the vaginal lumen.

Today, although this traditional method of contraception is still widely used with 5% of users worldwide, it’s nothing compared to female sterilization (24%) and male condom (21%).

However, the trend in Cambodia looks a little different compared to world statistics. In 2014, Cambodia DHS conducted a survey on contraception use in Cambodia. The survey found that withdrawal was the second most used contraception method (27.9%) only being beaten by oral contraceptives (31.9%). This means that a lot of people still prefer this traditional contraception method to others, which is why it is important for sexual partners to understand what choices are available to them and whether this method is what’s best for them.

Let’s start by talking about the good. Naturally, the withdrawal method has virtually zero ill effects on health since it is only reliant upon the withdrawal of the penis from the vaginal lumen before ejaculation. Compared to other methods of contraception, it’s true that they incur relatively lower risks. However, this method does not prevent against STIs like condom does.

The downside to the withdrawal method is that the pregnancy prevention rate is lower than other non-traditional methods. The success rate is only about 78%. For one, pre-cum or the pre-ejaculate might contain sperm that is viable to impregnate. Secondly, even if the semen lands on the vulva, it’s not impossible for the sperm to swim to the vaginal opening. Last but not least, you need a lot of self-control to withdraw the penis on time.

What emergency contraception options are available?

There are two notable emergency contraception methods that you can get when the withdrawal method fails, or when other contraceptive methods fall short (e.g. condom breaking…, etc.).

Emergency contraceptive pills are oral contraceptives with a slightly higher dose of hormone that can be used within 120 hours (5 days) or 72 hours (3 days) depending on the brand of the ECPs. It’s important to note that the earlier you take the ECPs, the more effective it will be. However, it’s recommended that you only use ECPs sporadically and not as the main contraceptive method if you’re sexually active.

Copper IUD is not well known in Cambodia as an emergency contraception option, but it’s important to know that it is, by far, the best emergency contraception method there is. It can prevent pregnancy up to 99.9% if they are placed within 5 days of unprotected intercourse. An important point to note is, if you are sexually active, this is the better contraception method than ECPs.

Destroying myths about ECPs

There are many odd things that were said about ECPs and contraception methods in general. The most popular one was that ECPs will cause infertility in women – This is absolutely UNTRUE. They also do not cause birth defects. The true function of ECPs is to delay ovulation, they do not cause abortion or disrupt an existing pregnancy.

You must be aware that you have to take ECPs after every sexual intercourse in order to prevent pregnancy, their effect is to delay ovulation after intercourse, you cannot use them to prevent FUTURE sexual acts. To simply put it, they are not effective if taken before sex. This is why long-term contraception method is recommended, rather than taking ECPs every time you have intercourse. Although, it must be noted that it is completely safe for you to take ECPs frequently, even during the same menstrual cycle.

However, they do come with some side effects such as slight bleeding, irregular period, abdominal pain, nausea, or dizziness. But the side effects are not harmful and generally resolve within 24 hours.

If you wish to purchase emergency contraceptive pills outside of pharmacies or you wish to get copper IUD, you can get these services with confidentiality at Marie Stopes clinics all over the country.

Sources:

  1. https://gynopedia.org/Cambodia
  2. https://path.azureedge.net/media/documents/RH_pharmacy_toolbox.pdf
  3. https://www.fpv.org.au/for-you/i-dont-want-to-get-pregnant/contraception-without-hormones/withdrawal-method-pulling-out
  4. https://dhsprogram.com/publications/publication-FA105-Further-Analysis.cfm
  5. www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception/how-does-copper-iud-work-emergency-contraception.

If you have any questions about the withdrawal method, emergency contraception and other contraceptive methods, consult with @MarieStopesKH now:
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✓ 012 999 002 or 098 999 102
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www.mariestopes.org.kh/contact-us-form/

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