Sexual intercourse for humans is not only a reproductive act, but is also considered to be an emotional and pleasurable act. However, statistics report that almost 30% of the women experience pain during intercourse also known as vaginismus. This not only hampers the pleasure, but is also an unhealthy sign since it is indicative of a problem.

Vaginismus / Painful intercourse could be a regular occurrence, or a sporadic one. There could be numerous reasons that cause the discomfort and pain. Though it might be an early manifestation of grave diseases such as endometriosis or fibroids, but more often, it is triggered due to conditions such as vaginal dryness, yeast infection, bacterial vaginiosis, which can be easily treated. It is pertinent to understand that it is not the physical infirmity of the entire female anatomy that causes such pain/ discomfort, but the existence of certain conditions that can be treated by a medical practitioner. 

Certain such causal factors associated with painful intercourse and the efficient ways to deal with them are discussed below:

Vaginal dryness- Vaginal dryness is one of the most commonly cited causes for painful intercourse. There are various causal factors of vaginal dryness. These include, but are not limited to, consumption of certain drugs, bathing with hot water, health conditions or even lack of foreplay. Vaginal dryness due to the aforementioned causes is a short-lived condition that can be treated well with the help of a medical practitioner. Usage of lubricants that is suitable for you, as advised by a medical practitioner, could go a long way in aiding the ease of sexual intercourse. The lubricants act as an effective substitute, if the body is unable to naturally secrete vaginal fluids to ease intercourse, thereby greatly reducing the pain that is experienced.

Improper vaginal expansion- The female anatomy is designed in such a way that it expands normally during intercourse. Proper foreplay enables the woman to get excited, which results in the release of vaginal fluids that aids in sexual intercourse. However, in the event that the female is not excited enough prior to the act, sexual intercourse can become a painful act, since the vagina is unable to expand in the absence of vaginal fluids. In such cases, take things slow and give your body time to comfortably go with the flow.

Vaginal itching caused by infection- Vaginal infections can be caused by antibiotics, prior sexual activity that has resulted in contraction of Sexually Transmitted Diseases etc. This results in an itching or burning sensation while having sex. It is essential to rest your body instead of forcing things, and to consult your doctor as soon as possible. The doctor can correctly diagnose the causal factors behind the infection, and prescribe the necessary medicines for it.

Emotional issues including fear of sex, marital issues/ disputes, etc are also leading cause of painful sex

Treatment:

However, symptoms vary from the common ones mentioned above, it is always advisable to consult a experienced doctor including a gynecologist, sexologist or sexual counselor.

Role of sexual counselor is very important, as he she can offer Sex therapy in the form of counseling, brief psychoanalysis, or behavioural therapy .This can help to address any underlying psychological issues, such as fear or anxiety, tackle any irrational beliefs that you have about sex, educate you about sex.

Also some special techniques can be taught eventually stop your vagina closing involuntarily, such as using vaginal trainers and pelvic floor exercises

If you wish to discuss about this problem, you can consult a doctor and ask a question.

Vaginismus - Make Sex Less Painful For Your Lady!

4 Types of Contraception for Birth Control

There are a number of contraceptives available but which method of birth control suits you depends on your sexual life, preferences and your lifestyle as a whole. Professional medical help should be sought in order to understand what method of contraception sis ideal for you.

Here is a list of 4 types of contraceptives for birth control.

1. Barrier methods

Barrier methods are designed to prevent the sperm from entering the uterus. They constitute-

- Diaphragms: It is a shallow and flexible cup that is made of either latex or soft rubber. It is inserted into the vagina before the sexual intercourse where it prevents the sperm from entering the uterus.
- Cervical caps: It is a thin cup of silicone whose function is same as the diaphragm, only it is smaller in size, so less noticeable and more rigid as well.
- Contraceptive sponges: These are soft foam sponges that are filled with spermicide and are disposable. They are also inserted into the vagina before sexual intercourse in order to prevent pregnancy by killing the sperm cells or preventing them from entering the vagina.
- Spermicides: These are chemicals that can kill the sperm and hence assist in birth control.

Other methods include male condoms and female condoms.

2. Hormonal methods

Hormonal methods use hormones in order to either stop or regulate ovulation so as to prevent pregnancy. There are various methods through which hormones can be injected into the body. Some of them are-

- Contraceptive patch: It is a thin patch made of plastic that sticks to the skin and is responsible for releasing hormones into the bloodstream through the skin.
- Vaginal rings: A thin, flexible ring that is inserted into the vagina where it stays for 3 weeks and is removed after that, only to be re-inserted in the 5th week.
- Implantable rods: They are inserted under the skin of the upper arm of women where they release progestin.

Other methods include contraceptive pills and progestin-only pills.

3. Intrauterine methods of contraception

The intrauterine device is a small device, T-shaped that is inserted into the uterus in order to prevent pregnancy. The good thing about intrauterine devices is that they can remain functioning for many years at a stretch. IUDs are two types-

- Hormonal IUD(Intrauterine Device)
- Copper IUD

4. Sterilization

Sterilization is the most reliable contraceptive for birth control as it is permanent. It either prevents the release of sperm or the fertilization of the egg. Sterilization methods can either be surgical or non-surgical. Some of the sterilization techniques are-

- Tubal ligation: It is the surgical technique used in females.
- Vasectomy: It is the surgical technique of male contraception.

Other methods include sterilization implants.



4 Types of Contraception for Birth Control

Use of contraceptives is really important to avoid unwanted pregnancy. Countries like China and India, facing the problem of population explosion lay more stress on the use of contraceptives. However, you must always use or take oral and barrier contraceptives following the advice of a medical practitioner unless it is absolutely necessary to go ahead without consultation. The reason behind medical assistance is your own health. Contraceptive methods do have a vast range of side effects that can result in health hazards. There are various kinds of contraceptives; each having its own set of advantages and disadvantages. Being acquainted with the side effects of some contraceptive methods can help you choose wisely in times of need.

Possible side-effects of using condoms: Some men are allergic to latex. Using condoms can lead to heightened sensitivity. It can also lead to rashes in your genitals. Condoms are not foolproof. They do not provide total protection against sexually transmitted infections, HPV or against Syphilis and Herpes. These diseases can be contracted by coming in contact with genital skin that is not covered by a condom.
Possible side-effects of a Contraceptive Film: A contraceptive film might act as an interruption in your sexual activities if it is not placed properly, that is to say it must come in contact with the cervix to be effective. Using the film nonoxynol- very frequently can make you susceptible to life threatening diseases like HIV and other STIs.
Possible side-effects of a Cervical Cap: A cervical cap has to be inserted by a clinician and requires immense care to be fitted in later. Some of its side - effects can be of serious concern. If it is left inside for more than forty eight hours, it can result in toxic shock syndrome. Toxic shock syndrome is an infection that mars your overall health. It is also known to increase the chances of inflammation of the surface of your cervix.
Possible side-effects of Progestin only pills: Progestin only pills or mini pills can subject you to long- lasting depression. It can make you feel bloated and can actually increase your weight to a great extent if used on a regular basis. Minipills lead to irregularities in your menstrual cycle and might also make bleeding during menstruation scanty.
Possible side-effects of combined oral contraceptives: If this is your first month on combined oral contraceptives, you might feel nauseous and they can give you a terrible headache. Women taking these pills have a higher chance of developing cervical dysplasia. If you wish to discuss about any specific problem, you can consult a gynaecologist and ask a free question.

Side Effects of Different Contraceptive Methods

Pelvic Inflammatory disease (PID) is a bacterial infection that affects a woman s reproductive organs. This disease is not contagious though men can host and transmit the bacteria that triggered the disease through intercourse. Chlamydia and gonorrhea are the two most common causes of this disease. Apart from being transmitted sexually, this disease can also develop through the insertion of an unsterilized contraception device into the vagina or during a gynecological procedure such as an abortion. In rare cases, normal bacteria from the vagina can also spread into the uterus and fallopian tubes triggering this disease.
PID can be fatal and should not be ignored. Lower abdominal pain is the primary symptom of this disease. This pain can vary from being mild to be seriously debilitating. Other symptoms of this condition are:
Abnormal or foul vaginal discharge.
Painful intercourse that may be accompanied by bleeding.
Irregular periods.
Spotting between periods.
Severe menstrual cramps.
Burning sensation while urinating.
Urge to frequently urinate and an inability to empty the bladder.
Swollen abdomen.
High fever alternating with chills.
Swollen lymph nodes.
Diminished appetite with nausea.
Weakness and depression.
Lowered libido.
PID can often produce a pus-like fluid that scars the reproductive organs. This can result in infertility. This risk is influenced by the duration and severity of the infection along with the number of times it recurs. Women suffering from pelvic inflammatory disease are also at a higher risk of having a tubal pregnancy. This type of pregnancy is fatal for the baby and also threatens the life of the mother.
In cases where the disease is triggered by an STD like gonorrhea or Chlamydia, it can also spread to the liver tissues. This is a complication known as the Fitz Hugh Curtis syndrome and causes a collection of pus in the form of an abscess in the fallopian tubes or ovaries. If this abscess ruptures, the pus would spread into the pelvic cavity causing severe pain, nausea and a fall in blood pressure. If it spreads further into the blood stream, it can be fatal.
Diagnosis of this disease is difficult as its symptoms are usually mild and common to a number of other conditions. However, once diagnosed, it can be easily treated through antibiotic medication. Surgery is required only in cases where there is no response to antibiotics or if an abscess bursts or is at a stage where it may.  


Can Pelvic Inflammatory Disease Prove to be Fatal?

Pelvic Inflammatory Disease, also known as PID, is characterized by an infection that occurs in a lady's reproductive organs. Usually this occurs as a result of a complications arising from a STD. The disease causes severe damage to the ovaries, fallopian tubes and the uterus. It is one of the bigger causes of infertility in women. 

Causes-

The cervix which is the entry to the uterus has the function of stopping bacteria that are present in the vagina from spreading to the other organs. Once infected by a STD, the cervix can no longer perform its function of preventing the bacteria from spreading to other organs. PID develops when the infection spreads from the cervix to the upper areas of the genital tract. 

There are certain factors which increase the chances of being affected by PID: 

Being sexually active 
Already affected by STDs such as gonorrhea 
Past history of PID 
Having multiple sexual partners 
Symptoms-

Women may experience pain while urinating and engaging in sexual intercourse, coupled with sore feeling in the stomach along with nausea. Abnormal vaginal discharge and a rise in body temperature are common symptoms as well. 

Treatment-
Once the disease has been diagnosed by a doctor, a treatment plan is devised. The treatment options that you can avail of are: 

Medications: If the symptoms are mild, then the doctor will prescribe antibiotic medications. Usually the antibiotics are administered by mouth unless the symptoms are severe, when the drugs are administered intravenously. Your partner would also require medications if you happen to be diagnosed with PID, so that he/she does not catch it. 
Surgery: Surgery is recommended by the doctor in case of tissue inflammation and the presence of pus (abscess). The aim of surgery is to get rid of the abscess to prevent any further infection. 
In addition to the treatment methods, there are certain precautionary measures that you can adopt to be safe: 

Have protected sex.
Try and stick to one sexual partner.
Visit your gynecologist for regular checkups.

Pelvic Inflammatory Disease - Can STDs be the Reason Behind it?

Emergency is helpful in preventing pregnancies post unprotected sexual activity. It can be used in case of contraceptive failure, in case of sexual assault, incorrect use of contraceptives and unprotected sex.

Emergency contraception can be done by three methods. These are emergency contraceptive pills, combined oral contraceptive pills and copper intrauterine devices.



The copper IUD is considered to be one of the most effective forms of emergency contraception, when it is inserted within 5 days of unprotected sexual activity.

However, the emergency contraceptive pill regimen as per WHO is:

1 dose of levonorgestrel 1.5 mg, or 1 dose of ulipristal 30 mg, taken within 5 days (120 hours) of unprotected intercourse

The Yuzpe regimen which consists of 2 doses of combined oral contraceptive pills

What is Emergency Contraception?

Emergency contraception is usually referred to as the contraception which is used to prevent a pregnancy within the first 5 days after an unprotected sexual activity. It is used post failures of contraception, coerced unprotected sex, rape or misuse of contraception.

Emergency contraception is only effective in the first few days after an intercourse and before the egg has released from the ovary, and before there is fertilization between the egg and the sperm. The emergency contraception can do no harm to an interrupted pregnancy and a developing embryo.

Who needs emergency contraception?

Any girl or woman who is at her reproductive age might need an emergency contraception in case of an unprotected sexual intercourse.

Uses
1 Breakage , slippage or displacement of barrier methods 
2. Three or more missed OCPills for more than 12 hours 
3. Missed Mini pill for more than 3 hours 
4. Missed Desoestrel pills for more than 12 hours 
5. DMPA injections taken more than 2 weeks late 
6. Miscalculated dates of last period and present ovulation side effects 
These are meant only for emergency contraception and NOT AS A REGULAR CONTRACEPTIVE. It involves pumping of a hormone inside your body at levels which are 5 times higher than normal. hence excessive and unnecessary use may cause irregularity in the period cycles and an adverse effect on the menstrual health over a period of time. Ideally it should be taken under guided medical supervision.


In what situations should emergency contraception be used?

Emergency contraception can be used after a sexual intercourse. These include:

In case of no use of contraceptives

If it is a case of rape or coerced sex, where the woman was not protected

When there is a contraceptive failure, like

breakage

incorrect use or slippage

OCPILLS,

mini pills

DMPA

3 or more missed combined oral contraceptives, progestogen-only pill (minipill) taken more than 3 hours late, desogestrel-containing pill 12 hours or more, norethisterone enanthate (NET-EN) progestogen-only injection taken more than 2 weeks late

Delay in placing or dislodgement or early removal of the skin patch or the hormonal ring

Breaking, dislodgement, tearing or early removal of cervical cap or diaphragm

Failure of withdrawal that is ejaculation the external genitalia or vagina

The spermicide tablet failure

Miscalculating the periods, failure from using a barrier on the fertile days

Expulsion of an intrauterine contraceptive device (IUD)

Methods of Emergency Contraception:

There are three emergency contraception methods:

Copper-bearing intrauterine devices (IUDs)

Emergency contraception pills (ECPs)

Combined oral contraceptive pills or the Yuzpe method



Safety of Emergency Contraception

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