Sex, Sleep or Scrabble

by Hammond, Phil

  My granny used to say: ‘Keep it in your trousers.’ What did she mean?

  I suspect she meant that not having sex is a highly effective method of birth control, and easier to execute if your genitals aren’t on display at the time. And learning to say ‘no’ is nearly as important as learning to hear it.

  Can you get pregnant during a period?

  Yes. It’s rare to get pregnant during a period but not unheard of, especially towards the end. A condom can prevent this and beetroot-stains on the penis, but you may still need an old towel. And remember to take the tampon out first or it may get lodged up high and forgotten about until it starts to pong (and there’s a small risk of toxic shock syndrome).

  One reason women get pregnant during a period is if they have a short cycle (say twenty-one days) and so the egg pops out on the last day of bleeding. The other is if it’s not a period at all. Some women get bleeding in the middle of the cycle, which maybe due to the contraceptive pill but is often due to Chlamydia. Bleeding after sex also needs checking out.

  NOTE: Toxic Shock Syndrome (TSS) is mercifully rare, and no one has proved a link with tampons, although they may encourage the growth or entry into the body of a bacteria (staph aureus), which can occasionally produce a life-threatening toxin. A sudden very high temperature (above 38.9°C) vomiting, a skin rash like sunburn, diarrhoea, feeling faint, muscle aches, dizziness and confusion seems a lot to pin on a tampon, which is why TSS is often diagnosed late, but if you get these symptoms (whatever the cause), get help urgently.

  More information about TSS is contained in the tampon manufacturer’s instruction leaflet, but I’ve never met anyone who’s read it. In summary, the top tampon tips are:

  • wash your hands before and after inserting a tampon

  • take the wrapper off

  • always use a tampon with the lowest absorbency you can get away with

  • alternate tampons with a sanitary towel or panty liner

  • change tampons regularly, at least as often as directed on the pack

  • never insert more than one tampon at a time

  • when using at night, insert a fresh tampon before going to bed and remove it on waking

  • make sure you remove the last tampon at the end of your period

  • don’t let boys put them in their nostrils; it’s not clever and it doesn’t prove anything

  How many hands does it take to put a condom on properly?

  For someone of average dexterity, three. Condoms can be a bugger to get on properly, unless you do it for a living. A sex worker once showed me how to conceal a condom in your mouth and then secretly pop it onto a banana (not that you’d expect a banana to notice such a thing, but it was for demonstration purposes only). The point is, if you’re expected to put assorted penises in your mouth in the course of a busy night shift, you soon learn how to take the edge off and reduce your risk of infection. She’d also do a quick check on her clients. Anyone with warts, ulcers, blisters, tender balls or a discharge got politely but firmly turned down and given directions to the nearest clinic. The customer is not king if he’s got the clap.

  Getting a handle on condoms isn’t easy. Actually, that might help. They’re slippery buggers. By far the most important condom tip is to involve your partner. Think of it as part of foreplay; dressing for the occasion. The rules come with the packet which you won’t have with you because the condom’s been in your back pocket for a year and through the wash twice.

  You need a new, undamaged one. Check the date and the kite mark (no one ever does this), take it out carefully and examine it closely. If you look at it one way, in a good light, the condom comes through the rim on the outside (this the way you want it). Flip it over and it encloses the rim. Try to put it on this way and you’ll get really frustrated, wiping a few leaky sperm all over the outside before you realise you’ve got it the wrong way round. Discard this condom if you’ve got another.

  If your eyesight is going and you can’t spot which way round the condom is with the seductive mood lighting, you can either turn the main light on, fetch your condom glasses or get a second opinion from your partner. Preferably all three. Condoms smell funny and even the gooseberry ones taste of old tyres, but anything that helps prevent pregnancy, HIV, hepatitis, herpes, gonorrhoea, syphilis, warts, Chlamydia and premature ejaculation is allowed to smell of old tyres. (NOTE: Condoms don’t completely prevent any of these. The only way to do that is to cover yourself from head to toe in rubber. Some people enjoy this, but don’t forget a breathing hole.)

  Before you roll it on, pinch the end to make space for sperm and remove air bubbles. Don’t snag it on sharp nails. Put it on well before any penetration. Don’t fall for the old ‘let’s go bareback for starters’ line. The finish line is never as far away as you’d anticipated. If you’re going through your full repertoire of two positions, it’s worth checking at changeover that the condom is still on. And grab onto the base and withdraw as soon as you’ve come. Condoms can quickly slip off a wilting penis, and then you’ve got to fish it out and get emergency contraception. Don’t flush condoms because they can block up the plumbing and it’s an embarrassing (and expensive) call out.

  If you’re still young enough to manage sex twice in one session, use a different condom. If you’re big enough to burst an average condom, ask for the large ones. If you’re too shy to do this (and not many men are), you can buy them easily online. Don’t buy condoms with added spermicide; they don’t give you extra contraception and they may increase the risk of transmission of HIV and hepatitis.

  ANOTHER TOP TIP. It’s good to get a condom on in good time, but the penis does have to be erect. Trying to put a condom on a floppy penis is a good aerobic workout (5,000 calories and counting) but ultimately destined to fail. If it just isn’t going to happen, that’s the time to create a diversion by putting the condom on your head and blowing it up. You may find the release and laughter gets over the performance anxiety and you’re good to go again. But please use a new condom.

  NOTE: Some people find it amusing to put a condom up one nostril and pull it out of the other. Funny (once) when it works, but I have seen it get stuck and casualty departments are busy enough as it is on a Saturday night (although we could always do with the light relief).

  Do vegan condoms count as one of your five portions?

  Sadly not. German manufacturer Condomi were the first to endorse dairy-free sex, using cocoa powder not casein to make their condoms. They’re endorsed by the Vegan Society, have a kite mark and a burst volume of eighteen litres, enough for even the most juiced-up vegan. They come with the usual selection of flavours (I’m told the chocolate is particularly authentic) and there’s even a hand-painted zoo tickler.

  If you’re allergic to latex or want to try something with a different feel, you can buy polyurethane condoms. They’re a bit more pricey but you feel the body heat more and you can use them with both water and oil-based lubricants (latex dissolves in oil. See Dr Phil’s Man Milk).

  For non-vegans, there are natural membrane (i.e. lambskin) condoms. They’re thinner and stronger than latex and apparently permit more sensation. But although they keep the sperm out, they allow some bugs to pass through so they wouldn’t be top of my Christmas list.

  The first rubber condom with a reservoir for the ejaculate was introduced in 1901 and trade-named Dreadnaught (literally ‘fear nothing’). Better, I guess, than ‘feel nothing.’ If you find a condom in your drawer made of linen or sheep’s gut and tied with a ribbon at the bottom, it’s likely to be very old indeed and shouldn’t be used (although it almost certainly will have been, many times before). However, it might be worth offering it to an auction house, An eighteenth-century condom illustrated with three naughty nuns fetched £3,300 at Christies. If you can knock off a passable Gainsborough on the side of a Mates King Size, your credit crunch worries could be over.

  Who was Dr Condom?

  The imaginary physician to Ch
arles II who is said to have invented the condom. He didn’t … because he was imaginary. Although bits of animal gut have been found at Ancient Egyptian excavations that might have been used as condoms, it was the Italian anatomist Fallopio (he of the eponymous tubes) who first described a sheath, made of linen, to protect against syphilis. What the world needs now is a real Dr Condom, spreading the message of proud, responsible and fun condom usage. I’m sure the Green Cross Code man is free. He just needs a few tweaks to the uniform.

  Does anyone use female condoms?

  I don’t and Dr Google doesn’t seem to have the sales figures to hand. The Femidom (or in America, Reality) female condom is made of polyurethane, so it’s less likely to tear or cause allergic reactions than latex, and any lubrication can be used with it. They’re a bit of a fiddle to get in (six inches long, three inches wide, with a ring at each end. The smaller ring at the closed end goes high in the vagina and over the cervix, so at least you learn some anatomy). If both the man and woman are using condoms without telling each other (as can happen in the dark in Epping Forest), they can stick to each other and cause mutual slippage. Then there’s the disposal problem. As Jo Brand observed, Epping Forest on a Sunday morning could look like ‘a jellyfish graveyard’.

  Whatever happened to the Today sponge?

  Good question. And whatever happened to Mott the Hoople? The Today sponge is a spermicide-impregnated contraceptive you pop into your vagina and push it up as far as it will go and until it completely covers your cervix. (Note: It’s for women only). You can then have as much sex as you like for twenty-four hours, so long as the sponge stays where it is for six hours after final emission. You have to take it out after thirty hours, because of the (small) risk of toxic shock syndrome. It’s not always a doddle to remove (you may have to bear down and break the suction with your finger), but the manufacturers do have a helpline based in America. Failing that, there’s always NHS Direct.

  The sponge had some production problems a few years back, and your local chemist may not stock it, but I gather it can now be purchased again online. Your chance of getting pregnant with a year of correct sponge use is ten percent, rising to sixteen per cent if you bung it in any old how. These risks are doubled if you’ve already had kids, because your cervix has opened up a bit and it’s harder to cover.

  Other barrier methods for women who don’t want to use hormones range from old favourites (such as the diaphragm and cervical cap) to new kids on the block (Lea’s Shield and FemCap). Overall, they have very few side effects other than the pre-coital fiddling and the fact that they aren’t as good at stopping pregnancy as hormonal methods or a copper coil. And only condoms give persistent protection against infection.

  Can you do your own vasectomy?

  There are all sorts of things you can do with a Swiss army knife, a supple back and a well-angled shaving mirror, but a vasectomy is something I’d leave to an expert. I know a few doctors who’ve done their own, and the commonest reasons for turning a knife to your own scrotum are ‘to see if I can do it’, ‘to make sure I get enough anaesthetic’, and ‘so it’s done properly.’ The last two hardly inspire confidence in the vasectomy industry, but as market forces transform snip clinics into conveyor belts, it’s not unheard of for patients to be aware of what’s happening down below and for surgeons to remove something other than a piece of vas deferens. One consultant was less concerned about his colleagues’ competence than their confidentiality. ‘I just didn’t want another surgeon to see my penis. Especially one I might come across socially.’

  Can you do a vasectomy without a scalpel?

  Yes. You could use your teeth (not recommended). Or you could try the no-scalpel method – developed in China in the 1970s, but don’t let that put you off. I’d opt for this because the risk of bleeding and pain are reduced. A puncture so small that it may not even need a stitch is made over the vas deferens (the sperm tube, one each side), it’s pulled out with tiny forceps and either cut, clipped or cauterised. Some men get quite significant bruising after the snip but I know a bloke who had the no-scalpel method and his wife was so grateful that he had sex the same afternoon (with a condom but after he’d left the clinic).

  Generally it takes about twenty ejaculations to clear the back log of sperm in the tubes so, depending how active you are, you need to use contraception for some months afterwards. You’re given the all-clear after two consecutive sperm-free samples but here’s a tip: See if you can do the samples at home rather than in an NHS side-room overlooking a crowded car park with a much-thumbed copy of National Geographic for inspiration.

  If you were a teenage girl, what contraceptive method would you choose?

  Abstinence sounds inviting. I’ve seen enough of life on the labour ward to know I wouldn’t want to go through childbirth unless it was absolutely necessary. I’m also very bad at remembering to take pills, so I’d probably opt for a small rod of progesterone in my upper arm to stop me having to worry about pregnancy for three years. I’d also insist on condoms every time and I’d inspect every penis meticulously in a good light before letting it near me. And I’d learn to say ‘no’, in forty-seven languages.

  What’s a Coca Cola douche?

  A very ineffective method of contraception. Known affectionately down our way as ‘a poke and a coke’, some young women have sex round the back of Leigh Delamere services and then try to wash out the sperm with a jet of their favourite carbonated thirst-quencher. The theory is that both the pressure of the drink and its mild acidity will wash out and kill sperm, but it may just force sperm up higher and through the cervix. And it doesn’t matter which brand you choose, because none of them work. To be fair to the Coca-Cola company, it has spent a tiny portion of its monumental profits trying to dissuade girls from the practice. And there are some very effective methods of post-coital contraception that work up to 120 hours after the event and don’t leave a big frothy puddle on lino.

  Should I keep emergency contraception in the pantry?

  Possibly not the pantry, but it’s not a bad idea to have a home supply (somewhere memorable, out of reach of dogs and children). Emergency contraception used to be called the morning after pill, but: a) you don’t have to wait until the morning after; and b) it still has a reasonable chance of preventing pregnancy up to 120 hours after spillage. It works best the sooner you take it, and by rebranding it ‘emergency contraception’, it gives you the hint that: a) it’s an emergency; and b) you needn’t be shy about asking for help. (e.g. ‘The doctor’s really busy at the moment. Is it an emergency?’ ‘Yes.’)

  You can choose between a single dose of a drug called levonorgestrel (marketed as Levonelle 1500) or a copper coil. Levonelle can be kept in-between the bandages and the TCP for use at your discretion. The coil needs to be fitted by someone who knows what they’re doing (preferably a health professional). Levonelle is available free on prescription from any GP practice or walk-in centre and, in some parts of the UK, you can get it free from the chemist without a prescription (often restricted to those under twenty years) For everyone else, you can buy it over the counter for £25 (cheaper than a baby, but still ridiculously expensive). If you take it within twenty-four hours, your chance of not getting pregnant is reduced by ninety-five per cent, which is pretty good odds.

  The copper coil is even more effective, but finding a fitter isn’t always easy on a Bank Holiday weekend. In America, adolescents can be given a prescription for emergency contraception (known as Plan B) at any visit, so they always have one to hand. In the UK, it’s left to the doctor’s discretion (one of many reasons why we have such high teenage pregnancy rates). But it’s not just teenagers who need it. The second most vulnerable group to unplanned pregnancy are middle-aged women, back out there after a divorce, whose dating skills are a little rusty and they forget to buy the condoms with the Sauvignon Blanc. It also puts them at risk of infection. If I had a pound for every time I heard: ‘I’m fifty-three, I can’t possibly have gonorrhoea …’r />
  Do all lady doctors have a Mirena coil?

  Not all of them, no, but a recent ‘hands up’ at a contraceptive meeting I went to suggests quite a few of them do. Mirena is ‘a hormone releasing intrauterine system’, so if you can’t remember the trade name you’ve got next to no chance of finding out about it. Think of a coil that also releases a very low dose of levornogestrel, the same hormone used for emergency contraception. It’s been around since 1995, is fitted (by someone who’s been properly trained) through the cervix in the first week of a cycle, stays in for five years, and is very, very, very effective at stopping pregnancy. And it’s reversible; your fertility returns when it’s taken out.

  It also reduces blood loss during periods (very helpful if you’re a heavy bleeder) and reduces period pain. On the down side, it can occasionally cause breast pain, fluid retention and acne. It also costs around £80 (nine times more than a copper coil), so you may not be offered it unless you ask. But over five years, it works out as very cheap contraception and you save a fortune on sanitary towels.