Monday, August 29, 2011
Family Planning in the Post Modern Era
It is my job to keep myself on the very forefront of knowing and understanding the latest medical technology as it becomes available. Amazing advances that significantly improve human life on this planet are happening nearly every day. But when it comes to medicine and how it applies itself to sex, pleasure, and reproduction (or avoiding reproduction) I am often sad how little there is to report.
My whole life I've been waiting for a viable, temporary male contraceptive and I am utterly shocked that we cannot seem to figure out how to keep sperm from flowing out the end of a penis without permanently severing, tying, and cauterizing the vas deferens. I got really excited by the VasClip, and even some crazy ideas that came out of Canada about placing glue in the vas deference that would block sperm flow until the patient had it surgically removed. Alas, we've found that even while restoring the function of the vas deferens isn't a problem, even for traditional "cut and burn" vasectomies, keeping the patient's body from learning how to destroy its own sperm is. As it turns out, not allowing your sperm to leave can cause your body to begin fighting it off with its immune system as though it were a virus. So, no vas deferens blocking methods are going to be FDA approved until the return to potency efficacy is ~100%
So in with the hormones, which I'm not a fan of for men or for women. Jade can be an awfully mean person when she's on oral birth control and she can turn on you on a dime. One minute you are hanging out enjoying pleasant conversation and the next you are crawling around on the floor chasing your testicles that she cut off midway through her last sentence. The hormones that seem to work pretty well for male contraception is one we all know too well, testosterone. It is the stuff that makes men manly and hairy and smelly and all that stuff. When given in relatively high doses to men via subdural injection, it sends a message to the testicles which sounds something like this. "We got plenty of testosterone already, shut down all testicular operations. Thanks for your cooperation." Then the patient's gonads just take a long nap until testosterone levels in the blood drop to unacceptable levels. While I'm sure that you and I can think of plenty of reasons why this is a horrible idea, I'm certain that this will be the continued strategy of drug companies who are looking for a way to market to people trying to not have ugly babies.
So bring on the sterilization for those who never want ugly babies or for those who have had enough cute ones and don't want to take the risk of
rolling an unlucky bounce off the back of the craps table. The vasectomy is the absolute best choice for couples who wish for permanent sterilization and who's gonad-toting half isn't a wimp. As far as discomfort goes, I'd rather have another vasectomy over even minor dental work. I took diazepam the day of the procedure and couldn't care less what the doctor was doing down there and spent the next day on the couch watching bad science fiction movies holding an icepack on my scrotum. Honestly it was mildly uncomfortable more than it was painful. It is a small price to pay for a lifetime of sex without worry. The new techniques don't even use needles or scalpels so I fail to understand why men are scared of this technique at all. If you are one of those freaks who read the internet looking for stories of guys complaining about Epididymitis after the procedure, you really need to understand that of all the medical procedures that you could have, this is one of the safest and most effective.
For female birth control, the options are as abundant as the choices in Jade's Amazon wishlist. To add to the pill, we now have the patch and the ring and I believe they are even working on tiara with matching earrings. :P Since I'm against hormones so much (due largely to the fact that I like my testicles where they are) I am confused as to why anyone who was planning on not needing to get pregnant over the next one to five years would choose anything but a non-hormonal copper IUD. Just listen to the advertising for these things. No pills. No hormones. No daily or weekly routines. No associated weight gain. Yes, this last one was right off of ParaGard's website. In my opinion this is the absolutely perfect solution for nearly any woman regardless of age or whether or not they've had kids yet. When you go looking for these you may encounter doctors that will steer you away from them if you are younger, or haven't had kids. You might even find doctors who don't endorse their use at all. If this happens to you, get a new doctor. I know a lot of women who have these and LOVE THEM and they are all ages and most of them don't have kids, a good sign that they are working :P. I've talked to lots of doctors about IUDs too and have found that not all doctors are good at what they do and the ones who prefer prescribing pills to patients are the ones that don't innovate. They were the ones in school that probably didn't hit all the extra-credit available to them.
My favorite thing about copper IUDs is that the manufacturers don't know, or more accurately claim to not know how they prevent pregnancy. Listen to the Dr. Bloom video on this web page ParaGard isn't a barrier like a condom or a diaphragm…" "It works primarily by blocking sperm from reaching the egg and fertilizing it." Does anyone else find these two statements contradictory? Later in the video she can be quoted saying, "It sounds pretty easy, right? It is." The reason that I find this bit of corporate fast handing so interesting is that they don't want to admit that it is very likely that sperm is fertilizing the eggs but because you've got a coper wire in your uterus, your body is going to kick that egg out like a star destroyer jettisons its trash before it jumps to light-speed. Only Boba Fett is wise enough to know the difference and most of the pro-life nut-cases aren't nearly crafty enough to start chanting and making posters that say, "IUDs are an abortion a month!" So I say, rock on with the careful wordplay and pretending to not understand something that may upset crazy people.
For female sterilization, tubal ligation has been used for the past 80 years to keep sad situations like the Duggars from becoming reality TV shows. It works but let's be very clear, it is no minor medical procedure, it is major surgery requiring the patient to undergo general anesthesia. if you are getting one because your partner is to wimpy to get a vasectomy, please give me his approximate location and I'll kick him in the balls hard enough where it may not be a concern for you any longer. Luckily, advancements in laparoscopic surgical tools made it possible to perform a very effective female sterilization without even making an incision. The Essure implant is a small coil that is inserted through the vagina, cervix, uterus, and finally the fallopian tube where it stays. With in a few months it bioincorporates itself like the Borg and causes a scar to form blocking your eggs from ever seeing the light of day, much less one of those vicious chromosome carrying sperm.
We'll find out soon enough as Jade is scheduled to get her own Essure installed in just a couple of weeks. We'll let you all know how it goes.
Watch vasectomy procedure
Watch a Copper IUD Procedure
Watch the Essure Procedure
Watch what happens if you don't use contraception.