TNP: CONTRACEPTION: S’PORE STYLE

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By Ng Wan Ching

May 31, 2009

By most accounts, Anna (not her real name) is an intelligent student. She scored mostly As and Bs throughout her school years.

But ask her whether there’s sperm in pre-ejaculate (which is produced when a man is aroused) and she’s stumped.

‘Er, no?’ she said.

She’s wrong and she isn’t the only one.

Amid all the buzz about sexual education programmes in schools and what is appropriate to be taught, a study has found ‘worrying’ gaps in the knowledge of even post-secondary students.

The study by a pharmaceutical company covered 365 students from polytechnics and institutes of technical education (ITE).

More than half of the students polled agreed with Anna’s answer on pre-ejaculate. Six in 10 thought that it does not contain sperm.

The sperm in pre-ejaculate can impregnate a woman, especially if she is young and fertile, say doctors.

Even more worrying is that Anna has been sexually active for more than a year and does not practise any consistent form of contraception.

She and her boyfriend, also a polytechnic student, buy condoms now and then. If they run out, they have unprotected sex.

‘If we had sex without the condom, I’ll make sure that I wash my private area very thoroughly and drink a lot of water and pee a lot,’ she told The New Paper in a phone interview.

Does she think that will prevent pregnancy?

‘I’m not sure, but I think it will help,’ she said.

Again, she’s not alone.

The survey showed that one quarter of the students think douching internal and external genital areas can help to prevent pregnancy.

The survey was conducted by Bayer Schering Pharma Singapore among 365 tertiary students, aged 17 to 20, from June to December last year as part of its ‘Say Yes’ to sexual responsibility outreach.

Another quarter of the students think that either urinating or exercise (called ‘sperm dancing’) can help to prevent pregnancy.

‘Sperm dancing’

‘Sperm dancing’ is a bizarre form of exercise where girls jump around in the belief that the sperm ‘will fall out of their bodies’.

When Anna is worried about getting pregnant, she sees a doctor to ask for a morning-after pill.

It is a hormonal method of emergency contraception aimed at preventing pregnancy after unprotected sex.

‘I don’t want to go on the pill long-term. I don’t want my parents to find out that I’m having sex. If they find out that I’m on the pill, it’ll be quite embarrassing,’ she said.

Not using contraceptives is something that happens often among the 365 students surveyed.

A quarter of them admitted to being sexually active. And half of those said they did not use any contraceptives during their last sexual activity.

Doctors here find this statistic ‘worrying’.

Five doctors interviewed by The New Paper say this is a sensitive subject.

Said Dr Janet Lee, family physician and medical director of Temasek Medical Centre, a GP clinic: ‘It’s very sensitive because we have always emphasised that abstinence is the best way to prevent unwanted pregnancies, abortions and sexually transmitted diseases (STDs).’

That was the message when sex education was introduced in schools from 2000 to 2007, she said.

Yet doctors have seen more teens coming down with STDs and going for abortions.

Said Dr Lee: ‘For the past few years, the number of teens going for abortions has remained in the region of over 1,200 a year.

‘This figure should be going down if we are educating the youths on the correct use of contraception.’

In 2006, the figure was 1,300, in 2007, it was 1,279 and in 2008, it went up to 1,390.

‘Singapore abortion rates show that teens account consistently for 12 per cent of the total number of abortions done a year,’ said Dr Lee.

The number of teens contracting STDs has gone up in the last few years.

In 2002, there were 238 cases of STDs among teens. Last year, it had gone up to 787 cases.

‘In 2007, the Ministry of Education decided it needed to add an extra message to the sexual education programme.

Negative effects

‘Since then, students were also taught the negative effects of unwanted pregnancies, abortions and STDs. They were taught how to prevent this using contraception,’ said Dr Lee.

However, there are parents who are uncomfortable about this.

‘They think that if you teach them too much, you may be encouraging them to do it,’ said Dr Lee.

But she thinks that it is better to teach the teens the correct way rather than have them find out from their peers or the Internet where they may not get the right information or message.

She and the other doctors interviewed feel that doctors should be roped in to help educate teens in school.

‘Doctors can complement the teachers who may not be familiar with new contraceptives,’ said Dr Lee, who has given sexual education talks at polytechnics.

So although the first and foremost message is to avoid pre-marital sex if possible, doctors think it is getting less realistic.

Said Dr Christopher Ng, an obstetrician and gynaecologist at GynaeMD Women’s & Rejuvenation clinic at Camden Medical Centre: ‘The perception in popular culture now shows that pre-marital sex is usual.

‘Shows on TV and movies often depict a man and a woman who are boyfriend and girlfriend and they are in bed together.’

Dr Ng, who has also given talks to students, agrees with Dr Lee that although the first message is abstinence, youths should be taught proper contraception methods.

‘As a responsible doctor, I will tell them that if they really cannot say no to pre-marital sex, the next best thing would be to use proper contraception,’ he said.

Many not using birth control methods well

IF you cannot say no to pre-marital sex, then at least protect yourself adequately from unwanted pregnancies and sexually transmitted diseases (STDs).

That is the key message that doctors want to tell teens.

In the survey among 365 post-secondary students, many chose contraception methods which were not optimal, said doctors.

Among those who used contraceptives during their last sexual activity, the top choice was the condom (83 per cent), followed by the pill (11 per cent). The third-most popular method of preventing pregnancy was the withdrawal method (6 per cent).

The condom (36 per cent) was rated the most reliable method, followed by intra-uterine contraception (19 per cent), pill (9per cent) and withdrawal (4 per cent).

The rest (32 per cent) thought either the rhythm method was best or had no response.

For the best protection, doctors say a combination of the condom and the pill should be used.

Said Dr Christopher Ng, an obstetrician and gynaecologist in private practice: ‘The condom, if it is to be used correctly, must be used at the start of intercourse.

‘Many young people I see say they use it halfway through sex. Then it offers sub-optimal protection against unwanted pregnancies as there is sperm in pre-ejaculate.’

The survey results showed that half of those who are sexually active did not use any contraception during their last sexual activity.

Reduced sensation

The main reasons for not using the condom were reduced sensation and having sex in the heat of the moment.

As for not using the pill, the reason was worry about side effects like weight gain.

Said LK, a 18-year-old poly student who is not sexually active: ‘I will choose to use the condom if I have sex.

‘As a male, that is all I can do.’

But he was not sure when was the correct time to use the condom and he did not know that pre-ejaculate contained sperm.

Hence, for optimal protection against unwanted pregnancy, the girl should be on the pill, said DrNg.

‘The pill offers more than 99 per cent protection against unwanted pregnancy,’ he said.

In contrast, the condom may have a failure rate of 2 to 15 per cent in preventing unwanted pregnancies, depending on how it is used.

But the boy should still wear a condom, for optimal protection against STDs, said Dr Ng.

GO FIGURE

Among the 365 students surveyed…

24%
of the students are sexually active, but only half use contraception

83%
of the sexually active who practise contraception choose condoms, followed by the pill (11%) and withdrawal method (6%).

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