A human sperm fertilizing an egg
The Photo:
A scanning microscope image of a human sperm fertilizing an egg. No form of
birth control (except abstinence) is 100% effective so a girl’s worst fear can
be realized when a pregnancy is unplanned regardless of why it occurred; from
an unprotected casual encounter or from a contraceptive failure. It’s what
responsible sexually active women try our best to avoid and what correct use of
effective contraceptive methods is all about. Fortunately women facing an
unplanned pregnancy now have several options.
pH (potential
of hydrogen): The term pH refers to a numerical measure of the acidity
or alkalinity of any solution. pH values typically vary across a scale from 0
to 14, with the pH of neutral solutions equal to 7, increasing values have
increasing alkalinity and decreasing values have increasing acidity. The pH of
the vagina corresponds to the secretions continually produced in conjunction
with the vaginal flora.
Normal vaginal
pH: pH refers to the
vagina’s acidity level. A vaginal pH of 3.8 - 4.5
(slightly acidic) indicates that there is a perfect amount of good bacteria
(lactobacilli), and no overgrowth of the bad bacteria that can cause odor,
irritation and sometimes infection. A
home vaginal pH test kit measures pH on a scale of 1 to 14. Abnormal vaginal pH
may be higher or lower than normal vaginal pH. High vaginal pH numbers indicate
less acidity, while lower than normal vaginal pH levels indicate high acidity.
Abnormal vaginal pH frequently indicates the presence of a vaginal infection.
However, not all vaginal infections cause changes to vaginal pH. This means
that having a normal vaginal pH test does not mean that you do not have a
vaginal infection.
If the vaginal pH is above normal, the most likely reason is
that the woman has bacterial vaginosis (BV) and not a yeast infection. In this
case, don't use OTC medications for vaginal yeast infections because the
medication does not treat BV. You’ll need to see your doctor for diagnosis and
treatment.
On the other hand, if the vaginal pH is normal or below
normal and she has had previous vaginal yeast infection diagnosed by a doctor,
she could try one of the OTC medications for vaginal yeast infections. If the
OTC medication for vaginal yeast infection does not cure the vaginal symptoms
or infection, see your doctor for diagnosis and treatment.
- Menstruation: Blood has a pH of 7.4, so during your
period, vaginal pH becomes elevated.
- Tampons: Since they retain the
fluids that cause pH to increase, tampons can contribute to the
problem, especially if you “forget” a tampon and leave it in too
long.
- Intercourse: The pH of semen is 7.1 to 8, slightly alkaline.
- Douching and cleansers: Any vaginal
infusion of water or other fluids can affect vaginal pH. The pH of water
is 7, and fragrances and perfumes can also irritate the vagina.
- Menopause or pregnancy: These are
times where hormones fluctuate, which is associated with elevated pH.
- FCM; Fertile cervical mucus: In
normal conditions, fertile cervical mucus has
a pH level of 6.5 to 8.5 and should be able to stretch 10cm in
either direction. FCM will temporarily decrease the acidity of the vagina
to help sperm survive the acidity of the vagina during a woman’s fertile
interval.
The average
sperm count today is
between 20 and 40 million per milliliter in the Western world, having decreased
by 1-2% per year, from a substantially higher number, decades ago.
Total sperm count, or total sperm number, is the total
number of spermatozoa in the entire ejaculate. By WHO, lower reference limit
(2.5th percentile) is 39 million per ejaculate. The
median ejaculation (50th percentile) contained 255 million sperm.
Sperm
motility: A more
specified measure is motility grade, where the motility of sperm is divided
into four different grades:
- Grade a: Sperm with progressive
motility. These are the strongest and swim fast in a straight line.
Sometimes it is also denoted motility IV.
- Grade b: (non-linear motility):
These also move forward but tend to travel in a curved or crooked motion.
Sometimes also denoted motility III.
- Grade c: These have non-progressive
motility because they do not move forward despite the fact that they move
their tails. Sometimes also denoted motility II.
- Grade d: These are immotile and
fail to move at all. Sometimes also denoted motility I.
Volume: WebMD advises that semen volumes between 1.0 mL and 6.5 mL are normal; WHO regards 1.5 ml as the lower reference limit. Low volume may indicate partial or complete blockage of the seminal vesicles, or that the man was born without seminal vesicles. In clinical practice, a volume of less than 2 mL in the setting of infertility and absent sperm should prompt an evaluation for obstructive azoospermia. A caveat to this is to be sure it has been at least 48 hours since the last ejaculation to time of sample collection.
Semen pH: WebMD lists a normal
semen pH range of 7.1-8.0; WHO criteria specify normal as 7.2-7.8
Acidic ejaculate (lower pH value) may indicate one or both of the seminal
vesicles are blocked. A basic ejaculate (higher pH value) may indicate an
infection. A pH value outside of the normal range is harmful to sperm.
Liquefaction: Liquefaction is the process when the
gel formed by proteins from the seminal vesicles is broken up and the semen
becomes more liquid. It normally takes less than 20 minutes for the sample to
change from a thick gel into a liquid. A liquefaction time within 60 minutes is
regarded as within normal ranges.
Spermicides:
In order to make barrier contraceptives more effective there are formulations
of chemical, Nonoxynol-9 (N-9) and lactic or citric acid mixed with a gel
carrier that provides an acidic pH to immobilize sperm should a condom break or
a diaphragm leak or become displaced. ContraGel (advertised by its maker not as
a spermicide, but as a barrier method when used with a cervical barrier) uses a
base of lactic acid with a pH of 3.8 which is hostile to the sperm.
For dive-sex we use a private label product called DiveGel+ (in
10 ml prefilled disposable applicators) which is a specially formulated
silicone gel that won’t degrade silicone cervical barriers fortified with a pH
balanced biocide and FloraFix a type of Lactobacillus with a pH of 3.8 that
helps maintain the acidity of the vagina regardless of how many unprotected men
a girl is penetrated by per day. For non-diving encounters the formulation is
being rebranded as ‘FloraFix’ and packaged in 5ml disposable applicators and is
being used very successfully by our escorts.
My cervical
barriers: I dislike using condoms unless the man has an unknown
sexual history. I love the skin-on-skin contact which Oves permits me and the
feel of a man’s liquefied fluids draining out of me after he has done his
biological best to impregnate me. While the rest of my circle is all fitted
with copper IUDs I still prefer to use an Oves cervical cap or a
diaphragm. I stocked up on Oves before
they went out of business and use them each for multiple cycles, so if I don’t
get preggers or have a change to the surface of my cervix I should have enough
to last me until menopause. At 42 my fertility is declining, but I still have
regular cycles and love how well both Oves and my diaphragm (depending where I
am in my cycle) are protecting me.
Contraception! Keeping the little swimmers from their goal! Many of us consider this key to a healthy sex life because physicians calculate that the theoretical limit of live births per woman is sixteen or twelve full years of pregnancy, often shortened by premature death until about 1900 when women's life expectancy first exceeded mens'.
ReplyDeleteThe pH balance is necessary for a healthy vagina and is also key to limiting the number of children we bear. Almost all forms of birth control used today have been used for millenia but are a bit more convenient, and a bit more effective, today. Based on her physicians writings, and only three pregnancies, Cleopatra is believed to have used oral contraception. Goddesses of the Hellenic and Roman eras used a variety of pessaries and barriers, alone or in combination, to enjoy life without overpopulating the top of Mount Olympus. Midwives of various, even pre-literate, societies dispensed various potions and even performed abortions. Most of this was done without men's knowledge as they wanted many children to demonstrate their personal virility.
Various acidic potions have been used as vaginal spermicides, the most common traditional form of contraception: lemon juice, tobacco juice, crocodile dung and various leaves crushed or chewed have been mixed with honey, dough, olive oil or other viscous liquids to keep the mixture where it mattered. Most of these have been estimated to be very close in effectiveness to modern vaginal spermicides.
Today, we simply purchase something off the shelf, cram it into us and hope it is effective. Usually is but it is interesting that all the spermicidal systems, with or without a barrier such as a diaphragm or sponge, have about the same "real life" effectiveness. Usually the marketing, and even research literature, uses theoretical effectiveness which is considerably higher than use in real life. Spermicide used alone, with diaphragm, with sponge, with cervical cap, with disposable menstrual cup comes out to about fifteen pregnancies per year per 100 sexually active women. By comparison, with no protection there will be eighty-five live births; with IUD, two; and, with hormonal systems, three. There are reports, but no complete studies, that find adding vaginal spermicide to condom use dramatically reduces the "failure rate." For teens not yet engaged in frequent sex the combination of vaginal jelly and a condom is likely the best choice. (Cont’d)
It was around the end of the nineteenth century that vaginal suppositories began to appear in adverts for "feminine freshness." This was the code word for contraception in those early twentieth century magazines. They were made of a waxy, melt at body temperature, substance with one of the old acids included. Still depending upon citric, lactic and carbonic acid to protect us. They resulted in about 30 pregnancies/year/100 women or about a two-thirds "protection rate" over nothing.
ReplyDeleteThe current “active ingredients” were developed in the mid-twentieth century so what you buy off the shelf has been in use for sixty years or so. Nonoxynol-9 is, by far, the most common. Mainly because it seems the most effective and is the least expensive. Benzalkonium chloride, sodium choate and menfegel (a foaming tablet) are also found in various spermicides. Non_9 is certainly effective but is a detergent and women and a few men who react to washing the dishes will have adverse effects, fortunately temporary. That does not mean no spermicide use; it means read the labels and find one that uses a different active ingredient. At least one of the sponges on the market uses a proprietary name which is actually a combination of three of these with Non-9 being the greatest constituent.
As for douching, not a good idea even for those women who douche after every vaginal sexual encounter to avoid the smell putrifying semen. It really upsets the pH of the vagina and is more likely to be destroying more good bacteria than bad. The only time I douche is when I have closely scheduled dates. Last Friday night, a male friend spent the night and Eva was coming over Saturday. Saturday morning I changed the sheets and douched. If she wants a mouthful of semen she can do a blowjob but I would not want a partner to be getting someone else’ semen from me.