The lights are dimmed, music plays softly on the stereo, and a fire crackles in the fireplace. Your date leans toward you.
”Don`t worry, honey,” he says in a deep, reassuring voice. ”I`ve had my shot.”
Sound far-fetched? Not to some people.
”The ideal birth control is something 100 percent effective, 100 percent safe and 100 percent reversible,” said Gerald Bernstein, professor of obstetrics and gynecology at the University of Southern California School of Medicine.
Unfortunately, he said, it hasn`t arrived yet.
”It doesn`t look like there will be any major breakthroughs in the near future,” Bernstein said. ”But in the meantime there are some new methods.” Even closer to being on the market than birth-control shots for men, used in experimental studies with various success rates for more than 10 years, is the first new intrauterine device, or IUD, to be marketed since 1984.
The Copper T-380A, created by the Population Council of New York, is longer-acting than copper IUDs available previously in the United States. It is expected to be available in June.
”This probably is the best of the IUDs,” Bernstein said. ”It is good for four years, pregnancy rates are very low and expulsion rates are very low.”
Since 1986 only one IUD, the Progestasert, effective for a year, has been available in this country. Various companies, such as the manufacturer of the defectively designed Dalkon Shield, withdrew IUDs from the market after experiencing a growing number of lawsuits. Even companies that won most lawsuits, such as the maker of the Copper 7 IUD, withdrew their products when the high cost of litigation and product liability insurance made production unprofitable.
The new Copper T, which will be distributed by GynoPharma Inc., received federal Food and Drug Administration approval in 1984 and has been available in foreign markets for several years.
On the near horizon for men is a no-scalpel vasectomy technique, developed by a Chinese surgeon and introduced to the California medical community at an orientation seminar for physicians in February.
”The major advantage of the technique is that there is much less bleeding and dramatically fewer complications, like hematoma (bruising), than with conventional vasectomy procedures,” said Douglas H. Huber, medical director of the Association for Voluntary Surgical Contraception, which cosponsored the seminar.
”It may make vasectomy more attractive to men who fear the scalpel.”
In the no-scalpel technique, the scrotal skin is not cut open. After a local anesthetic is administered, the skin is pierced by an instrument with two sharp points. As in a traditional vasectomy, the vas is then cut or cauterized, but no sutures are required to close the tiny puncture.
About 200 American men have had vasectomies using the technique since it was introduced in 1974, as have about 8 million Chinese men.
Women seeking equality may find it in a new condom designed to be worn by women. The condom is being tested in the United States and is expected to be approved by the FDA by the end of the year. European tests have shown that men and women prefer it to condoms for men and diaphragms for women.
The women`s version is inserted like a tampon, with a large opening remaining outside the body. Made of polyurethane, a soft material that is stronger than the latex of most male condoms, the device is expected to be effective in preventing infection with sexually transmitted diseases.
Also soon to be available is the much-publicized cervical cap, which recently received FDA approval. Similar to a diaphragm but smaller, the cap fits over a woman`s cervix and can be left in place for 48 hours.
There are new hormonal approaches to birth control, Bernstein said.
”There`s been a lot of work done with hormones that are implanted under the skin that are effective (at preventing pregnancy) for seven years,” he said, ”but they`re not yet approved by the FDA.
”But right now, nothing is perfect. And when nothing is perfect, you need a variety of things to satisfy. People are going to keep on doing what they`re doing.”
