Maxine's Journal

I have lots of other things to catch up with, but it seems I'm most productive when I'm angry - and this idiotic article (and a swathe of similar ones) makes me EXTREMELY angry.

So what's wrong with it?

Here's the headline: "Failure of contraceptive implants sets back battle against teen pregnancies"
and the subtitle: "Bad press surrounding 584 cases in which women trusting in Implanon implants fell pregnant is a blow to family-planning advisers"

Terrifying - 584 failures - that's got to be bad, right? Well, no.

Why not?

Because statistically, that number of 584 failures makes Implanon an AMAZINGLY EFFECTIVE contraceptive.

Let's take a look at a table of statistics about contraception - I've taken my stats from here

Type of contraception	Implanon Hormone Implant: 0.05% failure rate.	Condom: 2-15% failure rate.	Crossed Fingers (no contraception): 85% failure rate.
Number of women expected to become pregnant during one year (out of 100)	0.05	2 to 15	Around 85
Number of women expected to become pregnant during one year (out of 82,000)	41	1640 to 12,300	Around 69,700
Number of women likely to become pregnant over 11 years (out of estimated 1,000,000)	584*	20,000 to 150,000**	Around 850,000**
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*actual statistic
**this is a low estimate - stats are based on only one year of use.

Contraception failure rates are measured by the number of women out of 100 who would get pregnant over a year using that contraceptive. So as you can see above, using no contraception at all, 85% of women WOULD get pregnant. Condoms have between a 2 and 15% failure rate. That means between two and 15 women will pregnant over a year whilst relying on condoms for contraception. So if 82,000 women were using condoms for contraceptive protection for a year, between 1640 and 12300 of those women would get pregnant.

So let's just compare those condom statistics back to the headline: We are told in the article that 82,000 women per year are fitted with an Implanon implant. Compared to condoms, 584 failures out of 82,000 women is very low - far less than 1%.

But that's not the end of the story.

It's not the end of the story because the 584 pregnancies they're talking about in this article weren't over one year. They were over ELEVEN YEARS. We're talking about barely one twentieth of a percent, 0.06%.
If all of these women had used condoms instead, we'd be looking at an extra 11,716 women who would likely be pregnant due to contraceptive failure - not just once either, that's every year.
That's ELEVEN THOUSAND WOMEN! Eleven thousand lives that *haven't* been disrupted by unwanted pregnancy, because they were relying on a more effective form of contraception. If they hadn't used any contraception at all? 69700 unwanted foetuses PER YEAR. This is what happens when you put people off using safe contraceptives with idiotic scare tactics.

Yes, these women "thought they were 99% safe" - based on the number of women who have actually had Implanon fitted, they were actually 99.94% safe (equivalent to one in about 2000, vs. one in 100). I'm sure it's not much of a comfort to the women who have experienced a failure (after all, on an individual level it's no longer a statistic - you're either pregnant or you're not), and of course it would have been wonderful if they could have been 100% 'safe', but compared to around 70,000 of those same women each year who would have been pregnant if they had no contraception, that's a vanishingly small number.

It's not perfect. No method of contraception is perfect, and not everyone gets on with hormone based contraception, but it's by far the best out there. And it makes me sick with anger that scare tactics like these stupid headlines are being used to trash what is clearly the most reliable means we have of preventing unwanted pregnancy.

What's the real agenda here? I have no idea. Maybe some crazy idea that that declaring contraception 'unsafe' will put teenage girls off from having sex? Maybe a complete lack of understanding of statistics. Perhaps a misunderstanding of how contraception really works - and a belief that there's a better method out there? Currently, there isn't a better option - unless you combine several at once, eg. condoms *and* an implant, or a coil, or or whatever (and of course, implants and coils don't protect from STIs, so that's an excellent idea anyway). Sadly real science doesn't give us perfect answers, it just gives us better ones. And they're getting better all the time - or they would be, if only journalists would actually understand the information they're presented with.

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Additional information:

If you have an implant and you're worried if it might be incorrectly fitted:

What to do if you are worried?
If you are already using the Contraceptive Implant and are not experiencing any problems you probably don’t need to worry. However if this coverage has concerned you then you can speak to your GP, Reproductive Health Clinic or call the Family Planning Association (in the UK) on 0845 122 8690.

Remember this form of contraception is more than 99% effective and for the majority of women who opt to use it they experience no problems and are happy with it as their contraceptive choice.

--from Dr. Petra Boynton's blog entry, Contraceptive Implants and Media Panics – what you need to know (click for more details)

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Update two:

There's some more decent information at these sites (though many of them still fail to compare with failure rates for other contraceptives):

http://bishuk.com/2011/01/06/contraceptive-implant/
http://www.bbc.co.uk/journalism/blog/2011/01/contraceptive-failure-figures.shtml
http://dianthus.co.uk/implanon-and-contraceptive-failures
http://www.nhs.uk/news/2011/01January/Pages/info-implanon-contraceptive-implant.aspx

I was planning on making my first post in 2010 a bit of a retrospective, inspired by the 'new decade' posts on my friends list, and maybe add in a couple of new year's resolutions. Perhaps I'll still do that, but this piece of idiocy has got me annoyed enough to make my first post this year a rant instead.

The above link is about a supposedly scientific study about a part of the female body that has been politicised and argued over for several decades - The G-Spot (1). Academics and doctors are still arguing about whether or not this particular body-part even exists, while the more experimental of us are busily testing it out for ourselves in the bedroom (My own report from a small, but not insubstantial sample: Yes, it exists, as does female ejaculation).
So how do the researchers test the reality of this myth? Do they conduct a physiological study, and *look* at the female anatomy to determine whether, perhaps, there might be genuine physiological backing, as some studies (2) have done? Do they try stimulating the area, as one classic study (3) did?

No, they designed a questionnaire.

In a society where the average heterosexual male still has trouble finding the clitoris - a perfectly visible, external organ that nobody is debating the existence of, and when public knowledge of human biology is pathetically inadequate, apparently these researchers are claiming that asking women where their G-spot is located and getting inconsistent responses is evidence enough that it doesn't exist.
Whether the women are twins are not makes no real different to the idiocy in the design of the study. I mean, Hello? Is anyone even being taught the existence of the G-spot in schools? I think not. And certainly not when the participants of the study were at school. So all the average woman has to go on is hear-say, and if she's lucky enough to have had a GGG partner or two, maybe some small amount of exploration (I've been lucky enough to have some extremely open-minded and giving male partners, and it's been tough to get more than a brief exploration out of them - I hate to imagine what it's like for other girls.).

I wonder what would have happened if the same study had been done on males, asking them the location and function of their prostate gland? I imagine the results would have been much the same.

This study proves nothing at all except just how poorly educated women (and men) in the UK still are about their own bodies.

Me, I've come from a scientific background. I do understand about the issues with designing studies. The problems of medical ethics are many, and funding towards examining something like this is rare, especially since our attitude to sexual pleasure is still tinted by the victorian attitudes of our past, perhaps even more now than in the 50's when the original work began. Sexology is a field where most of the researchers hands are tied, and they risk being discredited at the slightest whiff of personal experience being included in their conclusions. But jeez... a randomly selected questionnaire to decide on whether a much beloved part of my sexual anatomy exists or not? I'm not amused.

I am, however amused by the turnabout from Freud up to now - Where in Freud's time the clitoris was deemed the 'incorrect' way for a woman to orgasm, and the vaginal orgasm was the only 'proper' way for a mature adult woman to climax, thus leading to decades of strife for women who could only orgasm through stimulation of the clitoris. Now we are being told that the vaginal orgasm does not, in fact, exist, and that the clitoris is the only 'real' way for a woman to receive pleasure.
Wait, actually, I'm not amused. I'm incensed.

Are we still in an age where researchers really think there is a 'right' and a 'wrong' way to stimulate the female body? Or anyone's body?

Considering Andrea Burri's claim that she is "anxious to remove feelings of “inadequacy or underachievement” that might affect women who feared they lacked a G-spot." What about the women out there who have already found theirs and are now being told it doesn't exist? So I've been having imaginary orgasms all this time? What?

I really wish that some of these self-appointed protectors of truth would simply shut up and stop telling me how to enjoy my own body.

Maybe some women don't have G-spots, and some do. Maybe some women don't have sensitive G-spots (and hell, I've met guys who don't have sensitive dicks), I'm sure some women have just never looked, and maybe some more of them have been cursed to a lifetime of miserable sex because their partners read the wrong news article.

Meanwhile I've had partners (male and female) who can come from having their ears sucked, their lower back stroked, their necks nibbled, their nipples clamped, only from being fondled through thick denim fabric, or from merely a word in the right tone of voice. Other partners have struggled to orgasm even with powerful vibrators and hours of work (we got there in the end, though!). Let's face it, we're a diverse species, with a myriad of differences, and that includes sexual function just as much as everything else.

People, if it works for you, use it. If you're with a partner, don't play the odds or go with what worked for previous partners. *Find out* what works for them, and use it. Treat sex manuals (and scientific studies) as suggestions for things you might like to try, not as the damned Holy Bible of Sex.

Can we please get the researchers out of the bedroom, now?


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*Last minute update: a voice of sanity, Doctor Petra Boynton says much that I have, and has more detail on the original study. Apparently lesbian and bisexual women were excluded because manual stimulation might 'skew the results' (i.e. women who actually knew what they were doing might incorrectly demonstrate the existence of this 'mythical' spot). Read More

Also a good (if depressingly close to the bone) piss-take article: MEN WHO CARE ABOUT THE G-SPOT ARE A MYTH, SAY EXPERTS
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References: (I don't usually bother with references, but this one pissed me off enough to actually put some work in)

(1) Link to Grafenberg's original article on 'The Role of Urethra in Female Orgasm'.
(2) BBC article about an Italian study.
(3) Time Magazine archive - classic study involving Beverley Whipple.
(4) Deborah Sundahl's book on how to stimulate the G-spot, and the phenomenon of female ejaculation.