CONTRACEPTIVES

I'm sitted in my 'usual' seat at the '10-sitter' proboxes on my way to work in the 'wilderness'. I hear on the radio the advertisement on the 'C' word that has been going round for a long time. The preaching on contraceptive use among the youth and especially teenagers. I get thinking during the one hour drive  and wonder if we are misleading our young brothers and sisters. It reminds me of episodes when young girls as young as 18 years would come in for depo-provera injections, Norplants, Mirena e.t.c. Young unmarried women using high hormonal methods and taking risks of future infertility because they need to keep their 19-year-old boyfriends. Yes, you heard me, boyfriends and not husbands. I'm able to have precognition in my office because in one instance a teenager would walk in asking for contraceptives and the next patient would be a 37 year-old unable to conceive because of anovulatory cycles caused by long-term high dose progesterone contraceptives use . I'm not being judgemental, not all women with anovulatory cycles used contraceptives.   Anovulatory cycle is lay-man's terms means an alteration in menstrual cycle caused by hormone disturbances  resulting in ovaries not releasing mature ovums. I have also witnessed a number of fairly young girls with intra-uterine copper devices (IUD) presenting with bad infections. Some researchers would argue that infections results from unhygienic conditions during insertion of the IUD or from unsafe sexual practices later on. But all in all, a foreign body would encourage more infection, wouldn't it? Then 20 years to come the same person presents with infertility due to blocked Fallopian tubes. (I'm being too harsh, aren't I?) I'm not against contraception use among teenagers and I'm not judging people battling with infertility; but do we also make the effort to preach to the girl-child some probable side-effects of some of the contraceptives use? It's all about avoiding pregnancies but we don't sit and think on how to protect the same pregnancies in the future after getting married and being at the right age for such responsibilities. Why not encourage the use of barrier methods or be conservative and preach abstinence. Nobody died from lack of coitus after all!! I have no problem when an informed decision about contraceptives is made at the right time, in a family-setting or when a person is mature enough. Contraceptives are good when used at the right time. I feel like our society is getting dangerously modernized. There are times I'm tempted to take a rod and instill some sense in my young patients. I have seen tens of cases of 18-20 year old boys (I call them boys) coming in with sole complaints of decreased libido over a number of years. So when did you start young man????? Weren't you supposed to be concentrating on your high school education and not running after 16-year-old girls? I see it all in the november - December period after KCSE. Some walk in and confidently request for a prescription of Sildenafil drug (google it). Then comes last week of December and first week of January when hospitals would be flooded with cases of criminal incomplete abortions gone wrong in girls preparing to go back to school. During our days( tens years back), getting ready for school meant shopping for new socks, new uniforms, toiletries, finishing assignments  and not visiting a gynecology unit.  ( I sound old, 'during our days' ).  Have parents neglected their duties? As i was growing up, ( and even now ), mother knew my every move and could foresee my future plans( I sometimes thought she used some juju).  She would instill thorough discipline and stop any naughty schemes ahead of time. I remember being shown a documentary on HIV Clinical manifestations  when I was only 10 years old. It was very scary . I remember having night-mares after watching it. She called a spade a spade and there was no beating around the bush. Those images are still fresh in my mind to this day. You can look out for the video, I remember it was presented and produced by Raphael Tuju. It changed my life forever in a good way and made me look at sexuality in a different perspective. I need to look for it somewhere in the family archives. The documentary was produced in the late nineties when there was a lot of stigma associated with the disease and when ARVs where not available to all.  I want to write some more about this topic but let me sit back and watch the reactions to this first.  #somebodytellthemedia to include long-term side-effects of some of the contraceptives so that young persons can make informed decisions.