 Hi, everyone. Welcome back to our podcast from the Kamasutra to 2020, where we look at your questions, your concerns, even your worries around all things to do with sex and sexuality. As always, we have with us Dr. Anrita Madan-Bihel. Anrita is a psychosexual therapist. She brings the psychological perspective to the advice that the Kamasutra has to give, but we also have with us today Dr. Nivedita Manukaran. Nivedita is a sexual and reproductive health clinician. She's based out of Sydney. You've met her over here on our podcast before talking about the all-important STIs, the sexually transmitted infections, but she's back today talking on an other extremely important subject that never actually gets spoken about, but we feel that when it comes to sexuality and pleasure, it is probably the most important thing to speak about. And yes, I am talking about contraceptions. Nivedita, welcome. Thank you so much for having me today here and it's been a pleasure being with you, Seema. So as Seema said, this is really, I think, the most important thing to talk about. And I feel like if we bring it in, as soon as we start talking about sex, I think we should start talking about contraceptions because they really change the game. They change the game with safety, with pleasure, with pressure, with stress, with tension. More importantly, today is the idea of STIs. What we're not known before now are very much part of our lives and we really need to make sure that prevention and safety is there. So let's start with Dr. Nivedita like talking about what are the different contraceptions that are accessible to people. Let's just lay it out for them, like for starters and then we'll talk more in depth about them. Thank you, Nivedita. There are a billion contraceptions available these days. This is how I should start because I don't think anybody can say there's nothing that suits me because there are so many. So there are short acting contraception which you can use just then when you're having sex and you can just throw it away after you've had sex. There are contraception which you can remember to take like every day, like the contraceptive pill, which has been around for a very long time. And then if you want to stop, you can stop them. There's the emergency contraception pill, just in case you forgot, and there is a plan B. And then we have like a middle contraception where you don't have to remember to take it every day, but at the same time, it doesn't last with you for years. There are some contraception like the Nuva ring. For example, it is a ring that you put inside your vagina. It sits around your cervix for three weeks. And then you pull the ring out, you have a period, you put another one in and you can keep doing this and this is totally under your control. And the second thing that can be used like that is probably one of those progesterone patches where you put a patch, it's like a nicotine patch, you put the patch in your body, it stays there for about three weeks, take the patch off, have it, you can have a period, you can put another patch on. If you don't want a period, you can go one Nuva ring after another, if all one patch after another as well, it works like that. Long-term contraception like can last for three years, five years, 10 years, depending on how long you're willing to or how convenient it is for you to not think about the contraception and spend time on it. So there are some things that you can use for three years. Intrautrient devices like the copper T has been around for such a long time. You can use a hormonal IUDs also, and you can use it for like three years, five years, 10 years. So this is a whole range that is available for you on Meda that is there these days. So I think basically what you're saying is people who come and say, oh, I couldn't find anything, that option doesn't exist any longer. Oh, sorry. No, I think. But let's, you know, let's talk with the king of all, can we call it the queen of all contraceptions, which Seema really truly supports and believes in the condom. So absolutely. I think the condom actually is like you said, it's a game changer. You know, this is when people talk about tools of pleasure and sex toys, to me, the condom is the ultimate tool of pleasure because it was no longer about having children. This was the fun. This was the first thing that was introduced, which said, have sex for pleasure. This is about saying this is just about you having fun and enjoying yourself. So yes, maybe the floor is on you to tell us about all about the condom. Sure. See condoms is my all time favorite. And I always vouch for condoms independent of whether somebody is on contraception or not. Because according to me condoms is the only thing that prevents you from falling pregnant acts as a barrier against sexually transmitted infections as well, which is very, very important, especially when you're in your short term relationships or casual partner when you're going out tonight and hoping to meet someone, you know, and things like that you definitely want to use a condom. The best bit about a condom is there's no fuss about going and able to buy a condom because almost every supermarket, every, you know, small store, a 7-eleven these days sell condoms and lubricants, which is I think absolutely brilliant. You don't need to go and discuss this to a doctor. You don't need a prescription to buy condoms and you don't have hormones or anything like that, you know, for you to be worried about or side effects and things like that. It's a use and throw thing. And condoms come both in latex and non-latex. So for those who say, oh, I'm allergic to latex, well too bad. We've made latex free condoms these days. So you're not getting out of it either. And for all those, you know, who keep saying, oh, they're too big for me or too small for me, that's not true either. So we have some fantastic companies which, you know, have brought like extra small to extra, extra large maxi condoms. So I'm sure that's again, that's not going to work. And for those who say pleasure, you know, is impaired and stuff like that. Again, we do have dotted, ribbed, you know, and a whole range of condoms. What is very important is you do also have ultra thin condoms. But occasionally condoms do impair people's, you know, sensuality. And if that is the case, it is always weighing against, do you want to have an STI? Do you want to use a condom? Do you want to have an STI? Do you want to use a condom? So I think it's always the balance there where, you know, you have to prioritize to be safe rather than sorry. So my condom condoms definitely go to, I think what's come out recently is the female condoms. But the female condoms have been around, I think, in some parts of the world for a very long time. It's a very old school thing. Because, you know, it's larger, it's of its bigger size. Somehow it feels like it's not very pleasurable, like the male condom. However, nowadays you have, you know, female condoms also made out of latex, really nice and thin material. And women can actually insert the female condom a few hours before they're going out. They don't have to go and insert the condoms while they're going to have sex or remove the packet or anything like that. Because it has a ring on the inside. You can use the condom on the inside and, you know, and put it in into your vagina around the cervix. And you can leave it in even a couple of hours before you're going to have sex. So in that way, I think female condoms have, you know, fantastic option these days. And very important about condoms before I wrap off is you can also use them for oral sex, especially, you know, to prevent against STIs. The flavored condoms are particularly for oral sex, because obviously for vaginal sex or anal sex, you don't need flavored condoms. The reason you have flavored condoms is because condoms are great for oral sex and to prevent against STIs from oral sex. So yeah, so you, so that's amazing. You can use condoms for all of those things. So definitely condom is a big, it's a hero. It's an easy thing. It's a hero. And you should be doing it. No excuses. You know, one of the things that Navy people generally come up with is that, Oh, it's about, it's so awkward. Or, you know, they've been having this very exciting foreplay, and they're all aroused. And then suddenly you have to stop to start putting it on. And of course, you never see that in a movie because films never show people sitting by using condoms, struggling to put on a condom. And I always advise people that, you know, if you're going to start, you know, you're going to go out and have sex and you're going to be putting on a condom. Don't do it for the first time in situation, like practice beforehand. So do you have a condom over there with you, which you can actually put on and maybe demonstrate how it's done. And that would go two ways for all the people who say, yes, let's have a little demo on your hand. That's a good thing because I can show it on my hand because my hand's so like really large. And, you know, for those who say that, Oh, it doesn't fit me, you know, it's but, you know, I'm going to make them prove them wrong. So I'm going to show how to use a condom and condoms, you know, the tip of the condom, usually like that condoms are pretty good. Even if you use on your hands, there is a good chance that this is going to tear in my hand because I have really long nails, but usually it doesn't. And you roll your condoms on the penis and it can go really, really long. The reason I'm doing this way is because I don't want to repair because I've got long nails guys, but usually condoms are just fantastic, and they can go around your hand and they are all large size. So if a condom can actually fit my hand and I can do this, it can definitely fit a penis. So I'm sure it's not going to be larger or bigger than that. So yeah. So condoms are great. They come in various sizes, and you can have really extra small ones to extra large ones that can definitely fit you. Lubricants are going to be your best friends so that you don't rip them off and they don't tears or breaks or anything like that. So always use a lubricant with a condom. I'm also going to show a female condom if that is okay. So yeah, so this is a female condom by one of the brands called PSafe or Domina. They're just pretty much centered to me and it's amazing. So the female condom is like a tube if you noticed and this round ring is the one that's going to go inside your vagina. So if that's your vagina, you press this ring, you put it into your vagina and this goes and sits nicely in the vagina. You can go and push it in as deep as you want. And then this just sits out on your vulva like this. And you can actually put it in two to three hours before you're going to have sex and it'll just stay in like that. Yes, it will be a little unpleasant because of course there's a small rubber in there, but it's not too bad because it's pretty soft and it's pretty flexible as well. So it's really good. The best bit about this female condom is if you notice this rim is so large, so it not only covers your vagina, but it will also protect your urethra and the chance that people are getting UTIs over and over by, you know, things going into the urethra. Actually a female condom can try and protect that because there's a big rim and it also covers the urethra which is fantastic for prevention against UTIs. So condoms, both male and female are fantastic and they have their own benefits. And they are the only things that protect you against both contraception and SDIs. So it's a definite good. And I'm so glad that you showed the female condom actually because I think one of the things that I've always found with the politics of who controls contraception and who controls use of contraception has been always problematic, especially in places. I actually would say globally because then the control leaves it to the man and the choice of will it be used, won't it be used. And also like you said, now it's easily accessible, but to actually go and buy a condom becomes the responsibility of the man. The taboo and shame is as much on them. And it also gets complicated when women buy it and bring it because then there are people judge women because they went and bought a condom because they must be lose women or have sex before or whatever. But I really think condoms was a problem. So it's the best thing ever, but it was an interesting politics around it because the choice and access was left to the man in some ways. So once again, women couldn't control if a condom would be used when it would be used, how it would be bought, what would happen. So the female condom feels like for women who want to keep, make sure about their safety and make sure that there is something for them in some ways. And I think it feels like them taking control of the situation. I think that is very, very important in today's time and either. And you're right, because I think sometimes buying contraception is one thing. Negotiating for someone to wear it is another thing because a lot of the times I have patients who tell me, yeah, we did have condoms, but it's just that I couldn't convince him to wear it. When you're in the middle of having sex, when everything is all heated up and the last thing you want to do is to stop and argue about using a condom or it becomes awkward. I think as clinicians or somebody else who's not at the point, I understand, I keep telling them, but you have to or you have to talk about it before you start the whole sexual thing, because this is not something that you can talk in the middle of a sexual act and things like that. But a lot of the times I find both men and women who find it extremely difficult to negotiate use of a condom. A lot of times the excuse that is left and it is very hard to argue with is I can't feel anything, the sensation goes. And I remember when we used to do sex education, we used to do the exercises where there used to be small condoms, latex condoms, and we used to ask people to dip in hot and cold water and dip their fingers in ketchup and everything. And basically to help them see that the sensation, you could feel hot, cold, texture, everything if you were feeling a condom. But what do you say to your patients when they come and say, oh, with the condom, the feeling goes or I can't really have the same sensation during sex? I always tell people when it comes to, if you can use a condom but you still don't want to use a condom, like I said, it's between whether you want an STI or you don't want an STI. Sometimes it'll be too late. If I'm going to diagnose you with an STI like HIV, let's just say. And for the thing of, let me not do it, it won't be me or all the time people think it won't be them. That's why they're not taking it seriously. So always tell them it's always HIV versus whether you want to use a condom or not. I usually, I know it's scary but I do like to scare people like that. I want them to take it serious because we're talking about serious illnesses, infections and things like that versus finding excuses not to use condom. And we can use different kinds of condoms. These days you have condoms which kind of have like a tingly lube on the inside, which kind of gives them that kind of a tingling sensation to keep it a bit more erect and feeling tingle. There are like very sensitive, ultra thin condoms where you can encourage them. So to be honest, from long gone, now we have come with a whole range of options and choices which we can give men. And I think not able to use it in spite of having casual sex with casual people is probably the last resort and probably not a good way to do it. And while we're at this topic, I really want to say the highest risk is especially when you're not using condoms when you're having sex with sex workers or men who have sex with men who do not use condoms, your highest risk is acquiring HIV. And if that is the case, there are prevention strategies in place these days called the PEP or the PREP, which is the post-exposure prophylaxis and the pre-exposure prophylaxis for HIV, which is probably something that is very, very important that you need to talk to your doctor. If you're just so spellbound that you will not use a condom or you cannot use a condom no matter what, then that is a conversation that you need to have with your doctor. I think what really needs, it needs is a normalization process. So because we don't talk about it, yes, you have ads which say you was a contraceptive or use a condom, but that's it. That's not really called normalizing it because it's not in situ. Again, it's not showing two people in the middle of having sex. And then where was the last time you watched a film where the two people suddenly in the middle of their passionate moment pull aside and the guy says, okay, hold on, let me take this out, put it on carefully. Oh, I'm fumbling with it. When was the last time anybody showed you that? Never, never, ever know that that's okay to do. And I've always put in that particular episode from Friends, which I think is fantastic where Monika and Rachel are fighting over the last condom because I mean, I just think it's the best scene because one is here are two girls who are actually taking responsibility and having a tug of war over it. Can you see that happening in an Indian film? I can't. Two girls saying, this is my condom. And then what I thought was even better was that Rachel gets it, Monika goes back into her room and Richard is waiting over there for her and he said, so did you get it? And she says, nope, we're having sex tomorrow. And that was amazing because, you know, it wasn't like, okay, I didn't get it, but what the hell, we'll do it this way. No, it's not okay. And we don't flag up things like that enough. I just think it's one of the best things. And just to this point, I want to throw in something because so many people will write in and say, but it feels so awkward. Oh, but you know, how do you start and fumble and blah, blah, blah. I'll tell you what, in the Kamsutra, it says that when you have your foreplay, at the point where the woman feels that the foreplay has been sufficient, now she's actually ready to have sex, you know, you have to move your body apart to then come back together to have sex. When you're kissing, and when you're cuddling and doing things like that, your bodies are in a certain position. To actually have sex, you have to come apart because you have to position the vagina and the penis in such a way that you can penetrate. And that doesn't happen just kind of naturally, it has to be positioned. At this point, the woman would actually sit up, she would make a pawn for her partner, and offer it to him as a sign to say, I am now ready for sex. But in actual fact, that's what gave them the time to get ready for the act of sex. So there was no fumbling involved. It was part of that whole process of coming together. Okay, this is so sexy, she's making me that pawn. Now I will do this. So it was almost like the Sringar for sex, you know, getting ready for the actual act. And I think we need to bring back some of these rituals just because it takes away all the awkwardness. And it makes it something simple. Absolutely. And I think part of that is why the industry has, and like maybe was mentioning the flavored condoms and everything, because people again and again would say, make it part of your foreplay, it doesn't need to be, okay, now it's the, we need to stop, because we need to take out the condom, we need to remove it, like make sure that you have it out or in the moment or make it part of the foreplay. And this myth that sex needs to go in one flow. And if there is a cut in the middle, it's all over, is actually not true. You can really, a little break or something is not going to change the arousal or thing, you can bring back the arousal, you can, you know, it is about making it part of your love making rather than seeing it as a thing. Yeah, so definitely, definitely. And I think that is why I feel Lube plays a very important role, because you don't need to necessarily use Lube only with, you know, a condom, you can use Lube as a part of your foreplay. So you are reaching out to a Lube, you know, just to keep the moisture, just to keep, you know, everything going on. And it's like that. And then you reach out to the condom, just place everything on the side table. So you have your Lube, you have a candle or whatever, you have your condom, you're just all ready for it, you know, it doesn't necessarily have to be an awkward thing where then you go and find it inside your bag. And, you know, you don't have to, you don't have to do that. That's right. You just have to normalize, you know, before the act, just, just keep everything, just make the ambience, make it all ready for it and go with it. And I think that's very important. Yeah, it shouldn't be, it shouldn't, you know, mostly condoms are hidden. So if you have hidden it somewhere behind four doors and in the middle, I think the four doors, maybe not a good idea. I actually want to add to that, because I find that particularly in India, the subject is so taboo. We don't talk about anything. So we don't talk about what sensations you feel when you're aroused, what can happen when you're aroused, when you get to a certain point, when you sort of lose a little bit of excitement. Nobody talks about any of that, you know, basic sex education is, this is one part of the anatomy, this is another part of the anatomy, and that's it. So I get questions literally from people thinking that anything that they go through during their intimate moments is not okay and should they be seeking help. And I'll give you an example. I had an email the other day from somebody said, why do I shake when I masturbate? Should I be seeking medical help? And yes, I know now everybody's sort of confused and thinking, but that's, you have to shake when you're masturbating. Well, so that is the level of ignorance that we have actually developed amongst society, amongst our young people. People have absolutely no knowledge of what their own body should react like when they're in the midst of desire, or when they're having arousal. And so unfortunately, literally anything, you know, when you say that, okay, you pull apart by the time you put it on, and it's gone a little bit flaccid, a lot of people will start thinking, that's their medical issue, that's their, you know, should they be seeing somebody? Oh, I can't do this. Yeah, I think we just have to make condom use a bottom line for everyone. Because I just, you know, we just hand out free condoms and give free condoms and condoms for everyone. You know, not using a condom is an excuse. And should be discussed with someone, you know, it's not okay to just decide saying, oh my God, I just can't come, it's not erect. Because like I said, a lot of the time it doesn't people's head. And you just, you don't need to talk to someone, you need to address this as to why you're not able to do it, because it may not be a problem. It may be something that you don't want to use it, or you're not, you know, you're not educated enough, you know, to be able to do that. So I think I agree with you, Seema. A lot of the times people do make excuses and there is no excuse to not use, like I said, there are 1 billion options and condoms even these days, you know, whether it's size or sensation or everything. So they should be able to use it. And condom use is very, very important in order, you know, for anything, STIs, contraception. And just in ease, you know, then not being anxious about, am I getting a period or not? Am I going to fall pregnant or not the whole anxiety thing? So yeah, definitely condom use, definitely. Well, I just hope that we've managed to convince everybody out there, because as you said at the beginning, I am a huge proponent of the condom. I think it's the hero in our society. And the lubricant is the heroine. And, you know, we don't use enough of either of them. We need to bring them back. We need to secondly, have some Netflix films, where the sex scenes actually are shown, or the intimate scenes actually show people pulling apart to wear the condom. I think that's really, really important. That's the wish that I'm putting out there, just so that we can normalize it. And I think that we need to have maybe, for any podcasters, any erotica writers out there who are actually creating erotic content, please include this as a little ritual in your writings, so that people out there can understand that this is not something bad. It's not something foolish. It's not something awkward to do. It's a really fabulous part of making your intimate act wonderful in every way. So that's the top of my wish list. Ladies, as we sign off, I'd love to hear if you have one wish list point that you would like to see come true. For me, the wish list is women carrying condoms and, you know, negotiating it before, because I really, as an, I, so my wish list would be another episode where we honestly just talk about, and please send in your questions of what has been your situation where somebody has said no to using a condom or you found it awkward to ask for a condom use, because I think we are at that stage where condoms are available everywhere, but actually talking about the use is very tricky and very complex. And we all understand that it's not an easy conversation. So I would love to do an episode on how to do that conversation. So send in questions where it's been tricky for you. And Nivi, do you have a wish list? Yeah, well, Anvita stole that wish of me. But I always, I think, look, I mean, I understand female condoms are there at the moment, but even with the male condoms, I don't feel like male condoms or lubricants should be only a man's responsibility to go and source it or carry it or have it. I think anybody, all of us can have condoms in our bags or wallets or wherever it is. And even lubricants come in sachets. So you can have a condom in a sachet and, you know, in a lubricant to go with it in your bags and handbags. And like I said, I want both men and women to take the responsibility of being to negotiate condom use and be successful at it. And like I said, yes, availability was a problem, judgment and taboo and stigma and all this. But I think the real problem is even when you have it, a lot of the times, the negotiation, the convincing that people need to do in order to make someone use a condom still seems to be a bit of a problem. So yeah. So I think that conversation, how do you exactly bring it up in an awkward situation? I think it'll be a good conversation to have and see how we go with that. Maybe maybe you need to write a script for a Netflix. Yeah, I think so. A few films on that. Imagine, I mean, it would just normalize it, you know, you could go back. Yeah, and it'll help people. Yeah, absolutely, absolutely. Okay, so till that just doesn't actually get made, people, I want you to use your imagination to see how you actually get there. Please don't compromise on this. This is extremely important. I hope that you found this conversation useful and that you're going to take away a very positive determination to use the condom at all times during your sexual act, whether it is with within a monogamous or a less monogamous partnership. If you have found it useful, please do comment, subscribe, like on the video. We are over here to answer your questions. I'm on info.seema.ana.gmail.com. You can send your questions into me. If you have any kind of consultation that you need to seek and if you want to get in touch with Anvita for that, she is on Anvita.medan.gmail.com and if you need to find out anything more about any kind of contraception and if you want more details about it, if you have any kind of hesitation or any kind of doubts in your head, the person to contact is Nivedita and Nivedita is on. I would like to get DMs on my Instagram page at DrNivee underscore on Tables, so please send your DMs there and I will definitely answer as many as I can. In the meantime, stay safe, look after yourself, your sexual health, your mental health, as well as your general emotional health is extremely important. Take care of every bit of you. See you next time.