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In Lebanon, access to contraceptives is not the problem

Though in Lebanon, sex remains a taboo topic, contraceptives are widely available.

“Here, you can find almost any of the contraceptives available in the US or in Europe,” said Beirut-based gynecologist Nicolas Baaklini.

Yet according to the physician, “Most people choose to avoid their use.”

Indeed, though availability is not a problem, Lebanon’s 58 percent contraceptive-use rate remains lower than those of neighboring states such as Iran and Morocco, which, according to World Health Organization figures from 2009, have rates of 73.8 and 63 percent respectively. The US and France’s contraceptive use rate is 72.8 and 81.8 percent.

“I’ve even seen patients favor an abortion over birth control,” Baaklani told NOW Lebanon, arguing that the problem is cultural. “A lot of people, still in 2011, think that young girls—and by young girls, I mean those who are not married—shouldn’t take contraceptives since they shouldn’t be having sex,” he told NOW Lebanon.

“Even within the couple, sex is frequently considered a means to an end rather than an end in itself,” he added.

In addition, many women mistakenly believe that the pill will give them cancer or render them infertile, said the doctor.

While abortion remains illegal in Lebanon, physicians frequently perform the procedure under the table, for anywhere between $300 and $3,000.

“Many are simply not aware of the other options, and many use the contraceptives in the wrong way,” said Souhail Darian from Mazen, one of Beirut’s largest pharmacies. For example, he said, starting the pill on the wrong day of the month.

Darian attributes the problem to a lack of sex-education in Lebanese schools, though he does feel Lebanon is better off than other countries in the region. He also considers the situation far worse in places outside of the capital, such as Saida or Tripoli, though he noted that awareness and usage of contraceptives is irrespective of age, religion and gender.

A pharmacist from Akkar, who requested not to be named because of the sensitivity of the topic, confirmed that use of contraceptives in Lebanon does not vary based on religious or social factors. “If anything, Muslims are probably more concerned about concealing the loss of their virginity,” he said. His most popular sales are the pill and the condom.

Another pharmacist, this one from Achrafieh, says that the majority of her customers are students, and her most common sales are condoms and pills, though the morning-after pill’s popularity has recently soared, she noted, with men typically purchasing the item for their partner.
 
NOW Lebanon brings you an overview of the most commonly used and available methods of birth control in the country.


The most popular contraceptive in Lebanon, especially among young, unmarried people, condoms are a safe way to avoid both pregnancy and contracting STDs, including HIV.
 
A 2000 report by the American National Institutes of Health said that proper use of latex condoms decreases the contraction of HIV/AIDS  by approximately 85 percent.

The method is also 85 percent successful in preventing pregnancy under “typical use,” which means using the condom correctly.

A wide array of condoms is available in Lebanon, though people, especially women, often complain of feeling judged by their pharmacist at the time of the purchase.

(Photo via datingsymbol.com)


The runner-up in frequency of use in the country is the birth control pill, which is often prescribed for regulating women’s hormones during their menstrual cycle or controlling acne. “But ultimately, we cannot really know why they are using it,” said the pharmacist in Achrafieh.
 
The pill does not prevent the contraction of STDs and must be taken on a daily basis to be effective. It has an up to 99.5 percent success rate in preventing pregnancy, with failure usually resulting from improper use.
 
There are widespread rumors, especially in Lebanon, that using the pill causes weight gain —though this side effect is much less common than people think —and that it causes infertility, which is untrue. The most frequent side effects of the pill are headache, nausea, unusual bleeding and breast tenderness.

(Photo via choosingraw.com)



The Intrauterine Device (IUD) is inserted into a woman’s uterus by her physician. It can last more than a decade if introduced properly. The patient should not feel any discomfort, nor should her partner.
 
Today, it is available in two models, one in copper, and more recently, one in plastic that is coated with a hormone called levonorgestrel. 
 
According to experts, Lebanese are not fully aware of the method and its practicality. Many also mistakenly believe it can cause cancer or infertility.
 
Research shows the method is 97 to 99 percent successful in preventing pregnancy, though its cost, between $500 and $1,000, might be a turnoff.
 
The IUD does not protect against STDs.

(Photo via merckmanuals.com)


The newest arrival to the Lebanese contraceptives market, the NuvaRing, is placed in the patient’s vagina every month. “This is possibly one of the reasons why it is less commonly used, especially among older women,” said Baaklani, as many Lebanese women are not used to or comfortable with the idea.
 
The ring releases small amounts of hormones but must be removed before a woman gets her period every month.
 
Its success rate varies between 90 and 99.7 percent, with some users finding it reduces the length and intensity of their period. It does not protect against STDs.

(Photo via mims.com)


Officially known as the Emergency Contraceptive Pill (ECP), the name says it itself: The tablet should be used for emergency purposes only.
 
The problem in Lebanon, however, according to Baaklani, is that people use the ECP as a routine method of birth control. “It’s catastrophic. It’s not a contraceptive; it’s for emergencies. You take it once in a while, but not regularly, and it doesn’t protect 100 percent,” he said.
 
If taken within 72 hours of insemination, the ECP has a 75 to 99 percent success rate. Its use can lead to nausea, though, as it disrupts the patient’s menstrual cycle.

(Photo via michigandaily.com)

  • typical

    Yes, he did say that, but he said it referring to what people commonly think in Lebanon, and I can only confirm that. The Lebanese society seems modern and open-minded at first, but turns out to be extremely narrow-minded when it comes down to liberties such as sex before marriage, womens' rights, etc. The wisdom that all men (including black people and maids and nannies) are created equal did not reach the majority of the population in this corner of the world, by the way. I just mention that since we are facing here the problem how people like to avoid looking at things they don't want to see. Wake up!

    November 14, 2011

  • stdpal

    I just want to tell the people that you are not alone even when you have an STD! There are so many people who have the same situation as you. Also, there are many online communities for you to find support and dating! I recommend you to read the STD inspirational stories on the largest STD support and dating site STDpal. com. Hope that you find the stories helpful and informative.

    November 14, 2011

  • F-Kay

    This is why SexEd is a must in schools. This is the only way you can debunk all these myths and prepare the minds of the young ones properly. Everyone wants to have fun, but its important that they do it safely to avoid all kinds of problems. I don't understand why SexEd is seen as such a taboo in Lebanon, I mean surely its better for kids to understand what a condom can and cant do than to go and do it without one potentially causing pregnancies. We need more liberties in Lebanon, and we need more education. It makes no sense to me how obsessed women are with their looks and how now we have beauty salons for young girls aged 9 in Beirut, potentially sexualizing and objectifying them, but we still don't teach our kids what a condomn is!

    November 13, 2011

  • anka

    i am not that surprised ordinary people do not know much about contraceptives, as for my experience, lebanese pharmacists are exactely the same ignorant. Personally i'd prefer to go back home and ask for advice concerning pills a doctor, than trust a pharmacist in lebanon

    November 13, 2011

  • Pill Lover

    Did he really say "those who are not married—shouldn’t take contraceptives since they shouldn’t be having sex" ? We're 2011 now, no need for assumptions like these. Belara and other contraceptive pills are probably the best scientific enhancement for all our sex lives.

    November 13, 2011