Safe Sex and Contraception
The decision to have sex should not be taken likely. It’s important to have all the facts to understand how your body works and what risks you will be taking. No matter what, sex should be a positive and safe experience. This article will highlight forms of birth control and barrier protection to prevent pregnancy and the spread of STIs, as well as discuss the signs and symptoms of various STIs and what to expect when you get tested.
Contraception
Contraception is a way for people to prevent pregnancy. All people, regardless of gender identity, can benefit from using contraception. Birth controls are also used to regulate menstruation cycles, prevent acne, and balance hormones. For many people, birth control can be a life-saving medication.
Here are some of the most common forms of birth control to prevent pregnancy:
Condom: 85% effective at preventing pregnancy
Condoms are made from latex, plastic, or lambskin. Most found in the stores are made out of latex, so if you have an allergy, check what it is made of! They are made to go over the penis and catch seminal fluid to prevent pregnancy. They are great because they also protect against STIs (except for lambskin condoms, which do not).
Condoms are a good option for every time you have sex (whether it is vaginal, anal, or oral). If you pair them with another form of hormonal birth control, you will be even safer. Just never “double-bag” condoms (use 2 at once), because the friction can cause it to tear.
If your condom does tear, you will need to take emergency contraception and consider getting tested for STIs. There are lots of different kinds of condoms. Do not use flavored ones for vaginal or anal sex, as they can cause an infection. And try to avoid “warming” condoms, as they can mess with the natural Ph of the vagina.
Condoms can also be cut lengthwise and used as a dental dam (a plastic barrier between the vulva/anus and the mouth), for safe oral sex.
If you are ever told a condom “doesn’t fit,” do not use that as an excuse to forgo a condom. Coercion to not use a condom can happen, so make sure you set clear boundaries with your partner. Condoms can stretch, they have different sizes, and they are necessary for safe sex.
Benefits:
Protect against STIs
Inexpensive (are sometimes free at health clinics)
Sold at most grocery stores and pharmacies
Condoms can work with other birth controls to make sex even safer
Non-hormonal
There are no side effects!
Disadvantages:
You have to remember to use a condom every time you have sex
Implant: 99% effective at preventing pregnancy
The implant, sometimes referred to by its brand name “Nexplanon,” is a small, thin rod that is inserted into the upper arm. It uses progestin, a hormone, to help prevent pregnancy. Progestin both thickens cervical mucus to prevent sperm from reaching the egg, and stops ovulation, so there is no egg to fertilize.
The implant is a long-term form of birth control that lasts for 5 years! But it can be removed at any point. To insert, your doctor will numb your arm with a shot, and use a special tool to insert the implant. To remove, the doctor will numb your arm again with a shot, and then make a small cut to remove the implant. After removal, your arm may feel sore or be swollen or bruised.
If you get the implant within the first 5 days of your period, you are protected immediately. If you get the implant outside this window, you should use another form of birth control (like condoms) for a week. Although, condoms are recommended for all sex to prevent STIs.
It is important after you get the implant to keep an eye on it and make sure it doesn’t move. If you suspect it has moved or shifted from its original place, you should see your doctor to ensure it is still working properly and use another form of birth control in the meantime.
Image credit: Nexplanon
Benefits:
It is one of the most effective forms of birth control
Most of the time, once inserted, no one can tell you are using birth control
Once it is inserted, you don’t have to worry about remembering to take or use birth control
It can help prevent period cramps or even stop periods altogether
It is estrogen-free, making it a hormonal form of birth control more people can use
The implant is reversible and it is possible to get pregnant as soon as it is removed
Disadvantages:
Irregular bleeding and spotting, this often sorts itself out within the first 6-12 months
Does not protect against STIs
IUD: 99% effective at preventing pregnancy
IUD stands for Intrauterine Device. It is a small, T-shaped object that is inserted into the uterus to prevent pregnancy. There are 5 types of IUDs available in the US: Paragard, Mireena, Kyleena, Liletta, and Skyla.
Paragard is a copper IUD, which doesn’t contain hormones, while the other four are hormonal. Paragard works because sperm don’t like copper, which prevents the sperm from reaching the egg. Mireena, Kyleena, Liletta, and Skyla all use the hormone, progestin. Progestin both thickens cervical mucus to prevent sperm from reaching the egg, and stops ovulation, so there is no egg to fertilize. IUDs are great because they last for a long time. The paragard can last up to 12 years, Mirena and Liletta can last up to 7 years, Kyleena can last up to 5 years, and Skyla can last up to 3.
The copper IUD can also be used as emergency contraception! If inserted within 5 days of unprotected sex, they are 99.9% effective at preventing pregnancy.
To insert an IUD, your doctor will use a speculum, which is a plastic or metal device inserted into the vagina to separate the walls of the vagina. This can be uncomfortable and awkward, but shouldn’t be painful!
The doctor will then use a special inserter device to push the IUD through the opening of your cervix and into your uterus. This process can be painful or cause cramping. Your doctor might recommend taking an over-the-counter pain medication or inject a local numbing medicine around your cervix.
Some people with vaginas can experience dizziness or fainting, and it is recommended that you bring a friend or family member with you to the appointment so you don’t have to drive home.
Period irregularity or spotting can occur with the IUD, but that usually stops after 3-6 months. In terms of maintenance, after insertion you should be able to feel the strings of the IUD if you insert your fingers into your vagina. Do not pull on this string as it will dislodge your IUD! If at any point you can no longer find the strings, or you suspect your IUD has dislodged itself, you should see your doctor to ensure it is still working properly and use another form of birth control in the meantime.
Benefits:
They are one of the most effective forms of birth control
Once it is inserted, you don’t have to worry about remembering to take or use birth control
The IUD is reversible and it is possible to get pregnant as soon as it is removed
The copper IUD is hormone-free and can be used as emergency contraception
They can help prevent period cramps or even stop periods altogether
Disadvantages:
Irregular bleeding and spotting, this often sorts itself out within the first 3-6 months
Does not protect against STIs
IUD insertion can be painful
Shot: 94% effective at preventing pregnancy
The shot, sometimes referred to as Depo-Provera or Depo, is an injection that is given every 3 months. It contains progestin. Progestin both thickens cervical mucus to prevent sperm from reaching the egg, and stops ovulation, so there is no egg to fertilize. This shot needs to be scheduled every 12-13 weeks. You can often schedule your follow-up appointments right after receiving the shot, but if you miss your shot due-date by 2 or more weeks, you should use another form of birth control.
If you get the shot within the first 7 days of the art of your period, you are protected right away. At any other time, you will need to use additional birth control for a week after you get the shot.
The shot can make your period irregular or stop it altogether. Depo has a lot of side effects and stays in your body for a while after stopping the shots. As with all birth controls, consult your doctor on what will work best for your body.
Benefits:
It’s very effective at preventing pregnancy
Most people using the shot long-term stop having their period while on this birth control
The shot is temporary and you can get pregnant after stopping, although it may be a delay of 9-10 months
Disadvantages:
You have to get an injection every 3 months
It can take 9-10 months to get pregnant after stopping this birth control
It has a lot of side effects, including weight gain, headaches, nausea, and depression
In rare cases, the shot can leave a permanent indent in your skin
Vaginal Ring: 91% effective at preventing pregnancy
The ring, also called the NuvaRing, is a replaceable ring that is inserted into the vagina. The ring is worn for up to 5 weeks and it is up to the user to remove and insert a new ring. It can be used to safely skip periods, or you just leave it out for a week to start your period. This works by utilizing estrogen and progestin to prevent ovulation and thicken cervical mucus. The rings need to be stored at room temperature and out of direct sunlight, or in the fridge if not used within 4 weeks.
Benefits:
It’s very effective at preventing pregnancy
It can make periods better
It is super convenient
Disadvantages:
It is hormonal birth control
There can be some negative side effects like sore breasts, spotting, and headaches. These normally go away in 2-3 months
You have to stay right on schedule
Pill: 91% effective at preventing pregnancy
The birth control pill is one of the most common forms of birth control. They are a once-daily pill that stops ovulation and thickens cervical mucus. It is important to remember to take the pill every day, as missed pills can make this birth control less effective and cause breakthrough bleeding.
There are lots of different pills with different hormone levels, so it can be a trial-and-error process to finding the pill that works for you! Make sure your doctor knows about and side effects you get from the medication, and they can help find a pill that works best for your body.
Benefits:
The pill can help prevent acne, ovarian cysts, and certain cancers!
It can make your periods better and ease PMS symptoms
It’s super convenient
You can get pregnant right away after stopping the pill (keep in mind that if you skip a pill, you will need to use another form of birth control to prevent pregnancy)
Disadvantages:
You have to take the pill every day
They can have various side effects such as spotting, sore breasts, headaches, nausea, etc.
Withdrawal (Pull-Out Method): 78% effective at preventing pregnancy
The withdrawal method is only effective if done right, and is never recommended as a form of birth control (especially for young people). This is where the penis is removed from the vagina before ejaculation. If the penis is not removed in time, there is a risk of pregnancy.
You can use this method combined with another form of birth control, but it is always recommended that you use condoms when you have sex to prevent the spread of STIs!
Benefits:
It’s free and has no side effects
Disadvantages:
It’s hard to pull out in time
You need lots of self-control and trust in your partner
Morning-After Pill
Also called emergency contraception, the morning-after-pill is a great option for any time you accidentally have unprotected sex. This could be because of a broken condom or a mistake in taking birth control. No matter why you need to take it, there is no reason to be embarrassed while purchasing it! It is a part of sexual health, and it is mature to realize when you might need to take it!
The different forms of emergency contraception are: Ella, Plan B, and the copper IUD (listed above).
Ella is only recommended for those 195 lbs or lower in weight, as it may be less effective to those heavier than that. You need a medical consult to receive it and you can take it up to 5 days after unprotected sex, but the sooner you take it, the better!
Plan B is only recommended for those 155 lbs or lower in weight, as it may not work if you are heavier than that. Most Plan B is over-the-counter and you don’t need a prescription to purchase, but you need to take it within 72 hours of unprotected sex.
Finally, the copper IUD is the best option for those who weigh over 195 lbs. It works just as well no matter how much you weigh! But you do need to get it inserted within 5 days, and it might be hard to get an appointment within that time. It’s best to call your doctor and see if they can schedule you in or have recommendations on offices that could schedule you within that time frame. In addition to contraception, it can be important to learn about your body and how it works. A way to familiarize yourself with the reproductive cycle is to learn about Fertility Awareness Methods (FAMs). This can be used as a form of birth control for adults but is not recommended for tweens or teens.
Fertility Awareness Methods (FAMs) involve tracking ovulation in order to prevent pregnancy. The days near ovulation are when you are fertile, so the goal of FAMs is to recognize what days those are to avoid having sex or use alternative birth controls during that time. One or more of the following methods can be used to track fertility:
The temperature method: which involved taking and charting your temperature in the morning before you get out of bed.
Body temperature usually increases during ovulation
The cervical mucus method: you check your cervical mucus every day.
Cervical mucus is usually clear and slippery during ovulation
The calendar method: you keep track of your menstrual cycle.
Please note that most period tracking apps are not accurate enough to successfully utilize FAMs
FAMs are most successful when all three methods are utilized and must be utilized consistently for at least three months to be considered at least semi-accurate.
FAMs should only be done with a doctor’s supervision, and are only 76-88% effective (with typical use) due to their difficulty to use properly. This is why it is not recommended as a birth control option for tweens and teens. It is also not effective if you have irregular periods on a reproductive health condition that can impact ovulation. A lot of the time, chronic conditions aren’t diagnosed until adulthood, so FAMs should only be used to familiarize yourself with your natural cycle but not as birth control until you are an adult who can see a doctor who specializes in FAMs. But they certainly are a great method to develop a better relationship with your cycle, your health and your body.
Contraception comes in all shapes and sizes. What is important is for you to be healthy and safe and to know what your options are. No matter what, it is still necessary to talk to a doctor before starting any birth control and sex should always be performed with a condom to help prevent the spread of STIs.
For more information on birth control, and for other sexual health questions, visit Plannedparenthood.org