What sorts of birth control are available?

What sorts of birth control are available?

Condoms are the only contraceptive method that protects you from HIV and other STIs. They are about 87% effective in preventing pregnancy, and can also be used in conjunction with other methods.

You can also be fitted for a diaphragm, a rubber cap that fits over your cervix and is usually used in conjunction with spermicide. Diaphragms are about as effective as condoms, but are reusable.

The birth control pill can have mixed side effects, which can vary by type. If you take them every day at the same time, they are about 98% effective. With less regularity, the effectiveness drops to about 92%.

Other options are a hormonal patch, which is placed in a discreet place on the skin and changed weekly, Nuvaring, a hormone-containing ring which is inserted into the vagina monthly, or Depo Provera, a quarterly shot. These methods require less diligence than the pill, but regular use is still important. Side effects are similar to those of the pill. The ring occasionally can slip out without being noticed. The shot suppresses menstruation, but spotting is common. Used correctly, the patch and ring are 98% effective, the shot 99%.

The morning after pill (Plan B) is available if you have unprotected sex or if your condom breaks or slips. It can be used up to 72 hours after intercourse, though it is more effective if used sooner. Plan B is less effective than other methods and often causes nausea and other unpleasant side effects, so it shouldn’t be used as primary contraception.

You can also have an IUD inserted. The procedure places a small t-shaped device in the uterus. There are two IUDs available; one lasts five years and releases hormones, which thicken cervical mucous and thin the uterine lining, the other lasts ten and contains copper, which kills sperm. IUD insertion is painful, and IUDs can cause prolonged spotting, worsen cramping, or make your period irregular. The copper IUD is 99.2% effective and the hormone-releasing IUD, the most effective contraceptive on the market, is 99.8%.

College health services offices usually have a variety of these contraceptives available, along with STI screenings, often for free. Health services can also often provide information and counseling services, and refer students to local doctors and clinics for services the school can not provide, like IUD insertions and abortions, which school health plans may at least partially cover. Condoms and lubricants are also often available in other locations around campuses, like dorms.

Planned Parenthood clinics provide many of the same products and services for free or affordable prices.

Recommendations: A couple of birth control options and a book about how to practice safer sex while keeping it hot.

Should we get tested for STDs before we stop using condoms?

I have been in a monogamous relationship for three months, and recently went on birth control pills. I have had one (protected) partner in the past, and my partner was a virgin before our relationship. Is it safe for us to stop using condoms? Do we need to get tested for STDs first?

It sounds like it’s unlikely that either of you has an STI, which would make it okay for you to stop using condoms if you’re comfortable with how effective birth control pills alone are and you trust your partner to continue being monogamous.

It wouldn’t be a terrible idea for you to get tested, though. It’s possible that you could have gotten an STI from your previous partner despite using protection. Non-penetrative skin to skin contact, a broken condom, and contact with bodily fluids can all sometimes be enough to contract an STI.

It might also be a good idea to make sure that your current partner’s definition of “virginity” means that they have not participated in any risky activities. Anal sex is not always counted toward virginity but can certainly spread STIs. Performing oral sex on a male can also pose some risk.

Recommendations: A general book about STDs, some condoms to keep using until you get tested, and another book about STDs.

Should he use a condom if she’s on the pill?

If she is on the pill/hormonal birth control is it still necessary for him to wear a condom?

Many feel using the pill or other forms of hormonal birth control is adequate. If used perfectly (at the same time each day, every day), they’re about 98% effective against pregnancy. But using either in conjunction with a condom is more effective, especially if you occasionally forget to take the pill. And hormonal birth control doesn’t prevent STIs, whereas condoms do.

Recommendations: A book about keeping safer sex hot and a guide to contraceptive options.

What is the correct way to use a dental dam?

What is the correct way to use a dental dam?

Lay it so that one side is flat against the vagina or anus before performing oral sex and hold it in place. That’s pretty much it. You can put water or silicone based lubricant on one or both sides. Either the giver or the receiver can hold it. When you’re done, try to fold it up so you don’t touch the side that was in contact with the vagina or anus. If you do, wash your hands.

Recommendations: Flavored dental dams (you can get them unflavored too), a guide to hot safer sex, and lube.

Why do condoms break?

I’ve heard of several instances where condoms are way too tight and have broken. Why don’t colleges have bigger ones available?

Condoms are designed to stretch enormously, and rarely break when used perfectly. A few studies have found that latex condoms, which on average break 3 percent of the time, break only 0.4 percent of the time when used perfectly. A condom which is too tight may be uncomfortable, but isn’t much more likely to break, so anyone having a problem with condoms breaking regularly is probably also having a problem with putting condoms on right. So, here’s how.

Many tears occur when the condom is being removed from the package, so be careful if you have long fingernails or are using teeth or scissors.

Putting a drop of lubricant in the inside tip of the condom can make it easier to put on and decrease the chance of it breaking. Some guys also really like the sensation it adds during sex.

Before you start rolling on the condom, pinch the reservoir tip and a little past (1/4 to 1/2 inch). This prevents an air bubble which could cause unnecessary friction (and unnecessary broken condoms), and also gives the semen a place to go.

Roll the condom all the way to the base of the penis. If the bottom of the condom is entering the vagina, it’s not rolled down far enough and is more likely to slip off or leak around the edge.

Although many condoms are already lubricated, adding more lubricant will make them less likely to break. Always use water- or silicone-based lubricants. Using Vaseline, mineral oil or any sort of cream or lotion which contains a petroleum derivative or other oil will weaken the condom and make it more likely to break.

Never use two condoms at once (or a male and female condom at the same time). The friction often causes both to tear.

Also, don’t store condoms in your wallet or the dashboard of your car. Heat weakens the latex. And check to make sure your condoms aren’t expired, as that also increases the likelihood that they will break.

Recommendations: Condoms, a history of condoms, and a guide to hot safer sex.

What are the risks/benefits of an IUD?

What are the risks/benefits of an IUD?

There are two IUDs on the market in the United States. One is called Paragard, and it contains copper but no hormones. Copper is an effective spermicide, and the presence of an object in the uterus makes it difficult for sperm to move through to fertilize eggs and makes the uterus an inhospitable environment for an egg. The other is called Mirena, and it releases an extremely low dose of synthetic progesterone, which thickens cervical mucous, making it hard for sperm to enter, and thins the lining of the uterus.

Both IUDs are extremely effective against pregnancy. Paragard is about 99.4% effective, and Mirena is about 99.8%. This is comparable to the effectiveness of surgical sterilization. Many monogamous people feel comfortable using just the IUD (without condoms) as birth control, which allows for more spontaneity. IUDs can be left in for a long period of time (Mirena for 5 years, Paragard for 10), so you don’t have to worry about remembering to change it or take it every day.

Unlike birth control pills, injections, patches, rings, and hormonal implants, Paragard has no hormonal side effects at all, and Mirena very rarely causes any hormonal side effects aside from its affects on menstruation. Both IUDs are acceptable for people who have had problems like nausea, weight gain, and sex drive reduction on hormonal birth control methods. Neither IUD significantly increases the chance of blood clots if you’re a smoker. Upon removal of an IUD, your fertility is immediately or nearly immediately back to normal.

Because Mirena thins the lining of the uterus, it significantly reduces menstruation in many people. For this reason, it is sometimes used as a treatment for painful periods and endometriosis (abnormal tissue growth associated with the menstrual cycle). About 20 percent of people with Mirena stop menstruating altogether, which some people like and some people don’t. During the first few months after getting a Mirena it is common to have spotting and cramping. This usually resolves within 3 months, but may last as long as 6.

Paragard tends to cause very long, heavy, painful periods for the first few months. Some women cannot tolerate this side effect and get it removed quickly. Periods usually return to about normal within 6 months of insertion.

IUD insertion ranges from uncomfortable to extremely painful, especially for women who have never had a baby. IUDs are also a little bit more likely to expel in women who have not given birth. Expulsion is when the IUD comes out partially or completely. It is only dangerous in that it makes the device less effective. For these reasons, some doctors are unwilling to use IUDs in women who haven’t had babies, so it is sometimes necessary to shop around. You can check to make sure the IUD is in place by feeling for the strings, which stick out of your cervix.

Like hormonal birth control methods, IUDs do not protect against STIs. If you have an STI when your IUD is inserted, it may increase your chance of developing pelvic inflammatory disease. Old IUDs made pelvic inflammatory disease more common if you got an STI while the device was in place. Studies seem to indicate that this is not the case with the new IUDs, but many doctors are still unwilling to use them in patients who are not monogamous.

Recommendations: A guide to the variety of contraceptive options.