Contraception

  • I have had sex once with my boyfriend? Can I get pregnant?

    Yes, a single sexual contact can lead to pregnancy or STIs (sexually transmitted infections), even if it is the first time for either or both the partners. A girl can get pregnant even on the first intercourse because getting pregnant is dependent on whether or not an egg has been released in her body (ovulation). Since there is no 100% guarantee that the egg will be released on a particular day or time, one cannot say for sure that she will or will not get pregnant. Similarly, one cannot tell whether or not one will get any infection because just by looking at a partner one cannot make out whether or not the partner has an infection. Also, many infections (including HIV) do not have symptoms. Sometimes one takes the risk of having unsafe sex assuming that the partner belongs to a “respectable” family or looks “clean” and therefore will not have engaged in risky behavior. People’s socio-economic status is no shield against infection as infections do not pick and choose their clients. These reasons make it essential to use a condom each time one has sex or engages in activities that pose no/less risk to self and partner.

  • Is it true that emergency contraception causes abortion?

    No. Abortion ends a pregnancy. Emergency contraception (EC) cannot end a pregnancy. EC works before a pregnancy begins. Pregnancy begins with the implantation of the developing fertilized egg in a woman’s uterus.

    EC can be started within five days of unprotected intercourse. It prevents ovulation — the release of the egg. Or it prevents fertilization — the joining of the sperm and the egg — which usually occurs within six days of intercourse. In theory, it’s possible for EC to prevent implantation, but implantation doesn’t occur until five to seven days after fertilization. To read more about emergency contraception, click here.

  • Can a woman get pregnant from pre-cum or if a man ejaculates near her vagina?

    Yes, a woman can get pregnant anytime sperm enters the vulva or is inside the vagina. This means that ejaculation near the vagina can also lead to pregnancy. This is possible when the vaginal lubrication (wetness) in the woman provides a medium for the sperm to swim into the woman’s body. There is no way of knowing the probability that pregnancy will occur when semen comes in contact with the vulva or vagina. Pregnancy can be determined using a home pregnancy test or more accurately through a pregnancy test done in a laboratory.

  • How soon after sex can pregnancy be detected?

    Pregnancy tests can detect pregnancy after a missed period — some can even detect it before a missed period.

    Despite what some people think, pregnancy doesn’t start the day a couple has intercourse. It can take up to seven days after sex for the sperm and egg to join and form a fertilized egg. Then, it can take up to eight days, or more, for the fertilized egg to bury itself in the lining of the uterus. Pregnancy begins when this happens.

    If you do not want to be pregnant and you’ve had unprotected vaginal intercourse, don’t wait to find out two weeks later with a pregnancy test. Emergency contraception can be started within 120 hours (five days) after intercourse. Emergency contraception is available without a prescription from pharmacies, under the name NorLevo or PlanB.

  • I missed my period. I should have had it last week. Do you think I’m pregnant?

    The only way to be sure of pregnancy early on is to have a pregnancy test. Pregnancy tests are accurate after a missed period — some can even detect pregnancy a few days before a missed period.

    The most obvious symptom of pregnancy is a missed period. Other possible symptoms include

    • nausea
    • inexplicable fatigue
    • sore or enlarged breasts
    • headaches
    • frequent urination

    However, it is possible that any combination of these symptoms could also indicate that a woman is premenstrual, or that she has the flu or some other illness.

    Many women, especially young women, have normally irregular periods. These irregularities may include missed periods and other changes in the menstrual cycle. These irregularities can vary from month to month. Although pregnancy is the most common reason for missing a period, irregularity is also caused by illness, travel, worry, or stress.
    Pregnancy testing is the only way to be sure.

  • How can I protect myself from pregnancy and infection?

    Regular condom usage provides protection from both pregnancy and infection. Washing, douching, urinating immediately after sex, using special positions, antiseptics, creams etc, DO NOT prevent pregnancy or infection. Precum (few drops of clear liquid are formed at the tip of the penis much before ejaculation) contains sperm (that can lead to pregnancy), and HIV (if your partner is infected). Therefore, a man should wear the condom as soon as he gets an erection. Your partner can practice wearing a condom during masturbation.

  • I’ve heard that the pill and other hormonal methods of birth control will lower my sex drive? Is that true?

    The side effects of the pill have been studied for more than 40 years. Many of these studies have examined the effect of the pill on sexual desire and arousal. A recent review of 30 original studies concluded that using the pill, the patch, the ring, and the shot has no effect on sexual desire or arousal for most women. For other women, sexual desire and arousal are affected: Some experience more sexual desire and arousal. Some experience less.

    The causes of these changes may be psychological — for example, a woman may enjoy her sexuality more when she doesn’t need to worry about getting pregnant. Some may be hormonal — for example, the estrogen in the pill may affect the testosterone in a woman’s body in ways that influence her sex drive. If a woman experiences an unwelcome change in her sex drive and thinks it is caused by her method, she may want to change to another method.

  • Does taking antibiotics make the pill less effective?

    Only one antibiotic is known to make the pill less effective. That is rifampin (brand names include Rifadin and Rimactane), a special medication used to treat tuberculosis. Other antibiotics do not make the pill less effective.

    Certain other medicines may make the pill less effective. These include

    • certain anti-HIV protease inhibitors
    • certain anti-seizure medications
    • a particular anti-fungal medication, griseofulvin (Fulvicin, Gris-PEG, Grifulvin V, Grisactin, and Gristatin), which is used to treat severe, often life-threatening fungal infections

    It is always wise to know how other medications may interact with the pill. Some medications may be less effective when used with the pill. These include

    • Analgesics (pain medications) — for example, acetaminophen (Pamprin, Tylenol, Parcetamol, aspirin-free Excedrin, and others)
    • Antihypertensives (for high blood pressure) — for example, cyclopenthiazide (Prothiazide)

    The effects of some medications may be exaggerated when used with the pill. These include

    • Antidepressants — for example, imipramine (Janimine and Tofranil)
    • Bronchodilators — for example, theophyline (Primatene, Theo-Dur, Marax, Bronkotabs, Quibron Tedra, and others)

    Tranquilizers — for example, benzodiazepam (Valium, Ativan, Librium, Serax, Tranxene, Xanax, and others)

  • I heard IUDs can cause infertility. Is that true?

    It’s a common myth, but it’s not true. IUDs — intrauterine devices, increasingly referred to as IUCs (intrauterine contraceptives) — are among the safest, most effective, and least expensive methods of birth control available. In fact, they are the most popular form of reversible birth control in the world. More than 85 million women use IUDs.

    The myth started in the 1980s. An insufficiently tested, defective brand of IUD — the Dalkon Shield — had to be removed from the market because of the damage it caused, including infections that led to infertility. Today’s IUDs are safe, effective, and do not cause infertility.

    Sexually transmitted infections (STIs) cause infertility, not IUDs. If you have an IUD inserted while you have an STI, you increase your chance of infertility. That’s why most health care providers test for STIs before inserting IUDs.  IUDs do not protect against STIs.

  • Is it safe to take the pill continuously to avoid having periods?

    Yes, it is — except for women who should not take the pill at all. Likewise, it is safe to continuously use some other hormonal methods, like Depo-Provera injections, the Mirena IUD, or the vaginal ring to suppress menstruation.

    Many women would rather not menstruate using hormonal contraception to control their cycles for various reasons — to plan a trips, travels, athletic event, to alleviate medical conditions such as endometriosis, to avoid discomforts like PMS, for convenience, or simply because they don’t like menstruating.

  • Can you tell me more about female condoms?

    A female condom is a polyurethane pouch that has a flexible ring at both ends. It is approximately 7 centimeters wide and 18 centimeters long. Its efficacy is known to be around 79-95%. It reduces the risk of STI and HIV transmission. It can be used by those with latex allergies and can be inserted up to 8 hours prior to intercourse. It can increase pleasure for both partners because the rim of the outer ring stimulates the clitoris and testes during sex. It does not affect fertility. However, it can be expensive and sometimes produces noisy crackling sound during intercourse. Also, some women find it difficult to insert.

    Usage: Add lubricant. Insert the closed end of the condom deep into the vagina to cover the cervix. The open end stays outside the vagina to partially cover the labia. After sex, remove the condom by twisting the outer ring and pulling it out gently to avoid spilling any semen.

    Precaution: Do not use the male and female condom together. Recommendations for the female condom indicate a single usage for each condom. However, there is research being done to study whether disinfecting and cleaning a female condom can allow for multiple usage.

  • I’m allergic to latex! What can I use instead of latex condoms?

    There are two alternatives to latex condoms for people who are concerned about reducing the risk of sexually transmitted infections and unintended pregnancy. Female condoms are made of polyurethane. When used correctly and consistently, they’re up to 95 percent effective against pregnancy, and they also reduce the risk of infection. Currently, the only brand on the market is FC Female Condom.

    Polyurethane male condoms are also available. Polyurethane condoms (both female and male) are usually more expensive than latex condoms, but they can be used with both oil — and water-based lubricants.

  • Can all women of any age use the pill?

    Young women and older one often choose the pill for its contraceptive and non-contraceptive benefits. Not only can the pill help prevent a surprise unintended pregnancy later in life, it can also help regulate menstruation during perimenopause, help reduce symptoms of PMS or certain symptoms of perimenopause, and help protect against ovarian and endometrial cancer.

    The pill, however, for fear of strokes cannot be used by women 35 or older who smoke.

    One other thing: the pill cannot protect against sexually transmitted infections. So, be sure to practice safer sex including condom use.

  • What if I’m not interested in hormonal contraceptives? Can you also recommend other effective hormone-free methods?

    Alternatives to hormonal methods include barrier methods, such as male or female condoms, the contraceptive sponge, the diaphragm, cervical cap. These methods have somewhat less effectiveness than hormonal methods, but do offer significant protection against unintended pregnancy. Behavioral methods, such as withdrawal (pulling out before ejaculation), outercourse, and “natural” methods, offer even less protection than barrier methods for typical users.

    The reason why “natural methods” are less depended on is because sperm can live in a woman’s reproductive tract for up to six days. So it is possible for a woman to become pregnant from vaginal intercourse up to six days before she ovulates. Some women reduce the risk of pregnancy with the “Standard Days Method,” (also called the counting method) where they avoid unprotected intercourse from Days 8 to 19 of the woman’s cycle. (Day 1 is the first day of a woman’s period.) This 12-day “fertile window” takes into account the six days before ovulation in which pregnancy can occur from vaginal intercourse and allows for a slight margin of error that may occur in predicting ovulation. The “Standard Days Method” can work for women who have cycles between 26 and 32 days, and who have a regular and accurate menstrual cycle.

    The only reversible method of birth control that offers the effectiveness of hormonal methods without hormones is the copper T, an intrauterine contraceptive, (formerly called an IUD — intrauterine device), which can be left in place for up to 12 years. IUCs are more than 99 percent effective and are, in fact, the most popular reversible contraceptives worldwide.

    Women and men who know they will never want more children than they already have may also choose methods that are intended to be permanent and hard to reverse — vasectomy for men, tubal ligation for women.

    Eighty-five percent of women of reproductive age who use no contraceptives during vaginal intercourse become pregnant each year.

    No method of birth control is right for everyone. Although hormonal methods of birth control are safe and highly effective for most women, many women cannot use them. And some women do not want to use them.

  • I heard it’s dangerous to take the Pill for more than 10 years. Is that true? Is there a limit?

    No, it’s not true, and there is no limit to how long a woman can take the pill. Millions of women around the world have taken the pill since the FDA approved it in 1960. It has been the most scrupulously tested medication of our time.

    Countless women take the pill from adolescence through perimenopause. Many stopped taking the pill only when they wanted to become pregnant and started taking it again after giving birth. Women not only rely on it for contraception but for menstrual regularity and other benefits. These benefits include

    • less menstrual flow and cramping
    • less infection of the fallopian tubes (pelvic inflammatory disease), which often leads to infertility
    • fewer ectopic pregnancies (those in a fallopian tube)
    • fewer noncancerous breast growths
    • fewer ovarian cysts
    • reduced risk of cancer of the lining of the uterus and of the ovaries
    • less iron-deficiency anemia that results from heavy menses
    • less acne
    • fewer premenstrual symptoms, as well as related headaches and depression
    • protection against osteoporosis — loss of bone mass
    • less excess body hair
    • less vaginal dryness and painful intercourse associated with menopause

    The fact is that over the long term, use of the pill has offered many health benefits to millions of women worldwide.

  • Can a woman become pregnant if her partner pulls out before ejaculating?

    The pull out method (also called withdrawal) is much more effective when you do it correctly.

    • Of every 100 women whose partners use withdrawal, 4 will become pregnant each year if they always do it correctly.
    • Of every 100 women whose partners use withdrawal, 27 will become pregnant each year if they don’t always do it correctly.

    Couples who have great self-control, experience, and trust may use the pull out method more effectively. Men who use the pull out method must be able to know when they are reaching the point in sexual excitement when ejaculation can no longer be stopped or postponed. If you cannot predict this moment accurately, withdrawal will not be as effective.

    Even if a man pulls out in time, pregnancy can still happen. Some experts believe that pre-cum (fluid released right before ejaculation), can pick up enough sperm left in the urethra from a previous ejaculation to cause pregnancy.

    Men who use withdrawal as a contraceptive method must always be able to feel when they are reaching the point in sexual excitement when ejaculation can no longer be stopped or postponed. And they must pull out when they reach this point. Its users say that withdrawal has the advantages of being easy to access, easy to use, and free of side effects and cost. Non-users believe it causes anxiety and decreased pleasure during sexual intercourse. The most important disadvantage of withdrawal, even when used consistently and correctly, is that it offers no protection against sexually transmitted infections.

  • My periods are irregular. The cycle varies between 14 and 20 days. Is there any safe period for me?

    To begin with there is no absolutely “safe period” during the period cycle if you mean safety from conception. This is especially true for those with irregular cycles like yours. The maximum chance of conception usually occurs 14 days before the next period. That’s the day when ovulation takes place (an egg is released in the woman’s body). If a woman has unprotected sex with a man at that time, she can get pregnant. If you do not know for sure when you will have your next period, it is not possible to calculate when ovulation has occurred. So, you will have to be on a contraceptive method or your partner will need to use a condom every time you have sex if you want to avoid getting pregnant. Bleeding twice a month is not always a healthy sign. You may want to consult a gynecologist to discuss the frequency and irregularity of your periods as well as get a prescription for a contraceptive pill.

  • Can I get pregnant if I have sex with a man on my period?

    Yes, it can happen. It is possible for a woman to get pregnant from intercourse during her period, especially if her menstrual cycle is brief.

    It is also possible that a woman may think she is having her period when she is not. It is also possible to get pregnant during breakthrough vaginal bleeding.

    It’s not only women with short cycles who need to be careful about unprotected vaginal intercourse during menstruation. Even when cycles are long and regular, ovulation may occur on different days in different cycles.

  • We only have anal sex so that my partner does not get pregnant. Is that OK?

    Anal sex has a high risk of transmitting infection and does not completely prevent pregnancy. This is because, the distance between the anus and the vagina is not much and few drops of semen may spill into the vagina during anal sex. Also, condoms and lubricants are essential here since the anal area is a breeding ground for a number of viruses and bacteria and there is more risk of injury in anal sex because it is less elastic and dryer than the vagina. These factors make transmission of infection from one partner to another easier. If you practice anal sex, always use a condom and a water- based lubricant, like KY Jelly. Using oil or cream causes infection and damages the latex of the condom.