Safer Sex
Once upon a time, it was called “safe sex” but the reality is that condoms, the pill, pulling out, they’re all imperfect. Short of locking your genitals up in airtight underwear, nothing is 100% effective… not even (hilariously enough) abstinence. So now we call it “Safer Sex“, to show that there’s a reduced (but not eliminated) risk of STI transmission and/or unintentional pregnancy.
Abstinence means not having sex. BUT… if you had a look at the What is sex section, you’ll notice that “sex” includes a lot of things. It’s important to understand that if someone says they’re “abstinent”, but they’re still having oral sex (just no vaginal or anal sex), they’re at super low risk of accidental pregnancy but they’re still at risk for more than a few STIs.
Withdrawal or “pulling out” is when the man removes his penis from the vagina so that he ejaculates outside of it. It offers little to no protection against STI transmission, and it’s possible to get pregnant from the small amount of sperm present in pre-cum, which comes out before ejaculation happens at all. Keep in mind that it relies almost entirely on the man’s awareness and initiative, even though the consequences of anything going wrong might not be theirs.
Condoms come in two basic varieties: male and female.
Male condoms are thin coverings that fit over the erect penis. They’re currently made from latex and polyisoprene (handy for people who are allergic to latex). If used properly, they significantly reduce the risk of most STI transmission and accidental pregnancy. They usually come lubricated with a spermicide, but unlubed condoms are out there (usually for oral sex, since spermicide tastes awful). Using an unlubed condom for any kind of penetrative sex is usually a Bad Idea - it’s uncomfortable and will greatly increase the risk of tearing.
Female condoms are sleeves of loose-fitting polyurethane that fit inside the vagina with rings on both ends. Much like the male condom, if used properly, they are a highly effective barrier against STI transmission and pregnancy. They do not have to be put in “at the last minute” like the male condom. It’s worth noting that they’re a fair bit more expensive than regular condoms.
Oral contraceptives are pills that contain hormones that fool the body into thinking it’s already pregnant. There are a variety of dosages. Possible side effects include nausea, mid-cycle bleeding, weight gain, depression, and changes in sex drive. It doesn’t prevent disease, so to reduce risk of STI’s you need to use a condom. Some people find it difficult to take it every day, which reduces the pill’s effectiveness. The pill is available by prescription or at your local youth clinic such as Options for Sexual Health (link).
Depo-Provera is a progestin-only hormone shot you get every three months. Depo-Provera does not prevent STI’s. Some people find it easier to take Depo than the birth control pill, others have a hard time remembering to get their shot every 3 month. The most common side effect is irregular bleeding (bleeding between periods, longer periods, or no bleeding for months). You can get a prescription for Depo from your doctor. Other side effects include: acne, depression and weight gain.
Diaphragms are a soft, thin dome-shaped rubber cup with a flexible rim. It acts as a barrier between the opening of the cervix and semen. The diaphragm works best when you put spermicide inside the dome and place the diaphragm high into the vagina. A diaphragm must be fitted by a clinician to be effective (they come in various sizes). It can be inserted hours prior to having intercourse, but must be left inside for at least six hours after intercourse. Diaphragms do not reduce risk of STI’s. A diaphragm can be used for 2-3 years if taken care of properly.
IUD stands for intrauterine device, a small T-shaped device inserted into the uterus by a doctor, though not all women can use it. The IUD has a string attached which hangs down through the cervix, which allows you or your doctor to check that it’s in place. IUDs can be effective from 2.5 years to 5 years (depends on type). IUDs are convenient and an alternative for women who can’t take estrogen-hormone forms of birth control. They do not reduce risk of STI’s. There are two types of IUD:
- Copper IUDs are made from copper and plastic. They stop sperm from fertilizing the egg and prevention implantation. Copper acts as the spermicide (kills sperm). Unusually, a copper IUD can be used as emergency contraception if is installed within 5 days of unprotected intercourse.
- Mirena IUDs are made of plastic and a small amount of progesterone. Continually releases the hormone at low levels to thin the lining of the uterus, thicken the cervical mucus, making it difficult for sperm to fertilize an egg. It can stop the release of an egg from your ovary.
Emergency Contraception Pills (or Emergency Hormonal Contraception, or the Morning After Pill) come in two varieties, progestin-only (Plan B) or combined progestin-estrogen (Ovral). In both cases, it is most effective when done as soon after unprotected intercourse as possible, up to 3-5 days at the most. Both varieties are given in two doses, taken twelve hours apart and are fairly effective (89% for Plan B, 74% for Ovral). Before you think “wow, that’s handy”, the side effects (primarily nausea) are unpleasant enough that you would NOT want to use this as a primary method of birth control.
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If you were more wondering what to do if you think you may be pregnant, try here.