How to make sex safer in 4 simple steps

Most of us have said, or heard a friend say, at one point or another “Hello birth control—goodbye condoms!” I get the thought process behind this—but as a healthcare provider for young women, it worries me. Here’s why: young women have the highest risk for accidental pregnancy and sexually transmitted infections (STIs).

Double trouble...

A recent study in Northern California showed that many young women (ages 15-24) have trouble using condoms and hormonal birth control at the same time. The study followed 1,000 young women who started a new method of hormonal birth control. When they started the study, 36% of the women used condoms regularly for protection, and 5% used both condoms and birth control (a.k.a. “dual protection”). At first, starting a new method of birth control inspired these young women to double up, but over the months, the women stopped using condoms, stopped their other birth control, or stopped both. After a year, the majority were still worried about getting pregnant or getting an STI, but weren’t using condoms or birth control.

When life gets busy or complicated, it can be easy to get distracted and suddenly find yourself—like many of the couples in the study—not using any protection when you have sex. But the risks speak for themselves:

• women ages 15-24 have about a 1 in 30 chance of contracting a common STI, like chlamydia or gonorrhea;
• young women have a 1 in 20 chance of getting pregnant from having sex at any time in the menstrual cycle–and a 1 in 4 chance around the time of ovulation.

So what can you do?

Fortunately there are 4 steps you can take to double your protection:

1. Talk talk talk about condoms. With your partner, with your friends, with anyone who will listen. If your partner doesn’t like using them, find out why. You may be able to resolve the problem by checking out condoms made with different materials or ones with different textures. Or bring him with you to your next clinic or doctor appointment so you can talk with a healthcare provider about using condoms and birth control together. Even though you both may promise to be only with each other right now, some infections take time to show up. This means an infection from the past could show up well into your relationship, even if you are both faithful. Using condoms every time you have sex is the only way to reduce your chance of infection.
2.  Find a birth control method that is right for you. Try different methods until you find one that works best for your body and your lifestyle. Your healthcare provider can help you through this process, and help make sure that you stay protected even when you’re switching to something new.
3. Keep using condoms. Starting a hormonal or long-acting birth control method can help prevent pregnancy, but you or your partner can still get an infection. Don’t stop using condoms just because you started birth control. Unless you’ve been in a monogamous relationship for more than six months and both been tested and cleared for STIs, keep up with the condoms.
4. Don’t stop your birth control without talking to your provider—or having a back-up plan. This is where many women get stuck. They used to use condoms, then they got on the pill, then they stopped using condoms, and now they’ve forgotten to take their pill so often that they decide to stop it altogether and don’t start using condoms again. To avoid being unprotected and frustrated, ask your provider when you start the method what you should do if you decide you don’t like it. I always tell my patients to let me know as soon as possible if they have questions or concerns about their method and are thinking about stopping it. Often, side effects can be controlled or will go away with time—or we can find a method that's easier to use or has fewer side effects. Regardless, if you ever stop using your birth control, always start using condoms immediately and every time you have sex to prevent pregnancy until you find a better method.