How to use contraception effectively

Q: I have been having sex with my boyfriend for about a month and a half. We use condoms, but I’m afraid I might get pregnant. What are my chances of that happening? We have had sex twice without a condom but he did not reach an orgasm. Would I still be able to get pregnant?

A: You bring up some excellent issues about contraception, and some very commonly held myths. For example, many people incorrectly believe that the man has to have an orgasm for you to become pregnant. That’s definitely not true, as one tiny drop of seminal fluid has millions of sperm that can get to an egg – so if even one drop of semen leaks out, you could get pregnant.

Let’s talk about pregnancy rates. These numbers are based on 100 couples having sex for one year, every other night. If these couples used no contraception, by the end of one year, 80 would be pregnant. If these couples used only condoms, five or six would be pregnant at the end of the year. If they used condoms and the woman used spermicide cream or foam, two of them would be pregnant. If they used only spermicidal creams, 15 would conceive. If they used birth control pills, less than one would be pregnant. I think these numbers make it clear that if you don’t want to get pregnant, a reliable method of birth control must be used. Certainly condoms are very helpful, but not a foolproof method.

Now of course, condoms also provide for infection protection, not only from HIV, but also from other sexually transmitted diseases like herpes and genital warts. So I encourage all of my patients using birth control pills to use condoms as well, if they are at risk for STDs. Many women are concerned about side effects from birth control pills. The newest pills on the market are really quite safe, and are much lower doses than the original pills that people associate with all the side effects. If you have a regular health care provider, do not hesitate to talk with her or him about the possibility of going on to the pill. If you do not have a regular physician, Planned Parenthood has clinics all over the country, and can counsel you, give you an examination, and provide you with contraceptives at minimal expense.

What you have in your mind?