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Heather Corinna replies:
Alright, so me and my boyfriend had sex for the first time yesterday. It was my first time ever having sex, but I was confident about it. We used a condom and he is very safe about it. As well, during sex he does not have an orgasm and will pull out for my comfort of mind. He makes sure there are no holes in them and uses them how he is told. However, I have a few questions.
1) How protective is a condom?
2) As another precaution, I made sure that he ejaculated BEFORE we engaged in sex at all. This we did in the morning at about 8:00AM and had sex at around 3:30PM. What are the chances of pregnancy using this method as well as a condom and pulling out?
3) I am making sure I start going on the pill or the patch, but do not know much about either. Which is more recommended and why?
I know that I seem paranoid taking so many precautions, but I do not want to continue having sex until I have made sure of as many contraceptive ideas as possible.
Condoms, when used properly, are highly effective: around 98% effective with perfect use. Perfect use means:
When you do all of those things, your condom is very unlikely to fail -- it's in that 2% window. Most condom failure is due to user error.
A partner does not need to withdraw before ejaculation wearing a condom. In fact, given that when we're about to orgasm, our heads are a bit spinny, and it can be tough to think clearly -- and a bummer to even have to -- it's more likely a condom will fail by doing that, as the wearer can easily space out holding unto the base when withdrawing -- than it will from ejaculating. If room has been left in the tip when it was put on, ejaculate will not break a condom.
Too, there's no need for someone (unless they want to) to have to ejaculate before intercourse otherwise, and that does not reduce the risk of pregnancy in any way. There also really isn't a need to check for "holes." In the rare instance condoms have a manufacturing flaw -- and it is incredibly rare that that happens, and rarer still that when it does, those flawed condoms end up being sold -- it's not usually going to be something you can see. The testing equipment a manufacturer uses is far more sophisticated than our eyes.
So, if you're going to use condoms alone, there is just no need to do those two things, and one of them may make it MORE likely for your condoms not to work.
Condoms alone aren't secure enough for everyone when it comes to feeling covered from risks of pregnancy. That doesn't mean a person is paranoid: just that that person really doesn't want to become pregnant. Obviously, you're one of those people, so rather than some elaborate song and dance, what you want is simply a backup method of birth control.
The pill or the patch are both good options, and which one you take depends a lot on you. Generally, it just boils down to what you prefer, and if you can remember to take a pill every day, or would prefer to only have to remember to change a patch once a week. The vaginal ring is another hormonal option you might want to ask your doctor about. All hormonal options when it comes to birth control do carry risks, and they're not right for everyone. If you smoke, have any cardiovascular issues, if you have issues with migraines or depression, for instance, hormonal options may not be best for you. There are also sometimes some sexual side effects with hormonal methods -- namely, decreased sex drive and decreased vaginal lubrication -- which may or may not be okay with you.
You might also ask your doctor about other backup methods, such as cervical barriers -- which you only use when you're going to be having sex, and which are pretty much side-effect free -- or you might just ask for a couple prescriptions for emergency contraception. Since when condoms fail, we almost always know they did, EC is great to be used that way since we're then only taking hormones when we need them.
But your OB/GYN is the best person to talk with about all of these options to determine which is best for you as an individual.
Just remember, too, that if even with condoms and a backup you are STILL feeling pretty worried and tense about pregnancy risks, that there are lots of kinds of sex, and most of them do NOT present risks of pregnancy. Intercourse is only one way to have sex, and if the risks it poses are greater than you'd like to take, even when you've reduced them, there's little sense in doing something where you just can't relax and really enjoy yourself, especially when there are so many other sexual activities which are just as enjoyable (and more so than intercourse for a majority of people), but which pose less risks.