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She's five days late: are condoms REALLY effective?

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Anonymous asks:

My girlfriend and I had sex about a week and a half before her period was due with a spermicidal condom on. Now she five days late and I'm really worried. We took a pregnancy test and it came out negative. I keep hearing that you can take a HPT after a missed period but, isn't there still a certain amount of days you need to wait regardless of a missed period? My worry, even after we took the HPT is that we had sex so close to her period that the test wouldn't be accurate for another week or so. Also, do spermicidal condoms work pretty well?

Heather Corinna replies:

I know -- boy, do I! -- that there is an awful lot of propaganda out there that condoms aren't reliable, but that really is all that it is: propaganda. There are no microscopic holes in condoms, for instance, which semen or viruses can invisible escape through.

When used properly, condoms are 98% effective, which makes them nearly as effective as just about any other reliable method of birth control out there.

With "typical" use, they are only 80% effective, but allow me a minute to explain what typical use rates really mean. In effect, when people are doing these studies, they're looking at what method of birth control people report they use, and then at rates of pregnancy. Now, that absolutely includes any given method not being used properly. For example, with the pill, that would include skipping or missing pills, or taking the wrong pills at the wrong time. With condoms, that would include things like not leaving room at the tip, not rolling it all the way down, not using extra lubricant to keep them from breaking, storing them improperly before use, not holding the base of them as you withdraw, and not using them for all genital contact, from start to finish. But it also includes -- with typical use rates for any method -- not using that method at all. In other words, I say condoms are my birth control method, but I only use them at all maybe one out of every three times I have sex, and I'm still part of that typical use statistic.

If you are using condoms properly and consistently, EVERY time, you really can rest assured that you two are likely in or near that perfect use rate. And if you're also using a spermicide with your condoms (and I'll address a better way to do that in a bit), you're also adding an extra method, so your effectiveness may be even higher than that.

This last time, if you had the condom on for all contact, from start to finish, and it did not rip, tear, break or slip off at any point (and when I say slip off, i don't mean slip down, I mean OFF, with the ring all the way in the vagina), then pregnancy is highly unlikely. If any of those things did happen, then it's a different story, obviously.

Since your partner took an HPT after her period was already late, it's also very unlikely her negative result was incorrect. When it comes to home pregnancy tests, they can be taken from either around 14 days after a pregnancy risk, or at the first sign of a missed period, whichever comes first, and net accurate results. False negatives are far more common than false positives, but so long as she followed the instructions of the test, and read the results correctly, her result is most likely accurate. By all means, she can retest in another week if her period still is a no-show, but that probably isn't necessary, as based on what you've said here, she took that test at a time when it was perfectly likely to be accurate.

A whole lot of things can delay periods, very much including worry about pregnancy. Weird as it may sound, we women can sometimes even worry so much about being pregnant that our minds can kind of "trick" our bodies into thinking we're pregnant when we're not, and that can stall a period. And periods are often not like clockwork, particularly with younger women. Some women also don't chart their cycles correctly, and expect periods to come on a specific date each month, when, in fact, given that the days in each month vary, a period that came on, say, the 15th of every single month would actually be a pretty irregular period, not a regular one. So, that may even be the issue here.

My best advice to both of you is to do what you can to just relax: that'll help both of your mental health, and in her case, reduce her stress levels if that stress is the cause of her period delay. By all means, because no method of birth control is 100% effective, pregnancy will always be a risk of some sort any time you have vaginal intercourse. But when you're using a good method of birth control -- and condoms are one of those -- properly and consistently, it is only a small risk.

Okay? As far as the spermicide goes, if spermicides work for both of you (they irritate a lot of people's genitals, but not everyone's), then it's actually better to use a separate spermicide if you want it as a backup method with condoms. The amount on a spermicidal condom -- just like the amount of lube on a lubricated condom -- is pretty miniscule. So, you might instead want to consider using VCF, or vaginal contraceptive film, a thin sheet of spermicidal film placed in the vagina before sex which dissolves into a goodly amount of spermicide. Spermicidal foams or jellies are also another option. You can just use any of those with any quality condom of your choosing.

Here are a few more links for you both:

written 25 Jan 2008 . updated 28 Jan 2009

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