He isn't okay with condoms, so I'm starting the patch. Is that safe enough?

I'm planning to start taking birth control, patches to be more specific. My boyfriend and I used to just use just the withdrawal method before we started using condoms and he is still very uncomfortable with condoms. He cannot be as aroused when he has it on. I know sex feels better without a condom but, I would like to know if using a condom is completely necessary when already taking another type of birth control, like the pill or the patch? What do most women regularly do?
Heather Corinna replies:

You know, hormonal birth control often reduces or inhibits female libido or arousal, too. Sometimes, for some women, pretty substantially. It does so because of what it does to a woman hormonally: the only way condoms inhibit arousal or libido is if a guy using them (or opting not to) has a cruddy attitude about them. And he can adjust that: you can't do the same with hormonal birth control. Arousal happens in the brain, not the genitals.

That isn't to say that if a hormonal method of birth control is what you want and feel works best for you there is anything wrong with that. It's simply to say that if you can deal with those common effects of your method, effects you can't do anything about if you get them, the least he can do is just adjust his 'tude and figure out how to use condoms.

Do you need to also use condoms when you're using a hormonal method to prevent pregnancy? If you're sure to always use your method properly, you probably don't unless you're not comfortable with the very small risk only using a hormonal method leaves: about a 1-2% risk if you're a perfect user of your method. It's a small risk. But for some women, not small enough, and that's one reason some will double up and use both condoms and a hormonal method.

Another big reason women on the pill will do that is to protect against sexually transmitted infections. If you and your boyfriend have not been together for at least six months, exclusively, been using condoms and latex barriers for any vaginal, anal and/or oral sex AND have each had at least two full and negative screenings for STIs, then it's really not smart to ditch condoms. After all of that, then you can both consider your risks greatly reduced, and it's okay to consider going without, but not before. Do remember that sexually transmitted infections are MORE common for teens and young adults than pregnancy: it's easier to get an infection than it is to get pregnant.

Too, plenty of women like for men to use condoms, regardless, because they don't think it's so cool to be the only person taking the responsibility with sex when sex is about two people, not just one. Wearing a condom is a very easy way for your boyfriend to take part of the responsibility. He could also chip in for your birth control costs. You ask what most women regularly do, and the answer is that it varies. But a lot of women express feeling pretty put upon because their male partners put all this on them, and some women who have felt that way make a choice to insist that sexual partners do their part, too (P.S. When you tell most men that if it's no condom, it's no sex, and you mean it, you'll rarely get an argument). And those women tend to express feeling a whole lot better about sex and their relationships. So.

All of these things are obviously up to you. The best protection, from pregnancy and STIs, would be condoms WITH whatever other method you want to use, but you may be comfortable with more risk than that, and only you can make these decisions for yourself.

But what I'd say to you is that you should never have to see things as a choice between condoms and no condoms when there are other options. Your boyfriend CAN STEP up and use a condom like millions of men do just fine. Again, most issues with condoms -- including them getting in the way of how sex feels for men -- are either about not using them properly (and I'll link you to some instructions and tips below you can both look at), or about just having a bad attitude. As well, if your boyfriend isn't ready to deal with condoms, another option is for him to just hold off on sex until he is ready: after all, he probably won't be with you your whole life, and it's unlikely he'll get away with all other female partners of his having sex with him without condoms. Maybe he just isn't really ready?

In other words, choosing what risks you're up for and what you aren't should not be about what a partner just won't do to help protect you, you know? Your hormonal birth control is more costly than condoms, carries risks of side effects (which condoms do not), may intrude upon your arousal in greater ways than condoms: and yet, you're willing to do that. It's always an option just to choose not to be with someone -- or to wait until they're really ready, including being equitable about taking responsibility -- who can't do the simple, easy and cheap things they can to do their part in reducing risks for both of you.

Here are those links for you about condoms, and another couple of things that might help you out.

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