SWM 120 – How you may be making your birth control methods ineffective
A few years ago, I was talking to a client during a coaching call, and we got off on a bit of a tangent about condom use. I explained a few ways that people tend to lower the protection of condoms when they use them. He was, well, shocked because he’d done many of them and had no idea that every time he did that, he was increasing the chance of conception.
And so, I’ve had this post idea on the back burner for quite a while until last week, when I mentioned in response to an anonymous question that if you don’t want kids, you shouldn’t have sex because even condoms and birth control are not perfectly effective when used correctly – and most people don’t know they’re not using them correctly.
When I posted that, one of our supporters asked if I could write that post, so here we go, because, well, my supporters do so much for me, I’m happy to help them out.
In this post, I’m only talking about the birth control effects, not the effect this could have on STDs/STIs. I’m also not going to address every birth control method, just the three I hear about the most. I’m also not going to be discussing natural family planning, but that is, at best, a delay method, not a method of birth control.
So, here are things you may be doing to mess up your birth control plans.
How not to use a condom
Let’s start with condoms because that’s how the idea started. Now, with perfect use, condoms prevent pregnancy 98% of the time. However, most people won’t use them perfectly. The accepted stat is that about 13 out of 100 people using condoms as their only method of birth control will get pregnant each year. A bit more than a 1 in 10 chance.
Sadly, most stats you see online about birth control methods only show a best-case result from lab tests under perfect conditions, not how people use it or a realistic environment or situation.
So, here’s how you can mess it up if you’re not a lab technician.
Starting intercourse without a condom
Lots of people (men and women) don’t like the feel of condoms, so they’ll start intercourse without a condom and wait until the man is about to orgasm before putting one on.
This is problematic for two reasons.
The first is that sometimes people orgasm quicker than they expect or without warning. All it takes is the right phrase, moans, move, or squeeze, and you’ve ruined your plan.
The second is that pre-ejaculate, also known as pre-cum, can contain sperm, and pre-ejaculate can be emitted at any time, and, unlike an orgasm, you’ll likely not feel it.
Failing to leave room at the tip of the condom for semen
Proper use dictates that you leave about 1cm (about ⅜”) at the tip of the condom to collect semen. If you don’t, there is a risk that it will be pushed back down the shaft and may escape the condom before you withdraw.
Along the same lines, while there should be room, that space should not be filled with air. Nearly half of people forget to pinch the tip of the condom when putting it on to remove air from the reservoir given. About half of the people fail to do this, according to surveys.
Failing to look for damage to the condom before you put it on
Condoms sometimes fail to be made properly, stored properly, or used before they expire (in about 1-5 years). Don’t use it if it’s faulty, torn, expired, etc. If you don’t check, though, then you won’t know.
Using the wrong kind of lubrication or no lubrication
It’s recommended that you use water-based or silicon-based lubricants when using condoms. If you use one that has oil in it, like lotions, vaseline, or oil-based lubes, including potentially coconut oil (I see conflicting studies on that), then it can damage the latex and make it break. One study showed that 40% of people have had a condom break on them.
As well, you should use some lubrication because if you don’t, too much friction can cause the condom to break.
Spreading pre-ejaculate onto the condom
This can happen in a couple of ways.
The first is that you simply have it on your hands before opening the condom or putting it on. Whether that’s because the man touched his penis or the woman did, and then they put the condom on him, opened the package, or picked up the package.
The other way is that people will sometimes accidentally put the condom on upside down, quickly realize it, and then turn it around and put it back on. Of course, in doing this, you’ve potentially contaminated the outside of the condom with pre-ejaculate, which may contain sperm, which, of course, could result in pregnancy. One study showed that up to 30% of people have done this. I’ve personally talked to men who didn’t realize this was problematic.
Not being careful where ejaculate goes
Another thing people don’t realize is that you don’t have to ejaculate inside of a woman in order to get her pregnant. If you ejaculate on the vulva or near the vaginal opening, sperm cells can swim into the vagina and cause pregnancy.
So, if you’re having sex, pull out, take the condom off and ejaculate on your partner, and it lands on her vulva – this could result in pregnancy.
By the same reasoning, anal sex isn’t a foolproof way of avoiding pregnancy either because, often, the sperm leaks out. If it travels towards the vagina, the woman can theoretically get pregnant. It’s unlikely, but it is possible.
Also, if the male orgasms and gets ejaculate on his hands or hers and then proceeds with manual sex on the woman, or she touches herself – this can result in pregnancy as well.
Unrolling a condom before putting it on
Condoms should be put on while still rolled up, and then rolled down the penis. However, some studies show that up to 25% of people unroll it first and then put it on, which can lead to damaging the condom. Don’t do that.
Not unrolling the condom the entire way
As well, condoms are designed to be unrolled the entire way to provide enough surface area and friction to keep them on. If you leave too much of it unrolled, then it can come off mid-session.
Not withdrawing quickly enough
While it’s nice to stay together and just be intimate after orgasm, unfortunately, this can be a problem with condoms. The longer you wait, the higher the chance ejaculate will migrate down the shaft or that the condom will slip off as you lose your erection, increasing leaks and the chance of pregnancy.
Lastly, we’ll talk about storage. Condoms are meant to be stored at room temperature and are not designed to withstand very hot or cold conditions. So, if you’ve left them in a car during the summer or winter, they are suspect. If you leave them in a cottage that isn’t heated year round and you get freezing temperatures in the winter – don’t trust them.
And that, I believe, is all the things I can think of that you can do incorrectly with a condom to make them work less effectively. Some are minor, some are pretty major, but each of them drops that protection percentage down from the 98% that exists in a lab by trained technicians.
Birth control pills
The hormonal birth control pill has a similar claim – 99% effectiveness – if used properly. And some of the improper uses are obvious. Some of the others are not.
Skipping a pill
Skipping a pill or forgetting to take them for a day, or a series of days obviously will negatively impact the effectiveness.
Now, most doctors will tell you that missing a single day isn’t a problem. However, they’ll also tell you to make sure to take them at the same time every day, and that is a bit confusing. Some will say there is a 24-48 hour “safe” window for missing a pill, but then others say that it should be taken at the same hour every day without fail.
It seems to be that the combination pill is more tolerant of a missed day or irregular times, whereas the progestin-only pills should be taken within the same three-hour window every day to maintain effectiveness.
Either way, I’d suggest sticking to a schedule if you want it to be at that 99% effectiveness.
If you’ve missed a pill, generally, the advice is that you should not trust it until you’ve had seven days straight of not forgetting it and taking it at the same time every day.
Medications & herbal supplements
Some medications can make birth control pills less effective. Now, some are pretty rare, like rifampin (Rifadin), which is used to treat tuberculosis, and some HIV drugs, but others are pretty common.
Some anti-fungal medications (griseofulvin/Grid-PEG, Ketoconazole/Extina/Nizoral/Xolegel) used to treat athletes’ foot, and jock itch do have a low chance of interfering with hormonal birth control.
As well a whole bunch of anti-seizure meds as well – so check with your doctor if you’re on any.
Modafinil (Provigil), used for sleep disorders like narcolepsy and sleep apnea, lessens its effectiveness as well, so you should use another form of birth control if you’re on them.
Some cold medications as well, specifically pseudoephedrine (Sudafed, NexaFed, Zephrex-D), tend to make your body burn through birth control faster, making them less effective.
And lastly, a bunch of herbs can as well, including St. John’s wort, saw palmetto, alfalfa, garlic pills and flaxseed.
I want to touch on breastfeeding as well because a lot of people use breastfeeding as a method of birth control. Thankfully, most don’t think it’s perfect because it’s not.
If you’re breastfeeding and you gave birth to the baby less than three months ago, there’s a very low chance of getting pregnant again. It happens, but it’s less than 1% – frankly, it’s more effective than condoms or birth control pills.
At 3-6 months post birth and still breastfeeding, that goes to about a 2% chance – about as effective as condoms in perfect conditions.
At six months, you’re at about 6% chance.
Lastly, all these numbers go out the window if your period starts. If it does, then breastfeeding is no longer an effective form of contraception. Only about 7% of women have their cycle start in the first six months, about 35% from 6-12 months, and about 8% manage the past 24 months – the rest (50%) generally start between 12-24 months after giving birth – if they keep breastfeeding, or when they stop.
Of course, those are all guidelines and merely chances. As I said before, if you’re having sex, you should be prepared to get pregnant unless you’re sterile through some other means. And a vasectomy or tubal ligation doesn’t count as sterilization – it’s a very low chance, but it’s still possible. A complete hysterectomy will do it, and generally, if you’re menopausal and haven’t had a period in over a year, then you’re considered sterile from my understanding – other than through IVF.
I hope that was educational for someone – at the end of the day – yeah, sex comes with the responsibility of children, and there’s not really much of a way of getting around it. You can try to lower your chances, but without serious surgery or waiting until you’re post-menopausal, you can’t completely get rid of the possibility.
So, be responsible. This is also one reason why I believe sex should be reserved for marriage – because the possibility of starting a family is always there, and that should be done, if not with intention, then at least in a committed (and by that I mean for life) relationship.