Practicing safe sex: all your contraceptive options explained!

October 16, 2022 7 min read

Practicing safe sex: all your contraceptive options explained!

At Aleenta we’re all about you, and your health. 


We want to arm you with factually based information to support and guide you through life. Sex, or more specifically safe sex, is one of those areas that is not talked about widely enough. We’re here to change that.


Sex is a natural part of life, so it’s important we arm ourselves with the tools and knowledge to do the deed safely. There are many forms of birth control and STI-protectants that you may have never been taught about in school, especially as new contraceptives continue to be invented and sex education evolves… so, we’re here to lay them all out for you! From hormonal methods, to barrier methods and cycle tracking, we list options here for all people, including the LGBTQ+ community who have been historically left out of sex education. We all deserve to know how to engage in sex happily and healthily!



But first…


Even if unwanted pregnancy isn’t a concern for you and your partner(s), sexually transmitted illnesses (STI’s) are very real and do not discriminate. Don’t be afraid to ask a new, potential partner if they have been tested recently before engaging in sexual activity, or to wear protection, and be sure to get tested yourself when necessary. The best way to normalize this kind of conversation is by making a frequent habit out of it! Additionally, you should never feel pressured into sex. If your partner is refusing to use protection when you’ve asked them to, no matter what reason they give, you always have the right to say no. Consent is the sexiest thing of all, and all parties involved should always be giving an enthusiastic ‘yes!’ before and during sex. 




Types of contraception


All information and statistics provided have been sourced directly from the US Centre for Disease Control and Prevention (CDC) unless otherwise stated (i).


  1. Barrier methods

Barrier methods are the only kind of contraceptive that also prevent STI’s. The most commonly used barrier method is the condom, which comes in two forms; one that is worn externally over the penis and another that is worn internally, inserted into the vagina or anus. Typically made of latex, these have an effectiveness rate of 79-87% when used correctly. Note that these condoms cannot be used simultaneously as it can cause tearing that will lower their rate of effectiveness. Follow these links to learn other safe usage tips forexternal andinternal condoms.


Another barrier method successful in preventing STI’s you may not know about is the dental dam. This is alatex or polyurethane sheet used between the mouth and vagina or anus during oral sex, and is an important method to know about especially for the LGBTQ+ community. They can be bought pre-made, or you can make one yourself out of an external condom. For safe-usage instructions, check outthis guide from the CDC.

Blue background with word "barrier" in green at centre. Images of condoms, spermicide and diaphragm.

The final type of barrier methods use spermicide to kill sperm, andare not effective against STI’s. This includes:

  • Foam, gel, cream, film, suppository, or tablet placed in the vagina no more than one hour before intercourse and left in place at least 6-8 hours after intercourse. Can be used in addition to condoms, diaphragms and cervical caps, with an effectiveness rate of 79%.
  • Diaphragm/cervical cap: placed inside the vagina to cover the cervix to block sperm. The diaphragm is shaped like a shallow cup; the cervical cap is a thimble-shaped cup. Before sexual intercourse, you insert them with spermicide to block or kill sperm. 83% effectiveness rate.
  • Sponge:  contains spermicide and is placed in the vagina where it fits over the cervix. The sponge works for up to 24 hours, and must be left in the vagina for at least 6 hours after the last act of intercourse. 73-86% effective, with it being most effective in those who have not had a baby. 

  1. Hormonal methods

Hormonal contraceptives use synthetic hormones to prevent pregnancy in various ways, andare not effective against STI’s. The most commonly used hormonal contraceptives are birth control pills, which contain either progestin only, or both progestin and estrogen. Progestin works by thickening cervical mucus to prevent sperm from entering the uterus and increasing the lining of the uterus to stop implantation. Meanwhile, estrogen prevents an egg from fully developing, preventing fertilization (ii). When used correctly, birth control pills have a 93% effectiveness rate. These pills must be prescribed by a doctor, however, there are now subscription services available in certain countries such asYouly.


Longer-term hormonal methods are also a popular option as they last for 3-5 years and have high effectiveness rates. This includes the kilena and mirena IUD’s which are inserted into the uterus and release small doses of progestin every day for 3-5 years respectively. These have a 99.06-99.9% effectiveness rate! Another similar method is the implant, which is a thin rod that gets inserted under the skin of the upper arm. Like the hormonal IUD’s, this rod releases small doses of progestin for up to 3 years and have a 99.9% effectiveness rate.

Orange background, word "hormonal" at centre. Images of vaginal ring, IUD, birth control pills and a needle.

 

The final category of hormonal contraceptives includes the vaginal ring, patch and injections. The ring is inserted into the vagina and the patch worn externally on the lower abdomen, buttocks, or upper body (but not on the breasts). The patch is changed once a week for 3 weeks, whilst the ring stays in place for 3 weeks. Then, both are taken off for 1 week to allow for a regular menstruation cycle. A new ring/patch is then placed for the next month. Both methods have a 93% effectiveness rate when used correctly. The hormonal injection is a progestin shot that is administered by a doctor every 3 months, and has an effectiveness rate of 96%.


  1. Non-hormonal methods

Not all people wish to use hormones to prevent pregnancy, as they can have significant side effects. In addition to barrier methods, there are several other non-hormonal methods, however, it is important to note that thesedo not protect against STI’s and it would be beneficial to use them in tandem with a barrier method like condoms.


A long-term alternative to the hormonal IUD is a copper IUD which acts as a sperm repellent. These are also inserted into the uterus, and can last for 7-10 years with a 99.2% effectiveness rate.

Green background, word "non-hormonal" at centre. Images of copper IUD, phone with menstrual app and woman breastfeeding.

 

Fertility-based awareness involves tracking your monthly cycle so you know when you are most fertile. If you have a regular, 30-day cycle, you likely have 9 or more fertile days each month during which you should abstain from sex or use barrier-method contraceptives. The remaining days are either days when you are infertile, and days when fertility is unlikely; knowing when these times are in your monthly cycle can inform you when the safest time to engage in sex may be. Using cycle tracking apps such as Clue can be helpful in beginning this method of contraception, however, if you have a more irregular period it may be difficult and less effective. Success rates vary from 77-98%.


If you have recently given birth, another tracking method you could use is the Lactational Amenorrhea Method (LAM). Note that this is only successful in those who meet all 3 requirements of: not having any menstrual periods after delivering a baby; fully or nearly fully breastfeeding; less than 6 months since delivering a baby. Track your eligibility with each requirement frequently: if you ever stop meeting any one requirement, you should revert to an alternate method of birth control.


  1. Emergency methods

If you find yourself in a situation where you were unable to use birth control at the time of sex, or your chosen method failed (e.g. the condom brakes), don’t panic! Emergency contraceptives are available.

Pink background, word "emergency" at centre. Images of copper IUD and plan B pill.

 

The most well-known method is the emergency contraceptive pill, also referred to as “plan B.” This pill can be taken up to 5 days after intercourse, however, the sooner it is taken the more effective it is. According to the World Health Organisation, emergency contraceptive pills have an effectiveness rate of 97.9-98.8% (iii). Note that this pillis not an abortion pilland works by preventing ovulation so that sperm cannot interact with the egg in the first place. If an egg is already fertilized prior to taking an emergency contraceptive pill, it will have no effect. Dr. Elizabeth Schmidt, assistant professor of obstetrics and gynecology and director of family planning at North Shore University Hospital in New York, explains:

"New evidence [that has] been around for about 10 years now has shown that actually, Plan B works, probably essentially only through that first mechanism -- blocking ovulation… Pregnant people make progesterone, and Plan B is a type of progesterone, so it makes sense that it would have no effect on a developing embryo."(iv)


A lesser-known fact is that you can actually have a copper IUD inserted as a form of emergency contraception. When inserted within 5 days of unprotected sex, it is more than 99% effective and can continue to be used as long-term birth control


  1. Permanent methods

Finally, there are more permanent methods available for all genders. This includes tubal ligation, colloquially referred to as “tying your tubes,” and vasectomies. Tubal ligation involves a surgical procedure to close the fallopian tubes which stops a sperm and egg meeting. A vasectomy is an operation that prevents sperm from entering the penis, so an ejaculation contains no sperm cells, and is reversible. Despite being permanent, each of these procedures do have a failure rate of 0.5% and 0.15% respectively.


Blue background, word "permanent" at centre. Image of a diagram showing tubal ligation and vasectomy.

What next? Do your own research!


Think of this blog like a starting guide to get an idea of which form of contraception may be right for you, then do your own research! We have only touched upon the available options and there are side effects to consider with each and every method listed. We are all unique down to the cellular level, so how hormones and materials such as latex interact with our bodies will be different for everyone. You should also consider discussing potential options with a healthcare provider, especially for methods that require prescriptions (the pill, injection, IUD insertion, etc) or referral (vasectomy, tubal ligation). Don’t be afraid to talk about contraception; the more we talk about it, the more normalised sex education will become, making sex safer for everyone. After all, knowledge is power! So, have the uncomfortable conversations, share this blog, and continue to engage in sex safely.

 

Written by Sascha Czuchwicki



Works Cited

(i) U.S. Department of Health & Human Services. Contraception. 13 January 2022. 29 September 2022. <https://www.cdc.gov/reproductivehealth/contraception/>.

(ii) IBM Watson Health.Estrogen And Progestin Oral Contraceptives (Oral Route). 1 February 2022. 29 Aeptember 2022. <https://www.mayoclinic.org/drugs-supplements/estrogen-and-progestin-oral-contraceptives-oral-route/description/drg-20069422>.

(iii) World Health Organization. Emergency contraception. 9 November 2021. 29 September 2022. <https://www.who.int/news-room/fact-sheets/detail/emergency-contraception>. 

(iv) Schmidt, Dr. Elizabeth.How Plan B works and why it's not abortion Dr. Esra Demirel and Sony Salzman. ABC News, 12 July 2022.

Campbell, Carni, et al.Contraceptives. 2018. 29 September 2022. <https://edspace.american.edu/lgbtqinclusivesexeducation/curriculum/contraceptives-and-protection/contraceptives/>.



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