Prevent Pregnancy Without a Condom

There are a variety of ways to decrease the risk of unwanted pregnancies without using a condom. You can speak to your family doctor to discuss (and receive prescriptions for) various medical options, or you can opt for natural methods. Keep in mind, however, that there are benefits to a condom beyond contraception - namely, the prevention of STIs (sexually transmitted infections). Also, the only 100% guaranteed way to prevent pregnancy is to abstain from sex; all other options significantly decrease your risk of pregnancy, but they are not guaranteed to prevent it.

Steps

Using Medical Options To Prevent Pregnancy Without A Condom

1. Take hormonal birth control pills. If you are a woman seeking to prevent pregnancy without using a condom, one of the most common options is to take hormonal birth control pills. These are available from your family doctor; the pills are composed of either a blend of estrogen and progesterone, or just progesterone. You normally take one per day for 21 days followed by seven days of "sugar pills" (during which your body experiences a "withdrawal bleed" in place of a period).
   • There are a variety of different birth control formulations, and you can speak to your family doctor about the different options to determine which one is best for you.
   • The advantage of taking birth control pills is that they are 91% effective in preventing pregnancy (and even more effective when used at exactly the same time every day without missing any doses).
   • If you are a man having sex with a woman and not wanting to get her pregnant, you can ask her if she is regularly taking birth control pills. The downside of this method of contraception for men, however, is that you are relying on taking the woman's word for it, and also trusting that she has been taking them daily and not accidentally missing doses.
2. Have an IUD (intrauterine device) inserted. An IUD is a small, T-shaped device that is inserted through your vagina into your uterus (where it sits for the next number of years and functions as birth control). They are over 99% effective at preventing pregnancy.
   • IUDs available include: the Mirena, Skyla, and Lilletta IUDs, and the Copper IUD.
   • The Mirena IUD is hormone-based. It is more expensive and lasts up to five years; however, the benefit is that it decreases menstrual cramps and bleeding. Skyla, and Lilletta IUDs are also hormone based and these last up to three years.
   • The Copper IUD is not hormone-based. The pros are that it is cheaper and lasts up to 10 years; however, the downside is that your menstrual cramps and monthly bleeding may be increased.
   • You may receive a prescription for an IUD from your family doctor. Your doctor can then set up an appointment to have it inserted, which usually only takes a couple of minutes.
   • Having the IUD inserted may be painful for a brief moment as it passes through the narrow opening of your cervix; however, after it has been inserted, you should no longer feel any pain.
3. Try other hormonal birth control options. Other hormonal options include a vaginal ring, Depo-Provera injections, and contraceptive patches. They are available via a prescription from your family doctor.
   • A vaginal ring (called the NuvaRing) is something you place in your vagina and leave there for three weeks at a time (and then remove it for one week for a withdrawal bleed). It suppresses ovulation by releasing hormones (a mixture of estrogen and progesterone) during the time that it is in your vagina. It is rare for the ring to cause any problems with sexual intercourse, and it is normally not felt by either the user or the user's partner. The failure rate is 9% with typical use, and 0.3% with perfect use. The ring can be removed for up to three hours, so if you are more comfortable having sex without it, then this is an option.
   • Depo-Provera injections are administered by your family doctor once every three months, so the advantage is that, as long as you go every three months, you do not need to remember to take birth control pills (or to use another method) on a regular basis. The failure rate is less than 1% for those who follow through with injections every three months.
   • Contraceptive patches are about 5cm x 5cm in size, and are placed on your skin. Each patch lasts for one week, and then must be replaced - therefore, you need to use three in a row, followed by one week off to allow for a withdrawal bleed. The patches contain the same hormones as the birth control pill, and, when used correctly (and replaced diligently every week), the failure rate is less than 1%.
   • Ask about the implantable birth control called Implanon. This birth control method is inserted into your arm and it will last for up to four years.
4. Opt for a spermicide. Spermicides are gels or foams that are inserted into the vagina, which trap and subsequently kill sperm through the use of chemicals that are toxic to sperm. They can be purchased at your local drugstore or pharmacy. The failure rate for spermicides is around 22%.
5. Use a barrier method such as a cervical cap or a diaphragm. Both a cervical cap and a diaphragm are devices that a woman inserts into her vagina to cover the cervix. This blocks sperm from entering the uterus. The cervical cap or diaphragm also normally contains chemicals that kill sperm, further reducing the risk of becoming pregnant. The failure rate is about 14% in women who have never been pregnant, and 29% in women who have previously been pregnant.
   • You can get fitted for a cervical cap or diaphragm at your doctor’s office.
6. Opt for sterilization. One of the surest ways to prevent pregnancy is for either the man or the woman (or both) to be sterilized. However, it is key to know that this is a permanent procedure. It should not be undertaken unless you are absolutely sure that you do not want biological children of your own in the future.
   • For a man, the procedure is called a "vasectomy." In this procedure, his "vas deferens," the tube that carries sperm, is cut. This prevents the man's ability to contribute to a pregnancy.
   • For a woman, the procedure is called "tubal ligation." The woman's fallopian tubes (which carry unfertilized eggs from the ovaries to the uterus) are severed. This prevents eggs from being fertilized and thus prevents pregnancy.

Using Natural Methods to Diminish Your Risk of Pregnancy

1. Try the "withdrawal method." One way to diminish the chances of pregnancy without using a condom is to try the withdrawal method. This method consists of the man removing his penis just prior to ejaculation, so that the sperm do not have a chance to travel up the woman's vagina in a way that may lead to pregnancy.
   • The challenge with this method is that some sperm may leak out prematurely (prior to ejaculation and thus prior to withdrawal of the man's penis), which is what makes this method only 78% effective at preventing pregnancy.
2. Use the "calendar method." Technically, there are only a few days each month when a woman can actually become pregnant. Most women have a 28 day cycle, which starts on the first day of her period. On average, ovulation occurs on day 14, but a woman can be fertile for several days before and after ovulating.
   • If a woman has sex significantly before or after her most fertile days, her chances of becoming pregnant are much lower.
   • The downside to the calendar method is that not all women have exactly 28 day cycles. There is quite a bit of variability between women, and one woman may even find that her own menstrual cycles are not completely consistent from month to month. It is for this reason that this method is only 76% effective at preventing pregnancy, without the use of a condom.
   • If your cycle is consistently more or less than 28 days, subtract 14 days from the END of your cycle and consider this the start of your most fertile few days. The second half of a woman's menstrual cycle (following ovulation) tends to be much more consistent than the first half of the cycle (prior to ovulation).
3. Track your fertility using physiological markers. One way to track your fertility is to use physiological markers such as basal body temperature measurements, and/or observing cervical mucus discharge, to help pinpoint the specific days when the woman's fertility peaks. You can then avoid having sex on those days when the woman's fertility is high.
   • With the "basal body temperature" method, a woman measures her temperature first thing in the morning and before eating every day. It will rise 0.4-1.0 degrees Fahrenheit following ovulation. Therefore, it is advisable to use a condom, a spermicide, or another non-hormonal form of birth control from the first day following the woman's period to three days after her basal body temperature has risen.
   • With the "cervical mucus" method, the woman observes the characteristics of her cervical mucus discharge. There is typically no mucus discharge immediately following a period, mild and sticky secretions in the days after that, greatly increased mucus secretions that are more wet and clear in the days surrounding ovulation, and no noticeable secretions following the end of her "fertile period" all the way until the beginning of the woman's next menstrual cycle. Therefore, during days when cervical mucus is abundant, clear and wet, it is important to avoid sexual intercourse as this is when a woman's fertility is at its peak.
4. Understand that natural methods still pose a risk of pregnancy. Both the withdrawal method as well as the calendar method are significantly less effective than the medical methods of contraception. It is important not to rely on these techniques if you are truly seeking to avoid a pregnancy. Here's why:
   • If you are a man and you inadvertently get a woman pregnant, in most places she has 100% choice as to whether or not to proceed with the pregnancy (or whether to get an abortion).
   • This may mean that, by getting a woman pregnant, if she chooses to keep the baby you are now responsible financially to help out, and may take on the responsibilities of co-parenting duties as well.
   • Both men and women are impacted by unintended pregnancies. Having the responsibilities of supporting a baby before you are ready can significantly impact (and potentially get in the way of) other plans you may have, regarding career, relationships, or any other sphere of life.
   • If you are the woman and you inadvertently become pregnant, you may be faced with the challenging decision of whether or not to keep the baby or to proceed with abortion, if this is legal in your area.

Understanding the Added Value of Using a Condom

1. Consider a condom for STI risk reduction. Before making the decision to forego condom use, it is important to consider the role that condoms can play in STI risk reduction as well as in preventing pregnancy. Even if you are using other contraceptive devices, such as a hormonal form of birth control, other contraceptive methods do nothing to prevent you from STIs (sexually transmitted infections). Therefore, condoms have an important advantage when it comes to practicing safe sex.
   • Condoms protect you from STIs by reducing genital-to-genital contact, and by also blocking the ejaculatory fluid from the man's penis from getting into the woman's vagina. Both of these types of contact are ways in which an infection can be passed from one person to another.
2. Use a condom if you do not fully trust your sexual partner. If you are in a long-term committed monogamous relationship, you will know whether your partner is taking alternative forms of birth control, such as taking "the pill" or using an IUD, as you will have developed a trusting relationship with that person and have presumably discussed the best contraceptive strategies for the two of you. However, if you have a new sexual partner who you do not yet know well enough to fully trust, it is important to understand that a condom can be one of the more reliable methods of contraception.
   • If you are a man, you can never know for sure if a new female sexual partner is actually on "the pill" (or another birth control method), and taking it reliably.
   • It is possible for a woman to be dishonest about using birth control while purposefully becoming pregnant.
   • Similarly, a man may be dishonest to a woman about having a vasectomy when he actually does not. Or, he may say he will withdraw and then fail to do so.
   • Using a condom is a clear and straightforward method of contraception that does not require trust on anyone's behalf.
3. Seek emergency contraception if your condom breaks or otherwise malfunctions. Condoms have an 82% effectiveness at preventing pregnancy. However, if your condom breaks while having sex, it is important to seek a form of emergency contraception immediately.
   • You can purchase emergency contraception at your local pharmacy or drugstore, or oftentimes even at the supermarket.
   • Your options are a pill (Plan B), or having a Copper IUD inserted. Plan B needs to be taken as soon as possible after unprotected intercourse (ideally within one day, as its effectiveness decreases the longer you wait). However, Plan B can be used up to 72 hours after having unprotected sex. A Copper IUD is effective as emergency contraception for up to 5 days following unprotected intercourse.
   • Other options include ulipristal acetate and combined estrogen-progesterone pills. Both of these emergency contraception medications require a prescription from your doctor.
4. Use a condom as backup protection if becoming pregnant would be unthinkable. Since every method has a failure rate, it is smart to combine more than one method - such as using both a condom and birth control pills - in situations where you absolutely do not want a pregnancy. It is better to be cautious than risking becoming pregnant, and having to then deal with the potential aftermath.

Sources and Citations

See also

• Buy the Morning After Pill
• Use a Condom
• Prevent Pregnancy
• Avoid Pregnancy Naturally
• Hide a Condom
• Put On a Condom with Foreskin
• Prevent Spotting on Birth Control
• Dispose of a Condom
• Use a Female Condom
• Prevent Pregnancy if a Condom Breaks

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