Scarleteen

Hi,

My boyfriend and I keep thinking about trying sex without a condom, but I'm feeling anxious about it, and I'm not sure if I'm anxious because I'm just overthinking things, or if I'm anxious because I'm not ready.

I am on the combination pill and we've done it before with me on the pill and him using a condom, so I know that we were having pretty safe sex. Now, even though I'd like to try with just the pill, most articles online that I've found advises against just one form of birth control. Would my chances of getting an unwanted pregnancy be that much higher? Is it really as scary and unsafe as everyone makes it out to be? My concern has nothing to do with STDs since my partner and I are both each other's first times, so I guess my worries lie with the fact that I've never had sex without a condom before and this is my first time taking the pill. Without any prior experiences with just the pill, I think I find it difficult to believe in the pill's effectiveness.

To put it simply: Is it really safe to just rely on the pill? Any advice or answers to my concerns would be appreciated.

We do recommend that folks using birth control (especially the pill, where there's more room for user error than there is with other methods) back up with another method, and condoms are one of the best choices for this. For an idea of the difference in effectiveness from one method at a time to two, check out this article with a full rundown: The Buddy System: Effectiveness Rates for Backing Up Your Birth Control With a Second Method You mention having a hard time believing in the pill's effectiveness; for more info you might find this helpful: Have a Little Faith in BC

It is true, though, that the birth control pill is very effective on its own. While we do recommend that people use a condom as well, for extra peace of mind, plenty of folks use just the pill and feel fine about it. What it comes down to, really, is what you and your partner feel most comfortable with (and because you're the one who would get pregnant, I think your opinion has a bit more weight here). Right now, you say you're anxious, and no matter the cause of that anxiety, I think that's a sign that foregoing condoms isn't going to be the right choice at the moment. That could change, but aggressively pushing past your worries now might lead to you having stronger ones afterwards.

I will say, too, that if you and your partner haven't ever had sexual healthcare that includes STD/STI testing, you go ahead and get tested before you have intercourse without a condom. It's a good habit to get into, and there are some infections that are primarily but not only transmitted sexually. Having no previous partners greatly decreases the likelihood that this will be an issue, but we can't say there's no chance at all.

Hi,
thanks for the reply. The article was really helpful. I have a question about what constitutes as perfect use though. When you first start taking the pill, they always tell you its effective after 7 days. Does this mean that after a week of taking the pill at the same time each day prior to having sex, your effectiveness will be at "perfect use"?

Also, I noticed that the percentages for combined use with pill and condom, and pill and withdrawal method are nearly the same. If the withdrawal method is so commonly associated with failure, why does it give such high protection when combined with the pill?

Effectiveness rates for every method are for one full year of use, not for a say or a week of use. In reality, when it comes to methods like the pill, almost no one is going to have "perfect" -- a standard based on supervised clinical trials -- use in a whole year. Someone who uses the pill very well, but still like a plain old human being, living a plain old human being daily life, and taking pills without a clinician handing them over and timing them, is more likely to be somewhere between the typical and perfect use rate in one year.

hen you look at those figures for combining the pill with condoms and with withdrawal, the perfect use rates are very close, because in perfect use, those latter two methods (mind, the perfect use rate for withdrawal is only an estimate, not based on studies) are only about 2% different. However, consistent, proper use of withdrawal over a full year, especially for younger people, is much, much harder to attain than with condoms, which is why the typical use rates for those two methods have a wider margin of difference. However, in the Buddy System figures, what's making those numbers be much closer isn't about either of those two methods, but about the much higher efficacy rate in typical use of the pill. In other words, it's the pill driving those numbers up and making them so close, despite their typical use rates, when another method isn't in play, being much further apart. Make sense?