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Sexual Health FAQ

Condoms

What is the failure rate of regular male condoms?

  • According to CDC, 18 out of every 100 women (18%) experience an unintended pregnancy within the first year of typical use of male condoms.

What is the correct process to apply a condom?

  • First, check the expiration date and for any obvious rips or tears in the packaging. (Just as old rubber bands break easily, latex condoms become less elastic and more susceptible to breaking after their expiration date)
  • Move the condom out of the way and tear open the packaging.
  • Hold the condom by the tip to squeeze out the air.
  • Leave some space at the tip to hold the ejaculate (cum).
  • Unroll the condom all the way over the erect penis.
  • If you put the condom on and start to unroll it the wrong way, don't flip it over and put it on again. Throw the condom out and start again with a new condom.
  • After sex, the man should hold the condom at the rim, face away from his partner, and pull out slowly while the penis is still hard.
  • Use a new condom if you want to have sex again or if moving from the anus to the vagina (preventing the spread of bacteria).
  • Provided by the American Sexual Health Association

Are cheaper condoms more likely to fail?

  • Not particularly.  The most common cause of condom failure is misuse, not the actual manufacturing of the condom.  Condoms are only effective when individuals use them correctly.

Are there other contraceptive options for males besides condoms/sterilization?

  • Birth control options for men include abstinence, condoms, vasectomy, and withdrawl.  The only option that will prevent pregnancy 100% of the time is abstinence.

What happens if the lube on the condom wears off?

  • If you are noticing problems with the lubrication on the condom wearing off, try using a different condom brand or applying some extra lubrication.  Some condom brands are more lubricated than others.  When purchasing lubrication, make sure to buy water-based lubricants.  Steer clear of oil based lubricants, which tend to decrease the effectiveness of the condom.

What is the proper use of female condoms?

  • Squeeze the smaller ring and insert it into the vagina. The large end should be place over the vaginal opening to protect the outer genitalia from infection.
  • Be sure the penis goes directly into the large ring to preclude unprotected sexual contact between the penis and the vagina.
  • Remove the condom immediately after sexual intercourse and before standing up. To avoid semen leakage the large outer ring should be twisted. Carefully pull the condom out and dispose of it.

Should the male wear a condom when a female is performing oral sex?

  • The risk for HIV and some STDs still exists with oral sex, but can be made safer by using a latex barrier.  For oral sex performed on a male, a non-lubricated condom is recommended.

Are the chances of pregnancy high if the guy doesn't wear protection but pulls out?

  • According to CDC, the failure rate of the withdrawal method is 22%.

What are the chances of a girl getting pregnant if you use no form of contraception?

  • It varies, depending on where the female is in her monthly cycle.  The risk is highest on the days right before ovulation, reaching a maximum of nearly 30%.


Birth Control

How available is each type of contraception?

  • Condoms, birth control pills, and Depo-Provera (injection) are all available at Penn's Student Health Service. Referrals and prescriptions are available for other methods.

Do most insurance plans cover birth control pills/shots?

  • Yes, under the Affordable Care Act, birth control is free if you are a woman who bought your health plan through your employer, through your state marketplace, or from another private company, or you have a prescription for an FDA-approved birth control method.  Birth control methods covered by the ACA are birth control patches, birth control pills, birth control rings, birth control shots, cervical cap, contraceptive implant, diaphragm, IUD, permanent contraception methods, emergency contraception and female condoms.

Can I get birth control pills/shots at SHS?  If so, how much does it cost?

  • At Women's Health, birth control pills are purchased for $15.00/pack.  Depo-Provera is $60 per injection.

What are the typical failure rates of birth control?

  • Depending on which type of birth control:
    • Copper T IUD: 0.8%
    • LNG IUD: 0.2%
    • Implant: 0.05%
    • Injection or "shot": 6%
    • Combined oral contraceptives:9%
    • Progestin only pill: 9%
    • Patch: 9%, but may be higher in women who weigh more than 198 lbs.
    • Hormonal vaginal contraceptive ring: 9%

What is the safest form of contraception, with the least side effects?

  • The intrauterine device and contraceptive implant are the most effective forms of reversible birth control.  The contraceptive shot, pills, skin patch, vaginal ring, and barrier methods have lower effectiveness because they depend on correct and consistent use.  Remember, all birth control methods are only effective if used correctly and consistently.
  • Side effects usually vary and depend on the individual.

Can you feel IUDs?

  • You should not be able to feel an IUD (even during intercourse) because it is placed in the uterus, not the vagina.  During intercourse, sometimes male partners feel the strings.

Is it true that you have to wait a month before birth control pills are effective in preventing pregnancy?

  • No.  If you take your birth control pills at about the same time each day and do not miss any, you will be protected from pregnancy in 7 days after starting.

How effective are birth control pill on their own?  And what if you do not take it at the same time every day? If you don't take your birth control pill exactly at the same time every day, is that bad? 

  • Oral contraceptives (birth control pills) have the potential of being 99% effective in preventing pregnancy when taken consistently at about the same time each day (within a couple hour time period).  In typical use they are about 91 to 94% effective due to compliance.  The most dangerous pills to miss are the first few in any package of pills as you were off for the 7 placebo pill days.  If you have had unprotected intercourse within the previous 5 days, it is recommended you take emergency contraception (Plan B or EContra EZ).  EContra EZ is sold at SHS cashier's office for $20.  You do not need an appointment.

How does the Ring work? Can you gain weight from it?

  • NuvaRing works the same as birth control pills, by stopping ovulation, the release of the egg.  The Ring contains the same hormones as birth control pills with a different delivery mechanism.  It is heat activated and when warmed above 86 degrees, it starts releasing the hormone to be absorbed by the vaginal walls.  The Evra Patch works in much the same way being absorbed through the skin. Evra and NuvaRing are the same medication as birth control pills with a different delivery mechanism.  Typically weight change attributed to any hormonal contraception is 1-2 pounds up OR down.

What are the side effects of IUD contraceptive?

  • Intrauterine devices (IUDs) are some of the most effective and safest methods of contraception available to women.  There is a very slight risk of perforating the uterus on insertion of the device.  There can be menstrual changes, heavier crampy periods with ParaGard, the copper IUD and unscheduled or lack of periods with Mirena and Skyla, progesterone releasing IUDs. There is a low risk that the device could be expelled by the women's body.  Risk of infection is very low.

Does it hurt to get the surgical birth control Implant?

  • Nexplanon is a single rod implant that is inserted in the upper inner arm.  The skin is numbed with lidocaine similar to having dental work done.  Some women may feel a pressure sensation, but should not feel pain.  The area may be slightly tender for a few days.   Nexplanon is the most effective method of contraception aside from sterilization.  It is progesterone containing and works by stopping ovulation.  It is used for 3 years. 

Is it safe to experiment with many different types of birth control pills?

  • Your provider will take a full history to determine which is the best method for you.  Considerations are how heavy your periods are, if cycles are regular, whether you have cramps, or acne, etc.  Your provider will recommend a particular pill for you.  If there are side effects, a different pill will be prescribed.  Working with your provider is the best way to find the pill that is right for you.  It is not harmful to change pills.


Emergency Contraceptives

How many times can you take Plan B One-Step before it doesn't work? Is it unhealthy to take the morning after pill frequently?

  • The morning after pill (emergency contraception or Plan B or EContra EZ) will not harm your body.  You may experience some irregular bleeding or nausea after taking emergency contraception.  Your next period may be a little early or late.  If you do not get a NORMAL period in 3 weeks after taking it, you should come to Women's Health for a pregnancy test.  If it has been more than 3 days since the unprotected intercourse or you have a BMI > 25, you should see a provider for a more effective method of emergency contraception called Ella.  Ella is a prescription only medication that is sold at SHS for $25.

 How do I know whether Ella or EContra EZ is right for me?

  • If you have a body mass index (BMI) that's higher than 25, EContra EZ (and Plan B One-Step) is less effective.  If you have a BMI that's higher than 30, it may not work at all. Ella has a 1.4% failure rate if taken within 5 days of unprotected intercourse. EContra EZ has a 2-3% failure rate if taken within 3 days of unprotected intercourse.

I've seen that Plan B One-Step is over-the-counter.  What's the difference between that, Ella, and EContra EZ?

  • Plan B One-Step is a one-pill progestin-only ECP available on the shelf in the family planning aisle, without age restrictions to women and men.  It must be taken within 72 hours of unprotected sex. There are other generic brands such as One Step, My Way, Next Choice, etc. Refer to the link to see other generic names.
  • EContra EZ is a one-pill progestin-only generic ECP available over-the-counter.  It should be taken as soon as possible within 72 hours of unprotected sex. There are other generic brands, such as One Step, My Way, Next Choice, etc. Refer to the link below to see other generic names.
  • Ella is sold by prescription only.  It is more effective than progestin-only pills and the effectiveness did not decline over a 5-day period after unprotected sex.

Can't you just take a bunch of your normal birth control pills instead of paying $20 for emergency contraception?

  • Only certain brands of birth control pills can be used in increased doses as emergency contraception.  Review the Emergency Contraception Website for information about what brands of pills can be used and how to use them.

Is there a difference in effectiveness between ella and Plan B?

  • Within the first 24 hours of having unprotected sex, Plan B prevents pregnancy in 95 out of 100 women; 85 out of 100 women within 24-48 hours; and 58 out of 100 women within 49-72 hours.  Ella prevents pregnancy in just under 98 out of 100 women if taken within 5 days (120 hours) of having unprotected sex.


Men's Health

What would happen if a guy put on a hormone patch?

  • If a man puts on a hormone patch, he is exposing himself to feminizing hormones that may cause secondary sexual characteristics (e.g. breasts), decreased libido, and increased risk for blood clotting and hypertension.

How big is too big?  Can a vagina rip and/or bleed due to the size of a man's penis?

  • The vagina is designed to relax and allow for penile penetration and birth of babies.  That being said, it is possible for the vaginal opening to rip/bleed if a) there is not enough lubrication, b) if there is insufficient "foreplay" to allow for relaxation of the muscles, or c) if the penis is too large for a vaginal opening.


STDs

Under what circumstances/how often should a person go for STD screening?

  • We, and the CDC, encourage students who have vagina & anal sex to screen annually for HIV and other STIs.  However, testing needs might fluctuate based on one's sex life; situational things -- like an increase in partners, a decrease in safer sex practices, condom breaks, starting or ending a relationship, possible symptoms --can mean testing multiple times in one year.

What sex position would decrease the likelihood of an STD?

  • Any position can be safer if a condom/dental dam is used, of course, but there's no real data that identifies a "position" for safer sex practices. In terms of "type" of sex, we know that oral sex, for example, is low, low risk for HIV compared to vaginal and anal.  


Miscellaneous

What is the best position for it to hurt less when you first lose your virginity?

  • There is no one right answer to this.  You need to be emotionally and physically ready for sexual intimacy.  Making sure you are ready to start having intercourse, you are not being coerced into having sex and you are not under the influence of drugs or alcohol are good first steps.  Condoms are encouraged for all acts of intercourse even if you are on a hormonal method.  Lubricants can be helpful.  Any position is fine and you'll need to experiment with your partner to find comfortable positions.

How do I know when I'm emotionally ready for sex?

  • Your emotions and reaction to sexual expression are uniquely yours, so only you can determine when you're ready.  Communication with your partner is important when deciding if you are ready for sex.  By communicating prior to engaging in any sexual activity, you can ensure that you are both on the same page.  Remember, it's YOUR body � you are the only person who should have control over it.  Take the time to notice your feelings and emotions.  Give yourself time and space to make the best choice for you and your well-being.

Is it safe to consume lube?

  • Although it is not intended to be eaten and may not taste great, it is safe.

What is the best age to freeze my eggs given that I become less fertile with time but eggs "go bad" the longer they're frozen?

  • Based on preliminary data from a study conducted at USC Fertility, long-term storage of frozen eggs does not result in any decrease in quality.  The longest frozen embryo in the study was frozen for 10 years.  USC Fertility recommends freezing eggs before the age of 38.  For more information, click here.

Does the pulling out method work effectively?

  • Like all forms of birth control, the "pull out" or "withdrawal" method is much more effective when done correctly.  Of every 100 women whose partners use the "pull out" method, 4 will become pregnant each year if always done correctly.  27 of 100 women whose partners use the "pull out" method will become pregnant each year if they don't always do it correctly.  If the male cannot predict the moment in which they are reaching the point in sexual excitement when ejaculation can no longer be stopped/postponed, withdrawal will not be as effective.

Is having sex while the girl is on her period unhealthy?

  • Not necessarily.  During menstruation, the cervix expands more, which creates a pathway for bacteria and viruses to travel into the female's uterus and pelvic regions and transmit an STI.  The vagina also has a lower acidity, which increases the risk of a yeast or bacterial infection.  Even during menstruation, it is important to remember to always use protection!

Comments

"I didn't know there was something called Next Choice (or EContra EZ), I only knew about Plan B."

"I didn't know that EC prevented ovulation. Informative."

"Displaying the various methods of birth control was very informative."

"Good learning opportunity."

"Very informative and useful information."

"The contraceptive table was very informative.  Perhaps include info on how economically feasible each is for college students."

"I thought the showing of the different types of birth control for women was very interesting and useful."

"Great set up.  Some stations seemed like there wasn't enough time though."

"It was pretty solid, just served as good reminders.  Maybe split by gender."

"Good job, very well-paced and informative."

"Didn't know that copper IUD's make periods longer."

"I did not know you could break your penis.  Good presentations!"