Our Top 5 Sex-Ed Questions Answered
While I’m a major proponent of making information about sexual and reproductive health interesting and accessible (and am lucky enough to do it for my job as well), I’m by no means an expert, and I’m definitely not a medical professional. However, I often get asked questions by friends concerned about their sexual health. I’ve collected the top five questions I get asked most often by friends that I thought might also be of interest to our Mindthis Magazine readers. While I always suggest they seek advice from a medical professional, especially for serious issues, I love getting the chance to share what I know, and to do a little more research if I can’t answer them right away.
Here are my top five Q&A’s that you need to know – and you might be surprised by some of the answers!
1. How does “the morning-after pill” work and when can I take it?
Perhaps the most misunderstood and confusing reproductive health technology of all time. First of all, its official name (emergency contraception) does this poor drug no favours: while emergency contraception is not the ideal method to use if you’re looking for regular protection (mostly because there are just more effective methods out there), it does not have to be used exclusively for emergencies, and it’s safe to take more than once. It also goes by another misnomer – “the morning after pill” – despite the fact that it can be taken up to 120 hours (yep, five days!) after sex to reduce the risk of pregnancy. Wait, what? You can prevent a pregnancy five days AFTER sex? You can! (I guess the “morning after the morning after your morning after the morning after pill” didn’t have the same ring to it). While emergency contraception will NOT disrupt an established pregnancy (aka it won’t induce an abortion, ever) it can disrupt the process of a pregnancy being established. There are two main ways this can happen: by inhibiting sperm’s ability to reach and fertilize an egg and/or by inhibiting the ability of a fertilized egg to implant on the uterine lining, thus establishing pregnancy.
Even more effective than emergency contraceptive pills is the copper IUD, which can be inserted up to one week after sex to reduce the risk of pregnancy, and provide continued protection for up to 12 years.
Emergency contraceptive pills are 89% effective in preventing pregnancy, and can be obtained from many pharmacies and sexual health clinics, depending where you live. If you find that you’re using them pretty regularly (as in a few times a month), a more effective method might be a better option for you.
2. How likely am I to get pregnant if…?
Did you know there are only 24 hours a month when you can get pregnant? I know when I finally wrapped my head around this my mind was kind of blown. Now, this is a bit more complicated than I’ve initially laid it out, and this doesn’t mean you can (necessarily) have all the unprotected sex you want without getting pregnant, but bear with me. Ovulation is the process whereby an egg (one egg per month) is released from your ovary into your fallopian tube. It happens about two weeks after your last menstrual period, although the exact time varies. For a mere 24 hours this egg travels through your fallopian tube waiting to be fertilized, and if it isn’t fertilized? It begins to dissolve and sheds with your uterine lining (what we call a period). Yep – 24 little hours is your one chance to become pregnant each month. So what does this mean? Unfortunately, since sperm can live inside you for up to 5 days, you can be at risk of getting pregnant if you ovulate anytime in there. Also, ovulation is unpredictable and easily thrown off by stress, food, and diet, so those little 24 hours can be hard to predict. Still, this means your risk of getting pregnant when you aren’t ovulating is slim. So while you should still be religiously taking that pill or using that condom every time, maybe hold off the monthly panicked pregnancy fears (or is that just me?) for now.
Proponents of the fertility awareness method (also known as the rhythm method) rely on tracking their ovulation religiously, so that they can have unprotected sex whenever they’re not ovulating. Again, since ovulation can vary so widely this is not a reliable method for a lot of people, and anyone with an irregular cycle should avoid it entirely. However, those who love it, love it a lot, so if it’s something you’re interested in, you can find a great overview of the different methods at Bedsider.org or Planned Parenthood.
3. Am I at risk of getting an STI or HIV?
If the sex education classes I took were any indication, high school teachers seem pretty determined to scare teenagers out of having sex, and they often did so through fear mongering about STIs and HIV. The problem is, it’s been proven that scare tactics (including those often used in abstinence-only education) do not prevent young people from having sex – instead, they just ensure that young people don’t know how to have safe sex.
So, back to your risk of STIs and HIV. Let’s get one thing straight: the only way to reduce your risk of getting STIs and HIV while having sex is to use a condom. That’s it. Without a condom you’re putting yourself at risk, unless you and your partner are both regularly getting tested (learn more at http://STDAware.com/get-STD-testing). Despite this, few of us actually regularly use condoms (studies show that only 50–60% of young people consistently use condoms, and condom use declines with age), and fear of pregnancy seems to trump fear of STIs/HIV for young people most of the time. Unfortunately, young people are often at higher risk of contracting STIs and HIV, due to a variety of socioeconomic factors, so this risk should be taken seriously. If you’re having unprotected sex or sex with different partners, getting tested every three months is an important way to stay on top of your sexual health.
Having said that, transmission of HIV is actually harder than many people think; HIV does not spread easily. HIV can only be spread through certain bodily fluids; namely, blood, semen, pre-cum, rectal fluids, vaginal fluids and breast milk. For HIV to be transmitted, these fluids must come into contact with a mucous membrane or damaged tissue, or be injected right into your bloodstream. Most cases are spread through anal and vaginal sex, or sharing needles. Your risk of getting HIV from things like oral sex or kissing is essentially zero (unless the person has sores or is bleeding; the virus does not survive well in your mouth) and you cannot contract HIV from touching.
4. Can I still get pregnant when I’m on my period?
Didn’t I just say you could get pregnant LESS than you thought? Does this totally contradict that point? Well, not totally. First of all, your chance of getting pregnant when you have your period is low (very low), and if you have a regular 28-32 day cycle, your odds are particularly low, but it’s important to know it’s there. The reason you could potentially get pregnant when you have your period is that sperm can live inside the vagina for up to five days after sex. This means that if you ovulate shortly after finishing your period (which is likely only if your cycle is shorter than 28 days), there could still be sperm in there and that egg could still get fertilized. Alternately, you could have spotting, or breakthrough bleeding, that could be mistaken for a period and make it hard for you to know just where you are in your cycle. So, you might consider still using a condom if you choose to get lucky during that most joyful week.
5. Does the withdrawal method actually work?
Withdrawal can work – when done perfectly. Key words: when done perfectly. When done perfectly, withdrawal (also known as “pulling out”, or ejaculating outside the vagina) can be 96% effective. In fact, it can be even be almost as effective as using a male condom. Unfortunately, as humans we’re pretty far from perfect, and accidents happen all the time which is why you’ll be hard pressed to find a sex education teacher encouraging young folks: “Just pull out! What’s the worst that could happen?!” Typical use of withdrawal (aka how most people actually do it) places withdrawal at about 78% efficacy. Pregnancy is a pretty big price to pay for a little slip up (or out, as it were). And withdrawal doesn’t prevent the transmission of STIs and HIV, so unless you and your partner are both getting tested, a condom is your best bet. If you’re really interested in trying out withdrawal, remember that practice makes perfect, and you should do your homework first. Here is a good place to start.
Your sex ed teacher may not have trusted your overheated adolescent brain with this information, but you’re a grown-up now and I’m not your overworked gym teacher who wishes she was anywhere else. Go forth and have fun. Remember, if you have real questions go ask a professional as Google is not a doctor.