Getting Frisky Without Being Risky

My boyfriend and I are disease-free and we both dislike condoms, but neither of us want an accidental pregnancy. I take the pill, and he uses the “pull-out” method, but other than that and peeing before sex to clear out sperm from pre-ejaculate fluid, are we taking every possible precaution? I don’t want to feel like we’re taking a huge gamble every time we have sex, and I don’t really know how big of a risk we’re taking. I feel like the law of probability will catch up to us the longer we stay together.
—Law of ProbaPILLity

The pill is a very effective form of birth control. With perfect use, it’s actually more effective against pregnancy than condoms. To put this into perspective, condoms are 85 per cent effective against pregnancy with typical use, and 98 per cent effective with perfect use.*

Perfect use means putting the condom on properly every time, which surprisingly isn’t all that common. Meanwhile, the pill is 92 per cent effective with typical use and 99.7 per cent effective with perfect use. In this case, perfect use means taking it exactly as directed, daily and at the exact same time.

Few people do this, and missing a day or forgetting to take a pill until later in the day affects the constant dosage of hormones and lowers effectiveness rates. Keep in mind this is effectiveness in terms of pregnancy and not STIs, since condoms are the only contraceptive that also provide protection from STIs.

Pulling out, also known as the withdrawal method, is considered 73 per cent effective with typical use and 96 per cent effective with perfect use.  Perfect use is also very rare when pulling out since it requires quick action, and accidents do happen. With most methods, the typical use percentages are more realistic.

When pulling out, the concerns come from the potential of pulling out too late, and of sperm being present in pre-ejaculate fluid. Some people believe that if there is sperm in pre-ejaculate fluid, it was left in the urethra from a previous ejaculation.

If this is the case, peeing would clear the urethra and flush sperm out, but I wouldn’t recommend putting too much weight on this as a precaution since we don’t know if this is really where sperm in the fluid originates.

In terms of what we’ll call “fresh” pre-ejaculate fluid, sperm has been found in some men’s fluid, while not in others. It’s good to remember however that if it were present it would be in much smaller quantities than in a full ejaculation.

On being “disease-free,” I’m assuming you mean that you’ve both been tested recently. Testing is great to do regularly and when you enter a monogamous sexual relationship.

It’s important to consider that some STIs can take time to show up in testing however, such as HIV or some strains of HPV, since these tests actually detect antibodies, or cells that have developed as a result of infections, rather than the infections themselves.

It’s also important for women to continue their annual pelvic exams, and for both partners to look out for symptoms of an STI, even in a sexually monogamous relationship.

Overall, it does sound like you’re being pretty careful. It’s worth highlighting that the rate of effectiveness of the pill and withdrawal method are based on when they are used alone, so combining the two is less risky than only using one alone.

Ultimately, choosing a contraceptive method is mostly about personal comfort and risk management because abstinence is really the only way to be completely safe from pregnancy and the risk of STIs.

Since that’s not really realistic (for most people), I would instead suggest identifying and taking the precautions that will make you most comfortable and keep you from constant worry, whatever they may be.

*All stats were taken from a pamphlet created by called “Choosing a Contraceptive That’s Right for U: Comparative Chart.”

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