Help us to not make a baby
March 4, 2010 10:33 AM Subscribe
How relevant is the menstrual cycle in avoiding pregnancy when a condom is also used?
My girlfriend and I religiously use condoms together with abstention on her more fertile days. Is using this system worth the sacrifice of no sex during this period?
I know that a condom is not 100% (far from it), but how close does the combination of these two methods bring us?
I tried to find statistical information, but I could find anything.
Yes, we tried the pill, but it didn't work for her and the hormones made us both crazy even after a couple months.
[anonymous because my girlfriend's family is extremely conservative]
My girlfriend and I religiously use condoms together with abstention on her more fertile days. Is using this system worth the sacrifice of no sex during this period?
I know that a condom is not 100% (far from it), but how close does the combination of these two methods bring us?
I tried to find statistical information, but I could find anything.
Yes, we tried the pill, but it didn't work for her and the hormones made us both crazy even after a couple months.
[anonymous because my girlfriend's family is extremely conservative]
Have a look at this page from the fpa - the pill is by no means your only option in contraception.
To answer your original question, it rather depends. Any contraception is only effective when it is used well; the pill may be awesome at preventing pregnancy, but only when you take it! So - how are you monitoring her fertility? Are you keeping records? Are there stressors in her life that might, for example, throw up erratic cycles that might take you by surprise? How good are you at putting on a condom?
posted by Coobeastie at 10:54 AM on March 4, 2010
To answer your original question, it rather depends. Any contraception is only effective when it is used well; the pill may be awesome at preventing pregnancy, but only when you take it! So - how are you monitoring her fertility? Are you keeping records? Are there stressors in her life that might, for example, throw up erratic cycles that might take you by surprise? How good are you at putting on a condom?
posted by Coobeastie at 10:54 AM on March 4, 2010
Well, look at it this way. Statistics are mostly on your side to begin with. A couple in their 20s has a 25% chance of getting pregnant in any given month. A couple in their 30s has about a 20% chance. So, already you have a 70-75% chance each month of NOT being pregnant due to Random Chance.
Condoms are pretty darned effective when, and I cannot emphasize this enough, they are used correctly. There's a 3% chance of getting pregnant if condoms are always used correctly.
And is she tracking her cycle using basal temperature and physical signs? Because you know what? Women can get pregnant in about a five day window -- the two days before ovulation, the day of ovulation, the the two days after ovulation. This, of course, varies from woman to woman. But you know what else? Sperm lives for 5 - 7 days inside the woman. Yup. So even if you are using condoms during about the time she ovulated, if you had unprotected sex up to a week before that, there's still a chance of pregnancy. And the more unprotected sex in that seven day window before her five day window, the greater the chances. Yup. So if you are having unprotected the sex at times other than her fertile days, there is a greater chance of pregnancy than you might think. So always, always, always use condoms.
As for the birth control for her, has she considered a non-hormonal IUD? The chances of pregnancy do go way down with two forms of birth control being used.
Fertility Friend is a great place for cycle tracking if you are going to use that as a method to avoid pregnancy, and it also has a great easy-to-follow course on fertility that you should both take. It goes over the biology of the female cycle, and there's a lot more to it than even I knew for sure.
posted by zizzle at 11:01 AM on March 4, 2010 [2 favorites]
Condoms are pretty darned effective when, and I cannot emphasize this enough, they are used correctly. There's a 3% chance of getting pregnant if condoms are always used correctly.
And is she tracking her cycle using basal temperature and physical signs? Because you know what? Women can get pregnant in about a five day window -- the two days before ovulation, the day of ovulation, the the two days after ovulation. This, of course, varies from woman to woman. But you know what else? Sperm lives for 5 - 7 days inside the woman. Yup. So even if you are using condoms during about the time she ovulated, if you had unprotected sex up to a week before that, there's still a chance of pregnancy. And the more unprotected sex in that seven day window before her five day window, the greater the chances. Yup. So if you are having unprotected the sex at times other than her fertile days, there is a greater chance of pregnancy than you might think. So always, always, always use condoms.
As for the birth control for her, has she considered a non-hormonal IUD? The chances of pregnancy do go way down with two forms of birth control being used.
Fertility Friend is a great place for cycle tracking if you are going to use that as a method to avoid pregnancy, and it also has a great easy-to-follow course on fertility that you should both take. It goes over the biology of the female cycle, and there's a lot more to it than even I knew for sure.
posted by zizzle at 11:01 AM on March 4, 2010 [2 favorites]
Wasn't there an article floating about recently regarding a study showing that pulling out is just as safe - if not safer - than using a condom? It isn't intuitive, but apparently it's true (?)
posted by Lutoslawski at 11:02 AM on March 4, 2010 [1 favorite]
posted by Lutoslawski at 11:02 AM on March 4, 2010 [1 favorite]
When used correctly the condom is much more effective than the overall data would suggest. Most of the failures occur because of misuse. As long as you are careful to use them correctly and you don't get so rough that you break them, the condoms alone should protect you during fertility periods.
posted by caddis at 11:12 AM on March 4, 2010
posted by caddis at 11:12 AM on March 4, 2010
The article. If the male partner withdraws before ejaculation every time a couple has vaginal intercourse, about 4% of couples will become pregnant over the course of a year. However, more realistic estimates of typical use indicate that about 18% of couples will become pregnant in a year using withdrawal. These rates are only slightly less effective than male condoms, which have perfect- and typical-use failure rates of 2% and 17%, respectively.
posted by The corpse in the library at 11:16 AM on March 4, 2010
posted by The corpse in the library at 11:16 AM on March 4, 2010
I would be interested in this article you speak of.
I can't do a very thorough search at the moment (at work), but maybe it was this? I thought I saw something more recent, but I could be losing my mind.
posted by Lutoslawski at 11:17 AM on March 4, 2010
I can't do a very thorough search at the moment (at work), but maybe it was this? I thought I saw something more recent, but I could be losing my mind.
posted by Lutoslawski at 11:17 AM on March 4, 2010
Planned Parenthood has a bit on withdrawal and its efficacy:
The pull out method can also make other forms of birth control, such as the cap, condom, diaphragm, or female condom, more effective.
posted by devinemissk at 11:17 AM on March 4, 2010
The pull out method can also make other forms of birth control, such as the cap, condom, diaphragm, or female condom, more effective.
posted by devinemissk at 11:17 AM on March 4, 2010
Can I ask two follow ups to the OPs question? I'm not the OP but am interested...
1) I keep hearing "if a condom is used correctly"...can someone give me a list or a link to common ways they are used incorrectly? They seem fairly self-explanatory to me...
2) If the IUD is so effective and has no hormones, why do only 1.9% of women in the US use it (stat pulled from Wiki)? What are the downsides there?
posted by arniec at 11:30 AM on March 4, 2010
1) I keep hearing "if a condom is used correctly"...can someone give me a list or a link to common ways they are used incorrectly? They seem fairly self-explanatory to me...
2) If the IUD is so effective and has no hormones, why do only 1.9% of women in the US use it (stat pulled from Wiki)? What are the downsides there?
posted by arniec at 11:30 AM on March 4, 2010
Answers to questions like this depend more on exactly how catastrophic a pregnancy would be for the two of you right now.
If, from yall's perspectives now, it would really wreck your lives if she got pregnant and abortion is either out of the picture for whatever reason or, from yall's perspectives now would also be truly catastrophic, then:
Yes, of course it's worth tracking her more fertile periods and abstaining then. Doesn't mean you can't fool around then.
The problem with looking at the failure rate of condoms as perfectly used is that surely the overwhelming majority of people who use condoms intend to use them correctly and then fail at it. The large gap between the pregnancy rate of couples who use condom perfectly and the overall rate of pregnancy for couples who use condoms tells you that not many couples who use condoms use them perfectly. If you had to bet whether you'd be in the group that uses them perfectly or the group that uses them as they tend to be actually used, you should bet that you're going to be in that second group.
posted by ROU_Xenophobe at 11:31 AM on March 4, 2010
If, from yall's perspectives now, it would really wreck your lives if she got pregnant and abortion is either out of the picture for whatever reason or, from yall's perspectives now would also be truly catastrophic, then:
Yes, of course it's worth tracking her more fertile periods and abstaining then. Doesn't mean you can't fool around then.
The problem with looking at the failure rate of condoms as perfectly used is that surely the overwhelming majority of people who use condoms intend to use them correctly and then fail at it. The large gap between the pregnancy rate of couples who use condom perfectly and the overall rate of pregnancy for couples who use condoms tells you that not many couples who use condoms use them perfectly. If you had to bet whether you'd be in the group that uses them perfectly or the group that uses them as they tend to be actually used, you should bet that you're going to be in that second group.
posted by ROU_Xenophobe at 11:31 AM on March 4, 2010
1) I keep hearing "if a condom is used correctly"...can someone give me a list or a link to common ways they are used incorrectly? They seem fairly self-explanatory to me...
Ways to use a condom incorrectly:
(1) Don't use one every time.
(2) Have a little bit of unprotected sex before putting it on.
(3) Don't pull out immediately after coming.
(4) Reuse condoms.
(5) Don't pull out immediately on the slightest suspicion of a broken condom.
(6) Don't pull out if you lose your boner in the middle of sex
(7) If you go soft in the middle of sex and pull out, don't put on a new condom.
(8) Leave the same condom on for a bout of sex, your refractory period, and another go at it.
posted by ROU_Xenophobe at 11:37 AM on March 4, 2010
Ways to use a condom incorrectly:
(1) Don't use one every time.
(2) Have a little bit of unprotected sex before putting it on.
(3) Don't pull out immediately after coming.
(4) Reuse condoms.
(5) Don't pull out immediately on the slightest suspicion of a broken condom.
(6) Don't pull out if you lose your boner in the middle of sex
(7) If you go soft in the middle of sex and pull out, don't put on a new condom.
(8) Leave the same condom on for a bout of sex, your refractory period, and another go at it.
posted by ROU_Xenophobe at 11:37 AM on March 4, 2010
Re: The IUD
It is seen as a more "permanent" method of birth control with a larger up-front cost. It also causes wicked periods for a lot of women. According to Planned Parenthood:
It is seen as a more "permanent" method of birth control with a larger up-front cost. It also causes wicked periods for a lot of women. According to Planned Parenthood:
* Spotting between periods is common.posted by muddgirl at 11:39 AM on March 4, 2010
* ParaGard may cause a 50–75 percent increase in menstrual flow. In some cases, this can lead to a low red blood cell count.
* You may experience menstrual cramps or backaches.
arniec- IUDs have a historically bad rap because of some unsafe ones that were used in the 70s (the pill in that era also had 3x more estrogen and was way worse, for comparison). Many women developed pelvic inflammatory disease or other issues from those IUDs, but the designs are considerably improved and they're incredibly safe now when inserted properly. They have a more favorable side effect profile than oral hormonal contraception but since they are primarily marketed and recommended for women who already have children, they're not used as often as they could be.
To the OP- even if your girlfriend has never had kids, tell her to ask her gynecologist about an IUD; its a great option and many gyns are open to doing them for women who have never been pregnant. They are also cost effective over the long run, even if she has to pay a couple hundred up front, because they last 5-10 years depending on type.
posted by slow graffiti at 11:52 AM on March 4, 2010
To the OP- even if your girlfriend has never had kids, tell her to ask her gynecologist about an IUD; its a great option and many gyns are open to doing them for women who have never been pregnant. They are also cost effective over the long run, even if she has to pay a couple hundred up front, because they last 5-10 years depending on type.
posted by slow graffiti at 11:52 AM on March 4, 2010
This is the article I believe is being referred to above:
http://www.nytimes.com/2009/07/21/health/21cond.html
"Withdrawal Method Finds Ally
“If the male partner withdraws before ejaculation every time a couple has vaginal intercourse, about 4 percent of couples will become pregnant over the course of a year,” the authors write.
For condoms, used optimally, the rate is about 2 percent.
posted by stealabove at 12:15 PM on March 4, 2010
http://www.nytimes.com/2009/07/21/health/21cond.html
"Withdrawal Method Finds Ally
“If the male partner withdraws before ejaculation every time a couple has vaginal intercourse, about 4 percent of couples will become pregnant over the course of a year,” the authors write.
For condoms, used optimally, the rate is about 2 percent.
posted by stealabove at 12:15 PM on March 4, 2010
oops. sorry. it was already posted.
posted by stealabove at 12:16 PM on March 4, 2010
posted by stealabove at 12:16 PM on March 4, 2010
>Because you know what? Women can get pregnant in about a five day window -- the two days before ovulation, the day of ovulation, the the two days after ovulation.
This is not quite accurate. Once released from the follicle, the egg lives a maximum of 24 hours, often much shorter.
Fertility Friend has a nice article about determining the length of the fertile window. The "five day window" zizzle mentioned is probably more like the four days before ovulation and the day of ovulation itself.
posted by fancyoats at 12:17 PM on March 4, 2010
This is not quite accurate. Once released from the follicle, the egg lives a maximum of 24 hours, often much shorter.
Fertility Friend has a nice article about determining the length of the fertile window. The "five day window" zizzle mentioned is probably more like the four days before ovulation and the day of ovulation itself.
posted by fancyoats at 12:17 PM on March 4, 2010
FWIW, the issues I see with the IUD are
a) I've heard, anecdotally and mostly on AskMe, that it can be hard to get one if you haven't had kids.
b) Frankly the idea of having something inserted inside my uterus squicks me out really bad, and I'd prefer to avoid having some device inside my body if other, less permanent and invasive choices exist
c) the possible complications- heavier periods and this lovely story, for instance.
I see it as the equivalent of offering guys a completely reversible vasectomy- sure, it's a sensible contraception option, but how popular do you think it would be? The up-front investment is a lot higher than buying condoms. Plus, messing with your valuable lady/guy bits.
posted by MadamM at 12:35 PM on March 4, 2010 [1 favorite]
a) I've heard, anecdotally and mostly on AskMe, that it can be hard to get one if you haven't had kids.
b) Frankly the idea of having something inserted inside my uterus squicks me out really bad, and I'd prefer to avoid having some device inside my body if other, less permanent and invasive choices exist
c) the possible complications- heavier periods and this lovely story, for instance.
I see it as the equivalent of offering guys a completely reversible vasectomy- sure, it's a sensible contraception option, but how popular do you think it would be? The up-front investment is a lot higher than buying condoms. Plus, messing with your valuable lady/guy bits.
posted by MadamM at 12:35 PM on March 4, 2010 [1 favorite]
1) I keep hearing "if a condom is used correctly"...can someone give me a list or a link to common ways they are used incorrectly? They seem fairly self-explanatory to me...
In my younger days I broke several condoms before I learned that you need to leave PLENTY of room in the tip. Wearing a condom the way my sex-ed teacher advised -- relying on the built-in reservoir -- would have made me a daddy very quickly.
posted by coolguymichael at 12:51 PM on March 4, 2010
In my younger days I broke several condoms before I learned that you need to leave PLENTY of room in the tip. Wearing a condom the way my sex-ed teacher advised -- relying on the built-in reservoir -- would have made me a daddy very quickly.
posted by coolguymichael at 12:51 PM on March 4, 2010
Combining the two does increase efficacy. Because both would have to fail at the same time for you to get pregnant, your (approximate) overall failure (i.e. pregnancy) rate drops down to the product of the failure rate for condom use times the failure rate for whatever cycle monitoring method you are using (there are huge differences in efficacy between rhythm vs. Fertility Awareness.) So if condom failure rate (per year) were 12.5% when used alone and whatever cycle monitoring method you use has a failure rate (per year) of 20% when used alone, your (approximate) chance of pregnancy (in a year) would be 20% of 12.5%, or 0.025%.
This is not exact, for a lot of reasons, but it is semi-decent approximation.
posted by needs more cowbell at 1:38 PM on March 4, 2010
This is not exact, for a lot of reasons, but it is semi-decent approximation.
posted by needs more cowbell at 1:38 PM on March 4, 2010
2) If the IUD is so effective and has no hormones, why do only 1.9% of women in the US use it (stat pulled from Wiki)? What are the downsides there?
While there are major issues getting an IUD, I’m pretty sure the reason why most women in the US don’t use IUD’s boils down to most women choosing their form of birth control at a very young age. Unless there are major issues with their form of birth control, they are unlikely to switch. IUD’s aren’t covered in teenage sex ed classes and there’s a lot of up-front costs. Nobody is going to get an IUD at sixteen, especially if they’re trying to hide the fact that you’re having sex from your parents.
posted by dinty_moore at 2:01 PM on March 4, 2010
While there are major issues getting an IUD, I’m pretty sure the reason why most women in the US don’t use IUD’s boils down to most women choosing their form of birth control at a very young age. Unless there are major issues with their form of birth control, they are unlikely to switch. IUD’s aren’t covered in teenage sex ed classes and there’s a lot of up-front costs. Nobody is going to get an IUD at sixteen, especially if they’re trying to hide the fact that you’re having sex from your parents.
posted by dinty_moore at 2:01 PM on March 4, 2010
Tracking fertile days is a laughably ineffective method of birth control on its own, so I don't imagine it adds much security to using condoms.
To add to the discussion of IUD/IUSs (intrauterine devices/systems): Research them. They are by far the most reliable form of birth control, with a lower failure rate than tubal ligation. Unfortunately, one bad design in the 70's has given them a bad name in America, but in many other countries they are the most popular form of birth control. Mirena is awesome, lasts five years, and has the added benefit of making most users' periods much lighter. (Mirena has horomones, but they are localized, so don't cause the side effecs pills do. The nonhormonal versions available last longer but tend to make periods heavier.)
I got my Mirena free and couldn't be happier. Feel free to ask me for more derails.
posted by catatethebird at 4:02 PM on March 4, 2010
To add to the discussion of IUD/IUSs (intrauterine devices/systems): Research them. They are by far the most reliable form of birth control, with a lower failure rate than tubal ligation. Unfortunately, one bad design in the 70's has given them a bad name in America, but in many other countries they are the most popular form of birth control. Mirena is awesome, lasts five years, and has the added benefit of making most users' periods much lighter. (Mirena has horomones, but they are localized, so don't cause the side effecs pills do. The nonhormonal versions available last longer but tend to make periods heavier.)
I got my Mirena free and couldn't be happier. Feel free to ask me for more derails.
posted by catatethebird at 4:02 PM on March 4, 2010
This thread is closed to new comments.
But there are other alternatives to abstention if you want a backup for condoms -- female barrier methods. The cervical cap may be tricky to find, but I swear by it.
posted by EmpressCallipygos at 10:53 AM on March 4, 2010