How dumb am I, ya know, sexually?

December 13, 2006 4:27 PM

Stranger, please pass judgment on our most intimate moments! So, my fiancee and I have been in a monogamous relationship for 8+ years, and the only method of birth control we use is condoms. Are we stupid?

We've never had a break or a pregnancy scare, and only a couple of near slip-offs. She had negative effects from hormonal birth control early in our relationship, and I don't really mind condoms (not nearly as much as I mind the idea of her suffering for the sake of the raw-dog).

We don't cheat on each other, and we have enough self control to just hang it up for the night if we find ourselves without condoms. Are we still taking a huge risk of an unwanted pregnancy? Us getting a baby right now makes as much sense as us getting a walrus.

posted by Ignatius J. Reilly to health (52 comments total)

Aren't the statistics for the contraceptive pill and the condom both pretty much the same: 99-point-something percent?

If you don't mind condoms, I don't think you have a problem at all! I've even been considering them lately... I have always despised condoms, but now I think I hate being on the pill, daily, more than I hate "ruining the intimacy" in the heat of the moment. So I'll be interested to see how others answer this. What proportion of couples in long-term relationships still rely on condoms?
posted by mjao at 4:36 PM on December 13, 2006

Uh, I don't think any of us can judge that for you. You're as safe as the condom is. As long as the little boogers don't break on you (and assuming your girlfriend isn't against getting a Plan B, or can FIND a Plan B), you'll be fine. If one of those things fails, then you won't be.

If this is asking, "Should I force my girlfriend to use hormonal BC" or something and I'm missing the point, that's up to your girlfriend. There's diaphragms and sponges (again) and spermicide and whatnot if you want backups that aren't hormonal.
posted by jenfullmoon at 4:36 PM on December 13, 2006

Lucky for you, this is a subject on which detailed statistics have been compiled. According to the FDA, when used perfectly, condoms afford a 3% risk of pregnancy for each year that they're used. If I understand this number (and I'm doing my math correctly), this means that over two years, there's about a 6% risk of pregnacy, and over your eight years, there was a cumulative 22% risk of pregnancy. Again, for absolutely perfect use. It's up to you as to whether you're comfortable with these numbers.
posted by mr_roboto at 4:36 PM on December 13, 2006

You ask this:
Are we stupid?

and then write this:
We've never had a break or a pregnancy scare

Seems pretty straight forward answer.

Are we still taking a huge risk of an unwanted pregnancy?

It's been eight years, nothing has happened.
Throw in some spermicide if you're really worried.
posted by Brandon Blatcher at 4:40 PM on December 13, 2006

Whoa. I am definitely not asking "Should I force my girlfriend to use hormonal BC". I really didn't mean to convey that, and I frankly have no idea why you'd think I did.

I think this setup seems to be working (unless I have a terrible eye for babies), but I wanted other opinions. I don't want to force anyone to do anything.
posted by Ignatius J. Reilly at 4:41 PM on December 13, 2006

If you combine condom usage with the Fertility Awareness Method to determine ovulation (but continue to use condoms either during her entire cycle, or until ovulation is very clearly past), you'll have a 99%+ foolproof birth control method. Plus FAM is a great way for women (& their partners!) to get to know their bodies, both in terms of physical comfort and hormonal shifts.

Raw-dog? Um.
posted by soviet sleepover at 4:42 PM on December 13, 2006

If she is looking for other non-hormonal options, there is a non-hormonal IUD. I've been really happy with mine, and the usual side effects (heavier periods and cramps) have been almost non-existent. (And if she's not morally opposed to hormonal methods (I kinda am) there's also a very-low-dose hormonal IUD which seems to cause fewer side effects in most people.)
posted by occhiblu at 4:48 PM on December 13, 2006

I've also been in a monogamous relationship for more than eight years. We use hormonal bcp and condoms. Our feeling is 1.) As you so beautifully put it, getting a baby= getting a walrus and 2.) We're rarely 100% perfect with either method (I miss a pill or the condom is a little late going on) so we like to think each method is covering the gaps of the other, so to speak.

So, for us, just a condom wouldn't be enough. We've never had one break or slip, but especially since spermicides aren't an option for me, we just don't trust them enough. We are very anxious types. I would absolutely get some Plan B and have it on hand. That way, if anything ever happens, you've got a backup plan.

Also, it is (as soviet sleepover said) an excellent idea for her to be charting her ovulation and fertility. It's not super effective on it's own obviously, but would sure add some useful peace of mind.

I've been thinking about one of the low-dose hormonal IUDs like mirena. After eight years, I'm not worried about STDs, so it would be nice to have the spontaneity and sensation of sex without condoms but also have the 0.2% failure rate with no margin for user error. I've also heard that the hormonal side effects are typically very minimal (unlike something like depo provera where the side effects are often wretched), so it's worth looking into.
posted by mostlymartha at 5:02 PM on December 13, 2006

What is your plan for an unwanted pregnancy? Are both of you comfortable with this plan?

The risks of pregnancy with any reversible birth control method are not as infinitesimal as some people would like to believe. If you are regularly engaging in the sex, I think you need to have an accepted plan for an unexpected pregnancy, no matter what method you use.
posted by trevyn at 5:05 PM on December 13, 2006 [2 favorites]

If you're asking if you're using the most effective form of birth control, the answer of course is no.

The Fertility Awareness Method (aka Ryhthm Method, popular with my friend's Catholic parents...btw he had 8 brothers and sisters)? There's a joke about that.
Q. What do you call a couple who uses the Rhythm Method?
A. Parents.

You mentioned that 'hormonal' forms of birth control were problematic. Which type of hormonal birth control was it? If it was Depo-Provera, the shot, I can understand why your special lady would run away. That stuff is terrible. The patch is much milder and is highly effective. I believe newer birth control pills are also milder than they previously were. All factors to consider.

Of course if that's off the table it's off the table, but man, 8 years of condoms? *shudders*
posted by mullingitover at 5:12 PM on December 13, 2006

If you're really worried about getting her pregnant, add some contraceptive foam into the mix.
posted by drstein at 5:23 PM on December 13, 2006

btw my comment about the Fertility Awareness Method was in response to soviet sleepover ;)
posted by mullingitover at 5:27 PM on December 13, 2006

mullingitover, the Fertility Awareness Method is not the same as the Rhythm method, although lots of otherwise reasonably educated people often mistakenly believe so.

FAM seems daunting to take on but isn't really once you get the hang of it, and it's just really useful to know. This book is a great resource.
posted by ambrosia at 5:34 PM on December 13, 2006

I'm going to attempt a pre-emptive information dump about other forms of birth control, again just in case this is something your fiancee wants to change.

Planned Parenthood's super-duper up-to-date comprehensive info on birth control options

Because I've noticed that these threads in AskMe often degenerate into "Here's what I'm using" or "Here's what my partner's using" without necessarily including facts or considerations that might be appropriate for your particular situation (and I fear my IUD reference may trigger that, so I'm atoning in advance).
posted by occhiblu at 5:34 PM on December 13, 2006 [1 favorite]

If she hasn't gotten pregnent yet after 8 years with condoms then one of you has fertility issues.
posted by euphorb at 5:34 PM on December 13, 2006

Seconding ambrosia. The Fertility Awareness Method is NOT the Rhythm Method. I've been using FAM happily for three and a half years.
posted by cybercoitus interruptus at 5:41 PM on December 13, 2006

If she hasn't gotten pregnent yet after 8 years with condoms then one of you has fertility issues.

WTF? Worst answer ever!

There's a risk with everything. The risk you're taking is a risk I personally would be ok with, but it's your call. My parents used condoms as birth control with no problems for almost 20 years, but other couples conceive.
posted by crabintheocean at 5:42 PM on December 13, 2006

euphorb writes "If she hasn't gotten pregnent yet after 8 years with condoms then one of you has fertility issues."

From personal experience you have no clue.
posted by Mitheral at 5:42 PM on December 13, 2006

Do you ever want children? A vasectomy is simple and absurdly effective.
posted by phrontist at 5:44 PM on December 13, 2006

which means, roboto, that after 50 years there is a 150% risk of preganancy. I like those odds.

if you model pregancy as a poisson process with an expected rate of 0.03 per year, based on the 3% figure, then the probability of a pregancy occuring within t years is
P = 1 - exp(-0.03*t)
Thus for 8 years, there is a 21% chance. So far so good.
If you were to continue for another four years, for a total of twelve, the probability becomes 30%. And so on:
15: 36%
20: 45%
30: 59%
50: 78%
100: 95%

However I checkde the link and 3% is the lowest expected rate; 14% is typical. So,with some adjustments:
8: 67%
12: 81%
15: 88%
20: 94%
And now you're playing with fire!

From a strictly mathematical point, so far you've beaten the odds and the longer you go on the less likely that will become. From a practical standpoint, well, these are all averages and you're one case, and you've made it so far... if you were operating in the risky end of the spectrum chances are a pregnancy would have already occured.

(by the way, I get all kinds of twitches in the back of my mind questioning the rigor of this analysis, so don't take this too literally!)
posted by PercussivePaul at 5:50 PM on December 13, 2006

No, it's not stupid. Condoms are a very effective method and if you are both fine with them, then do the deed.

Mr. Roboto, if there is a 3% risk for a year, then this year the risk was 3%. Last year it was 3%. Next year it will be 3%. For the last 8 years the risk was... wait for it... 3%. That is assuming you are using a new condom every time.

It's like roulette, if the last spin hit red with a 48% probability, then on this spin it will hit red with what probability? Yep, 48%, the probability of hitting red on any given spin is the same, just as the probability of condom failure is the same under the same circumstances.
posted by Pollomacho at 5:51 PM on December 13, 2006

apologies roboto, now that I read your post again I realize you did the same math as me. I mis-read it the first time.
posted by PercussivePaul at 5:56 PM on December 13, 2006

Oh, boy, statistics arguments!

PercussivePaul writes "which means, roboto, that after 50 years there is a 150% risk of preganancy. I like those odds."

Don't be an insufferable pedant. I was calculating the risk of pregnancy as P=1-(.97^t), which is perfectly valid, and which happens to work out to about 0.06 for t=2 (just like your formula!). Notice that we're in pretty good agreement for t=8 (.217 vs .213), too.

I like using a Poisson process, though. That's nice.
posted by mr_roboto at 6:02 PM on December 13, 2006

And my apologies for calling you an insufferable pedant. I hope my compliment of your Poisson model made up for it.
posted by mr_roboto at 6:03 PM on December 13, 2006 [1 favorite]

hehe, yeah roboto, I thought you were just multiplying the probability by the number of years, which is such an obvious error that I was prompted to respond. you know how it is.

and pollomacho, I agree with your point. That was one of the flags that went off in my head; whether we should consider the starting point as being now, or 8 years ago. However I thought the poster was interested in knowing how much of a risk they had been taking. The risk of at least one pregancy over one year of use is intuitively much less than the risk over 8 years of continuous use.
posted by PercussivePaul at 6:10 PM on December 13, 2006

Since you're using them correctly, then no, you aren't taking a huge risk. Obviously, there's always a little risk. But really, you're fine.

/been using condoms with SO for four years
posted by desuetude at 6:11 PM on December 13, 2006

Pollomacho writes "Mr. Roboto, if there is a 3% risk for a year, then this year the risk was 3%. Last year it was 3%. Next year it will be 3%. "

That's right.

Pollomacho writes "For the last 8 years the risk was... wait for it... 3%."

This might just be a matter of semantics. Certainly the probability in any one of those eight years was 3%, but the cumulative probabilty over eight years is 21 or 22%.

PercussivePaul writes "That was one of the flags that went off in my head; whether we should consider the starting point as being now, or 8 years ago."

Definitely now, right? I mean, we already know the outcome from the previous eight years: the probability that they had no pregnancies in the previous eight years is 1.
posted by mr_roboto at 6:17 PM on December 13, 2006

Obviously, you guys are good at it, and barring material flaws in a batch of condoms I'd say your risk is as low as it gets.

But, if you want to augment and the $500 investment is in your budget, you might consider the Ladycomp is a sort of electronic port of FAM that would allow you guys to decide how much risk you want to take during the fertile period. (I found FAM a little obsessive-making, though it is more thorough.)
posted by Lyn Never at 6:24 PM on December 13, 2006

Yeah, definitely now, but I think it's useful to have both pieces of information. Knowing how much of a risk he had been taking up to this point might affect his future behavior. I guess the 12 and 15 year figures aren't relevant. Up till now you can calculate the 8 year probability to see how much of a risk you were taking, and then it should start over at zero for future events. OK I'm done.
posted by PercussivePaul at 6:33 PM on December 13, 2006

I did what you did for ten years, just use condoms due to hormone sensitivity on the part of my partner, and we never had a scare or a problem.

There is an upside to this (purely anecdotal, but maybe it's something): when we did plan to have children, we got pregnant in about a week, probably in the first or second try. Contrast that with several friends that came off the pill after ten years and it took them ages to get pregnant (as they waited for their body to acclimate).
posted by mathowie at 6:35 PM on December 13, 2006

It's not just dudes who hate condoms - I'm a lady and I don't particularly like them either. I'm surprised she hasn't got an IUD by now. IUDs have much much better protection rates and don't feel, smell, and taste gross. Go IUD!
posted by loiseau at 6:40 PM on December 13, 2006

For 10 years now me and my monogamous partner have used condoms only. I love how cheap, easy and non-invasive it is for both of us. For us - this is what we like best.

I'm over 35 so I don't want to use pills and increase my risk for blood clots. I really don't like the idea of altering anything if I don't have to. Every once in a while when we don't have any condoms around - we've run out or don't want to run to the store - I love the way it diversifies our activities, if you know what I mean.

So no - I don't think you're dumb or anything.
posted by dog food sugar at 6:51 PM on December 13, 2006

Pragmatic anecdotal experience:
7 years with condoms with my spouse and no unintended pregnancies. Cumulative experience with partners using condoms before that: 6 years and no pregnancies. Broke precisely one polyurethane condom and gave up on the brand.

So no, you're fine from that point of view.

From a sensation point of view, condoms are really lousy. Hormonal methods wreak havoc with Mrs. Plinth. I'm told that modern IUDs are way better than the Dakon shield fiasco. Other barrier methods are not reliable enough or require the addition of substances that make certain activities rather unpalatable.
posted by plinth at 6:57 PM on December 13, 2006

And if your partner is not interested in an IUD there is also the NuvaRing that a number of my friends are using and they can't say enough good things about it! (I'm happily on the pill so I haven't tried it myself.)
posted by madokachan at 7:22 PM on December 13, 2006

There are always going to be people who say, "Well oh ya? My uncle smoked two packs a day and he's 85!" That's great for your uncle but it doesn't tell you much about the hazards of smoking.

Like it or not, in the real world, 10-20% of couples using condoms get pregnant in a year. Would you buy a car that had a 10-20% chance of breaking down every year of driving?
posted by euphorb at 7:29 PM on December 13, 2006

Citations from peer-reviewed sources, euphorb? Because that's some rank bullshit right there.
posted by solid-one-love at 7:38 PM on December 13, 2006

solid-one-love writes " Because that's some rank bullshit right there."

Nah, the FDA puts the rate for condoms in typical usage at 14% per year, which is right in the middle of euphorb's range. 3% is an ideal number.
posted by mr_roboto at 7:41 PM on December 13, 2006

Citations from peer-reviewed sources, euphorb?

I'm not euphorb, but I play him on tv.
posted by ROU_Xenophobe at 7:44 PM on December 13, 2006

That's for "typical use", which means that they weren't always used or always used correctly. I think it's safe to assume that the OP is using them always and correctly, so that stat doesn't apply here nor does euphorb's analogy work because of it. (Would you buy a car that had a 10-20% chance of breaking down every year of driving if you didn't take it in for maintenance and sometimes aimed for other cars?)
posted by solid-one-love at 7:45 PM on December 13, 2006

More broadly:

Mrs. Xenophobe¹ and I use con-doms, but because in our circumstances having a kid would not be a disaster.

If your circumstances mean that a kid really would be disastrous, then you want stronger medicine than condoms. If hormones are not a real option and you don't mind being weirdos, you could always use a condom while she uses a diaghragm. That would bring your risk in a year down to something like 3% if the risks are independent, about the same rate as birth-control pills.

¹Let's call her GCU Sweet and Full of Grace, cuz she is.
posted by ROU_Xenophobe at 7:55 PM on December 13, 2006 [1 favorite]

No, not stupid at all. We did the same thing for many years, since I also have issues with hormonal birth control, yes, even nuva ring. I never got pregnant in all that time. If you're both happy with it, and it has worked just fine for 8 years there's no reason to change unless you want to. Every method has a risk of unwanted pregnancy, so regardless of which one you use, there is always that chance.
posted by Joh at 8:11 PM on December 13, 2006

This is just me, but I've had condoms break on me 3 or 4 times. They never got pregnant, but still, it does make me a bit wary as to the effectiveness of the Condom.
posted by markesh at 11:03 PM on December 13, 2006

My GF had negative side effects from every type of hormonal contraception we initially tried (pills, patches, rings), so we resorted to condoms. I suppose it's subjective, but the condoms totally killed the point and pleasure of sex for me. I became disinterested and depressed about it, and it was a huge blow for both of us. Less sex, worse sex.

Searching for a solution, we decided to try a hormonal IUD, and it's the best decision we ever made. No side effects even though she's sensitive to hormonal changes. She had some discomfort for maybe a week after the IUD was installed, but smooth sailing afterwards.

The copper IUD is somewhat dated, AFAIK. I suggest you try a hormonal one, and switch to copper if necessary.
posted by lifeless at 11:53 PM on December 13, 2006

After eight years I'm seconding phrontist's answer of a vasectomy. Cheap, quick (your unit will be out of action for three days, max) and no mess. Think about it, and talk it over with your girl.
posted by Bora Horza Gobuchul at 4:38 AM on December 14, 2006

Ha! IUD. My mom delivered me, and then delivered the IUD that shared the womb with me for 9 1/2 months. I'm sure that in the last 30 years they've made them better, but... my older brother was a condom baby, my little brother was conceived while my mom was on the pill. For some people, things just don't work. For you, sounds like condoms are fine. My wife and I used them for about 8 years too. She went on the pill afterwards - and spent quite some time working with her doctor to find the one that worked best for her. There are many, many different formulas out there. One may be right for your girl. The thing is, it has to be her decision - you can't push her into doing anything she isn't comfortable with.

FWIW we both were fine using condoms but both agree that everything just feels better without. The downside is that until you get used to it your part of the deal will be embarrassingly brief. Be prepared for that. Her bits have been shaped over millions of years of evolution to make your bits happy, and they will be surprisingly effective at that job when and if you do go "raw dog". Give it some time, and you will collectively work out how to manage things so that you're both happy with the outcome. (Nobody ever talks about this part. Why not? It is definitely important to know.)
posted by caution live frogs at 7:03 AM on December 14, 2006

It sounds like condoms have been a pretty effective method for you two as a couple; though there will always be a (small) risk of pregnancy, it sounds like you two have a good system in place.

That said, if you want to decrease your odds, you fiancee could talk to her GYN about getting fitted for a diaphragm. It's a non-hormonal method that can be used in conjunction with condoms, and even when used on its own has a better success rate than condoms. Diaphragm usage includes using spermacide, which other people have mentioned, above.

Also, if you absolutely know you never want to have kids, get the vasectomy. But your post sounds more like not-right-now, not never-ever-ever.
posted by Sprout the Vulgarian at 8:38 AM on December 14, 2006

Okay, two points.

1. For whatever it's worth: I've been using condoms "successfully" for going on 19 years now and suffered only one instance of "breakage". (Never had any "slippage".) I'd definitely recommend the ones with the spermicidal bonus, and go ahead and splurge the extra $2 for Trojans. Sure, the generics or off-market ones might save you a smidge, but is it really worth the risk?

2. I think you stats guys have some issues. According to you folks I'm supposed to already have two kids! How could the probability be approaching 100% so quickly? That seems like fishy math to me.
posted by GatorDavid at 9:33 AM on December 14, 2006

Been using condoms as the main form of BC for over 17 years in a monogamous relationship. Never had a slip-up, never had a failure. Only kid we have was planned.
posted by cass at 9:39 AM on December 14, 2006

GatorDavid writes "I think you stats guys have some issues. According to you folks I'm supposed to already have two kids! How could the probability be approaching 100% so quickly? That seems like fishy math to me."

They are making the possibly incorrect assumption that the chances of getting pregnant in any one year with condom usage is independent of the results of previous years. I'd bet if someone was to follow couples for a longer period, say 5 or 10 years, that the results would show that careful and dedicated condom users would have a failure rate over the course of the study of not much higher than the single year rate. (IE: 3% for one year 3.5-5% for 5 years).
posted by Mitheral at 10:13 AM on December 14, 2006

Mitheral writes "They are making the possibly incorrect assumption that the chances of getting pregnant in any one year with condom usage is independent of the results of previous years."

Yeah, this is true. It's impossible to know how valid that assumption is without knowing the methodology behind the FDA data. It might very well be normalized to a per-year basis from long-term data; it might not....
posted by mr_roboto at 11:38 AM on December 14, 2006

Statistical questions aside, I second the idea of keeping a course of emergency contraception/Plan B on hand, just in case something breaks or slips. That should help with peace-of-mind issues. (Unless, of course, her past reactions to hormonal BC were severe enough to preclude Plan B.)
posted by paleography at 12:04 PM on December 14, 2006

You might as well weigh the option of using spermicide AND condoms, the combination of which is supposed to be as effective as using birth control pills. Applying spermicide takes the same amount of time as putting on a condom, and is no more disruptive; that is, since your mood can survive the pause to don a condom, you're unlikely to mind having one of you do the spermicide thing at the same time. Here is a typical college health service discussion of effectiveness.

I think it's worthwhile considering it because you're concerned enough to ask the question. You're not worried, but you're aware that condoms can fail. Peace of mind has value. Only you and your partner can decide if you'd lose more than you'd gain if you did more to prevent pregnancy.
posted by wryly at 7:29 PM on December 14, 2006