Birth control can be an awkward topic. But it’s an important heart-to-heart talk to have before sex with your partner. Sharing the responsibility of protection from the start can prevent unwanted consequences and also build a healthy relationship.
“Bringing up conversations about sex and birth control aren’t always easy at first and can take some practice,” says Robin Watkins, a certified nurse midwife, women’s health nurse practitioner, and senior director of health care at Power to Decide, the campaign to prevent unplanned pregnancy.
Depending on your relationship, you may need protection from pregnancy, sexually transmitted diseases (STDs), or both. Do some soul-searching before you talk about birth control. Do you want children? If so, when?
The answers to these questions will guide your conversations and help you make decisions as a couple.
When you’re ready, prepare this way, Watkins advises:
- Say it out loud. Put what you want to say into words. This can make sure the talk goes more smoothly when the time comes and nerves take over. Repeat it in the mirror a few times.
- Turn to someone you trust. Ask a friend to rehearse the conversation with you.
- Make sure the time is right. That’s probably not in the heat of the moment. Set aside a time and a private place that’s as stress-free as possible for both of you.
If you’re in a heterosexual relationship, “make sure you and your partner have the same desires around getting pregnant or not. If you aren’t aligned, take a step back and have that conversation before you have a specific one about what method to use,” Watkins says.
Another discussion you need to have with a sexual partner is about HIV and other STDs. It can be embarrassing. It might cause you to squirm. But use the same low-stress approach when asking your partner if they’ve been tested. Some strategies to do that include:
- Talk about your most recent test.
- Ask your partner about whether they have tested positive for any STDs, and stress you’re not judging them in any way.
- Talk about other partners you both may have.
- Tell your partner you care about their health, so it’s better to know and deal with it.
- Say sex can be more enjoyable if you both know you’re safe.
Watkins says you can even start the conversation off in a text or by a phone call if you don’t want to bring it up in person.
If you or your partner hasn’t gotten the vaccine for human papillomavirus (HPV), you can get it until age 26. In some cases, even adults 27-45 can get the shots, so ask your doctor. It’s an important vaccine because HPV can lead to genital warts and even some cancers.
How to Ask Someone to Wear a Condom
Condoms are the only birth control method that also protects against HIV and other STDs. If you or your partner is not monogamous – meaning you’re having sex with other people – it’s smart to use one every time you have sex.
The most effective condoms to prevent STDs are made of latex and fit over the penis. But sometimes, people don’t want to use them because they say it interferes with sexual pleasure.
Some ideas for asking your partner to use a condom are:
- “My other birth control method isn’t 100%; let’s use a condom, too.”
- “Honey, I got us a present!” (while pulling out a package of condoms)
- “I’d feel more comfortable and relaxed if we used these from now on.”
- “We (or I) haven’t been tested in a while; let’s use these.”
An internal condom is another option. It fits inside the vagina or anus and is an option for straight, gay, or bisexual couples. They’re made of nitrile and are a good choice if you or your partner is allergic to latex.
If you can’t find them easily, talk to your doctor or pharmacist.
Birth Control: One Size Doesn’t Fit All
The type of birth control you choose depends on a lot of things. Lifestyle and personal beliefs are among many factors that play a role. This needs to be a part of the conversation, too. Learn about your options together. And find out how to use your contraception the right way.
IUDs (intrauterine devices). A health care provider places this device into the uterus. It can prevent pregnancy for years or until it’s removed. IUDs are very effective. Most contain hormones. One uses copper (instead of hormones) to keep sperm from fertilizing the egg. If you and your partner want a long-term contraception method that’s “set it and forget it,” this could be a good choice.
Hormonal methods. Most work by stopping the ovaries from releasing an egg. A doctor must prescribe them. You need to take a pill every day. So if that’s a problem, other methods like a hormonal patch, vaginal ring, a shot, or an implant last for weeks, months, and even years. Ask your doctor about all the hormonal options available to weigh the pros and cons.
Barrier methods. Condoms aren’t the only barrier method. Others include:
- Diaphragms
- Sponges
- Cervical caps
You need to have this type of contraception ready to go every time you have sex. Be prepared to stop in the heat of the moment to use some of them. They work best when you use a spermicide with them. The spermicide (a cream, gel, foam, etc.) will kill most of the sperm that enter the vagina. The barrier blocks the rest.
Fertility awareness. This also is called natural family planning. Both partners need to know when the female is most fertile during the month. You’ll have to say no to sex on those days or use a barrier method. It works best in women who have regular periods.
If you use fertility awareness perfectly, you have about a 1 in 100 to 5 in 100 chance of getting pregnant. But if you use it the way most people do, it has a pretty high failure rate (12 in 100 to 24 in 100). That means you make mistakes or don’t use it all the time. If you shouldn’t, or really don’t want to be pregnant, you may need to consider a more reliable form of birth control.
Emergency contraception. Talk with your partner about what to do if a condom breaks or a birth control pill, shot, etc. is missed. Mistakes happen. You need to figure out how you will deal with a mistake before it happens. Emergency contraception comes in two forms: pills and the copper IUD. You can get the “morning after pill” at drugstores or by prescription. A doctor needs to put the IUD in the uterus. You’ll have to act fast – within 5 days of unprotected sex.
Emergency contraception is not the same thing as the abortion pill.
Permanent solutions. You may decide children aren’t for you or you don’t want any more kids. Discuss with your partner the pros and cons of sterilization. Men can get a vasectomy that will stop sperm from going into semen. Women can get their fallopian tubes tied (also called a tubal ligation) to stop eggs from the ovaries from getting to the uterus and sperm from traveling up the tubes to the eggs.
Contraception When Life Changes
A couple’s birth control needs will change throughout life. Women need to ask their doctor’s advice when they have questions, including at these times:
- Right after childbirth and if you’re breastfeeding
- You smoke and are older than 35
- You have heart disease, blood clots, or cancer
- You enter perimenopause or are in menopause when periods become unpredictable or stop
If you are a transgender man (assigned female at birth), you may need contraception. “If you take testosterone but have not had gender-affirming surgeries and have penis-vagina sex with someone who makes sperm, you can get pregnant,” Watkins says. Not having a period does not protect you from conceiving, either. “So if you don’t want to get pregnant, you need to use protection,” she says.
“Keep in mind that it’s OK to ask your partner to use protection, whether that’s to prevent STDs or pregnancy. It’s always OK to ask for what you need during sex, and if you’re not getting it, say no,” Watkins says.
