Ask the Sexpert: March. 24, 2011

Dear Sexpert,

My boyfriend and I have been happily together for six months. Recently, we’ve begun having sex. When we first started having sex, we used both male and female condoms. Since going on “the pill,” however, my boyfriend and I have stopped using condoms altogether. He is conscientious about always “pulling out” before he comes. Is this safe? Is it safe if he reenters me after coming? A friend mentioned to me that using spermicide in the place of condoms protects against pregnancy and the transmission of STIs. Is spermicide safe by itself as a method of contraception and/or preventing the spread of STIs?

— Worried About Withdrawal

Dear Worried,

It is great that you are reaching out to seek more information on these important concerns and about protecting your sexual health. Before delving into a comprehensive answer, let me just say that it sounds like it may be helpful for you to seek further information and resources on campus for contraception and prevention. University Health Services provides low to no cost testing for sexually transmitted infections, counseling on contraceptive options and contraceptive tools for all Princeton students through Sexual Health and Wellness Services. To find out more, including how to make an appointment for contraceptive counseling, call 609-258-5357.

Regarding your concerns about preventing STIs, the withdrawal method, or the method of “pulling out” before ejaculation, does not prevent the transmission of STIs. This is because most microorganisms that cause STIs need only contact with skin or the sexual tissue/organ of your partner for successful transmission. In a nutshell, the transmission of STIs does not depend on either male or female ejaculation. Barrier methods such as male or female condoms will be most effective in preventing pregnancy and the transmission of STIs if they are put on before intercourse and left on during the entire time you are having sex. Even if you have been tested for STIs in the past, and/or you are currently in a monogamous relationship, receiving regular reproductive health care that may include appropriate STI testing is a good idea, as some STIs do not cause any visible symptoms.

With regard to your concerns about preventing pregnancy, many sexual health experts agree that the withdrawal method and/or reinsertion after ejaculation alone carries several risks and may not be as reliable as other methods of contraception. For example, there usually remains some sperm left in the urethra a few hours after ejaculation, and although the amount of sperm is only a fraction of what constitutes the typical ejaculate, there is still the possibility of pregnancy if your partner reinserts after ejaculating.

To answer your question about spermicides, using spermicides alone is not a highly effective method of contraception, according to Planned Parenthood. In addition, spermicides alone do not protect at all against the spread of STIs.

Whatever methods of protection and contraception you and your boyfriend choose, make sure you have mutually agreed upon them, feel comfortable using them and that you are knowledgeable about the risks and benefits involved. There are many contraceptive options available, including oral contraceptives that have high success rates for preventing pregnancy when used correctly. To educate and empower yourself to make the right decision for you on protecting yourself from STIs and preventing pregnancy, I recommend making an appointment with UHS and talking with a Sexual Health and Wellness provider. In addition, if you are experiencing other concerns, such as anxiety, or if you are having trouble navigating these issues, you might consider taking advantage of other resources available through UHS, including individual or couples counseling at Counseling and Psychological Services.

Stay safe, and take care!

— The Sexpert

The Sexpert is written by a team of peer sexual health educators and fact-checked by University health professionals. Submit questions to sexpert@dailyprincetonian.com. Don’t be shy!