My girlfriend wants me to stop using a condom.
August 1, 2008 8:02 PM   Subscribe

My girlfriend wants me to stop using a condom.

My girlfriend is on the birth control pill--and has been for some time. We normally use a condom during sex, but she'd like me to stop. I'm a bit paranoid about this, and I'm not sure whether it's a valid concern or a holdover from the scare videos in my middle-school sex education classes. I'm 30, and I should be old enough to handle something like this... but I'm not sure what to do.
posted by anonymous to Human Relations (61 answers total) 8 users marked this as a favorite
As long as everyone is monogomous, STD free (you both got tested, right?) and willing to accept the consequences, go for it.
posted by jeffamaphone at 8:11 PM on August 1, 2008

You should get tested for everything. Like seriously, every little thing. I got tested and we went to condom-free sex and it was amazing. Although, frankly, condoms have tons of uses in monogamous relationships and should not be abandoned completely. Maybe you are afraid of getting tested (or even seeing a doctor) but the truth is that every man must face this fear someday and when you know you're good, everything else shines completely.
posted by parmanparman at 8:14 PM on August 1, 2008

What exactly are her reasons for asking you to stop? I assume you don't want a child.

It's always a good idea to use more than one form of birth control. Even if your girlfriend were using the pill perfectly, there's still a failure rate - and that's if she doesn't forget to take it or take it incorrectly. According to a quick Wikipedia search, failure rate of birth control (first year) with perfect use is .3% - 8% with typical use. Those aren't fantastic odds.

If you don't feel comfortable stopping, I'd advise you not to.
posted by Solon and Thanks at 8:15 PM on August 1, 2008

What's the nature of your paranoia? STDs or pregnancy?

Using the condom is the best control *you* have over whether there's a chance of her getting pregnant. If you don't want her to get pregnant by you, and if you have less than complete trust in her on the pregnancy issue, then keep using it.

By "less than complete trust", I have in mind three scenarios:
- you think she might be flaky and accidentally skip some days of the pill, or
- you think she might deliberately skip some days of the pill, or
- you think that, should she get pregnant, she would want to carry the pregnancy to term and you don't want that.
posted by LobsterMitten at 8:19 PM on August 1, 2008 [1 favorite]

(and by 'What exactly are her reasons for asking you to stop?' I'm not trying to be obtuse - just wondering if there's anything more to the idea than 'it feels better,' which is different from some sort of allergy or who knows what.)
posted by Solon and Thanks at 8:23 PM on August 1, 2008

Nth getting tested for everything.

It can be frustrating and difficult being on this side of things. If you try talking to people about it you get blank stares from drinking buddies and outright shock from female friends. I've had nurses doing a sex education course laugh at me for suggesting that sometimes it's the woman who pressures for condomless sex and not the man.

Even if you agree to it, you might not be psychologically ready and able to perform, either because you are worried about disapointing your girlfriend who you feel has built this up too much or because you are worried about conception/STDs. It sounds like an obvious thing to say, but don't give in if you don't want to. Seriously.

It's not unreasonable at all for you to want to be responsible for your own birth control. Unfortunately, she might see it more as a "trust issue that you have to get over".
posted by ODiV at 8:33 PM on August 1, 2008

Are you 100% confident that both of you are STD-free (or are comfortable with sharing what STDs you have)?

Are you 100% confident that if for some reason she becomes pregnant, she will not want to have the baby (provided you don't want to have a child with her)?
posted by schroedinger at 8:39 PM on August 1, 2008

I'm kind of surprised by the general consensus here. I've dated a few girls who I trusted and who were on the pill and didn't use condoms. The effective rate is 99% with perfect use. I'd usually let just a bit of paranoia seek in by asking if she'd taken her pill, which you have to be careful about because you don't want to insinuate anything.

But millions of folks rely entirely and wholly on birth control as their sole method. It's shockingly effective; otherwise they would call it "birth reduction."

Yes, there's a small chance. Yes, she needs to take it consistently. And make sure she doesn't go on antibiotics.

But if you haven't had sex without a condom... at thirty... wow. To me at least, it's *considerably* better.

And of course, on the flip side, and to feel a little better about it, pull out. Problem solved. -ish.
posted by disillusioned at 8:43 PM on August 1, 2008

Have you talked with her about your concerns? I can definitely see how a woman could be offended if you insist on condoms, whether it's logical or not. She might think you don't trust her to take the pill correctly, or don't trust her, period.

Anectodally, the pill is very effective - I don't know of a single failure in my circle of female friends, and most of us have been using it for years and years. But you need to talk about what would happen in case of failure anyway. It could be she's 100% certain she'll have an abortion, for instance.

In any case, TALK to her! No condoms should come off unless there is trust.
posted by Mr Bunnsy at 8:44 PM on August 1, 2008

Look--whether your girlfriend takes offense or not, nobody here should be up in arms because this dude may want to take birth control into his own hands, insinuations into the babymaking desires of his girlfriend or no. Anonymous poster, I commend you for considering sex and birth control to be a decision to be made by both participants, not just the woman. If your girlfriend gets fussy because you don't want to take the condoms off, she can go screw herself. That's the same thing I would tell a girl whose boyfriend wanted to stop using the condoms despite her being uncomfortable with it.
posted by schroedinger at 8:55 PM on August 1, 2008 [26 favorites]

First, if you aren't comfortable with it, don't do it, whatever the "it" is. It's your body, and unless you are ok with it, no one has a right to go bareback riding on you or anything else without your consent.

That said, I think you need to talk with her and articulate what are your concerns, and listen carefully to her reasons for wanting to ditch the condoms. Things like "it feels better," "it is more intimate and spontaneous," and "I don't like the taste" are totally valid reasons, and deserve a respectful and thoughtful consideration by you; at the same time, your consent, if you decide to give it, needs to be genuine.

If you are considering proceeding, yes, get tested. But it isn't practical or possible to get tested for "everything," and anyone who claims to have been tested for everything has probably misunderstood what they were told at the clinic. Here is a really straightforward page on STD testing from the Mayo clinic. Key excerpts:

For men:
Centers for Disease Control and Prevention (CDC) guidelines don't suggest routine STD screening if you don't have any symptoms, unless your sexual practices include having sex with men.


If you can't trust a partner not to give you an STD, you may not want to have sex with that person. You can ask them to be tested for gonorrhea, chlamydia, HIV, syphilis and hepatitis, but negative tests for these may mean the infection is just in too early of a stage to detect. Also, there are no good screening tests for herpes, and HPV testing is limited — men can't be tested unless they have visible warts, and HPV testing generally isn't recommended for women younger than 30.

If (and this is a really, really big "if") neither of you has any STD symptoms, you both test negative for HIV and anything else your doctor wants to test you for, you don't engage in high risk behaviors, and you guys are monogamous from here forward, those scare films in junior high don't really apply to your situation. The purpose of those films, in fact, is to scare you into behaving exactly as you are doing now -- monogamous, careful about STDs, etc.

To put this in more graphic terms, bareback sex has basically no risk (other than pregnancy, natch) IF neither of you fuck other people and neither of you have a preexisting condition. How big that "if" is depends on your personal situation -- none of us can tell you that.

If you've never had unprotected sex before, the first time or two might be kind of weird. It feels really different (which I think of as a good thing, but I'm sure someone out there prefers the sensation through latex); the whole rhythm of sex is different because there doesn't need to be such a clear "ok, now it's time for intercourse" moment and instead you can drift back and forth more fluidly between different acts; and there is a lot more mess to deal with afterward.

More than the physical differences, though, is that it can be kind of mind-blowing to realize "woah -- my parts are inside her parts, and everything is touching, and ... woah!" Or maybe for you it won't be a big deal, who knows.
posted by Forktine at 9:13 PM on August 1, 2008

Yes, get tested for everything. And have a frank discussion about your options if an unexpected pregnancy does happen. Nobody wants to terminate a pregnancy, but the small risk of contraceptive failure may be easier to bear if you're both comfortable with that as a worst-case scenario. If abortion is unnacceptable to either of you, then you're wise to stick to condoms and the pill. If you're okay with it as an absolute last option, then doubling up two reliable methods of contraception may be, well, overkill. If you genuinely don't trust her not to bear a kid you don't want, then there are more serious issues in your relationship than your choice of contraception.

Your girlfriend should visit Planned Parenthood or a trusted GP to get educated about the non-barrier forms of contraception that might work for her. Seriously, the options have improved a lot since either of you were in sex-ed classes. Has she considered an IUD (intra-uterine device)? They have a low failure rate and she won't need to remember a pill every day. Doctors used to be reluctant to offer them to younger women with no kids, but that's changing and they're now considered quite safe for most women. I have one and it's remarkeably liberating to not even have to think about my contraception. (At least until the five years is up and I need a new one).

And yes, for the doubters out there: for many women, sex without a condom is A LOT more fun. Seriously. For men it seems to be "good with a condom, even better without one". For women (at least, women who trust their contraception and their monogamous partner), it can be the difference between "sometimes fun, sometimes uncomfortable" and "AWESOME, wherever, whenever". I know this is a comparitively shallow consideration compared to the rest, but if you do ditch the condoms, you might get more action.
posted by [ixia] at 9:27 PM on August 1, 2008

(I deliberately didn't address the pregnancy issue in my answer because I think that that, even more than STD's, birth control becomes more about trust and emotion than statistics. The pill has a very low failure rate when taken every day... but a very high failure rate when not taken. Relying on her to take it every day is a major act of trust, and most of us know someone who accidentally-in-that-deliberate-way had a pregnancy that way. So the statistics tell one story, but it's your relationship with her that you need to evaluate, not the averages.)
posted by Forktine at 9:27 PM on August 1, 2008

Assuming that you're trying to prevent a pregnancy and want to make sure that she's taking her birth control as advised -- the birth control patch might reassure you. Obviously, it's something she'd have to want to switch to, and it's not always easy or pleasant to change hormonal birth control methods, but the visual confirmation that she's on birth control could help. It's also less likely that she'll forget a once-a-week patch, versus a once-a-day pill.

(Nuva Ring is another option, and it's even easier to remember).
posted by OLechat at 9:41 PM on August 1, 2008

Unless you don't trust her, or you don't think she knows how to take the pills properly, then it's fine. If you're concerned about STDs, get tested. If she seems like the type that might purposely quit taking her pills in order to get pregnant and bait you into staying with her if you break up, then always use a condom.

Seriously, though, if pregnancy is your only concern, plenty of couples use only birth control pills.
posted by Nattie at 9:46 PM on August 1, 2008

My son has two beautiful children both of whom were conceived while his now ex-wife was taking birth control pills. To quote ..."we don't know what happened".

Considering that several people have mentioned that using two kinds of birth control is far safer than one, maybe now would be a good time to start using two condoms. Please don't misunderstand. I am suggesting that safe is far better than sorry.
posted by snowjoe at 9:49 PM on August 1, 2008 [1 favorite]

Two condoms? I'm not sure if that was a typo, but using two condoms at one time is a horrible, horrible idea. The friction makes them more likely to break, so the failure rate is higher than if you were using just one condom.
posted by needs more cowbell at 10:10 PM on August 1, 2008 [1 favorite]

She might subconsciously or consciously be trying to get knocked up.

Condoms are just about the only way for to make sure he does not become a father before he's ready.
posted by sondrialiac at 10:35 PM on August 1, 2008

some (heated) further discussion on this very topic.
posted by killy willy at 10:35 PM on August 1, 2008

I'm female and I hate condoms. Sex is about 50% as fun with them as without them.

I use them but I don't like them.
posted by small_ruminant at 10:48 PM on August 1, 2008

If you don't want to do this, then don't do this. The stuff about you being old enough to handle it, whether or not you trust her, if you're scared of being tested is irrelevant. Don't do this if you don't want to.

As an exercise imagine if someone asked the same question with the genders reversed.
posted by rdr at 11:03 PM on August 1, 2008 [1 favorite]

Also, there are no good screening tests for herpes,
posted by Forktine at 11:13 PM on August 1

I am under the impression that there are blood tests for both types of herpes and that they are quite accurate -- am I wrong in this?
posted by dancestoblue at 11:07 PM on August 1, 2008

setting aside STD's for the moment ...

1) If she be comes pregnant & wants to keep the child... you will have no say in the matter. But you WILL pay child support for the next 18 to 23 years...for a child you may or may not ever see.
And the goverment can show up many years later & "tag" you with a massive amount of retroactive child support. [ I have a friend who is paying back support on a "child" who is now 35. He owes from when the child was born until the child finished 3 years of collage]

2) If she becomes pregnant & wants to abort... You will have absolutely no say in the matter.

+ either way, marriage is a guarantee of nothing.

If that does not concern you.... then consider then STD issue.
posted by digital-dragonfly at 11:34 PM on August 1, 2008

I'm going to assume that you and your girlfriend are really in love and trust each other completely.

Because you are both confident of each other's love and fidelity, I'm going to assume that the bigger consideration is contraception.

And I'm going to assume that your girlfriend does take her birth control pills responsibly.

Now, I'm asking you to consider how you would feel if the unthinkable happened and you two became one of the REALLY, REALLY, REALLY rare cases where she got pregnant anyway.

What would your reaction be?

1) Wow, we didn't expect this, but don't worry hon, I'll support you in whatever decision you make. I'll come to the clinic and hold your hand every step of the way if that's what you choose, or I'll participate and contribute in every way to raise this child if that's your choice also.


2) WTF? You said you were taking the pill every day?!?!? What happened?!?!?!? It's not my fault!!!! I should have never listened to you!!!! Now, I'm really screwed!!!!

If you can answer #1, then yes, you're ready to toss the Trojans. If #2, then you're not.
posted by marsha56 at 12:37 AM on August 2, 2008 [10 favorites]

This question is interesting because I think the advice would be a bit different if the issue were that she insisted on him continuing to use a condom even though she's taking birth control pills.
posted by emelenjr at 3:35 AM on August 2, 2008

You know, maybe this guy really, really isn't ready to be a father, in which case I salute him for taking steps to safeguard his own reproductive preferences.

And the pill is 99% effective with perfect use. Antibiotics and some prescription medication--and over the counter herbal remedies--decrease efficacy. If a woman is overweight or obese, that raises the risk of failure as well. Forget to take it, throw up sometime after taking it, etc.....if we're going to use anecdote as evidence, I know several babies conceived while mom was "on the pill."

So even with it, if you're going to go bareback, you should be at a point in your relationship where, not only are you feeling secure about fidelity issues, but you're reasonably comfortable with the idea of possibly dealing with the consequences an unintended pregnancy with this individual. It's not sexy or hip, but there it is. You're not being unreasonable to ask for two different protection measures if you're not comfortable with that level of trust/intimacy yet.

(And, if you were a woman and a man was trying to pressure you into skipping the condoms since you were already using the Pill, you'd be getting an overwhelming amount of support here for the fact that you feel empowered to look after your own comfort and health with this.)
posted by availablelight at 4:15 AM on August 2, 2008

Just chiming in to say that a guy who wants to wear a condom is a very responsible guy. Good on you.
posted by theora55 at 5:31 AM on August 2, 2008 [2 favorites]

I totally respect everyone's right to choose birth control methods that make them comfortable and to not feel pressured into any sexual behavior they are not comfortable with. Everyone should look after their own comfort and health. And everyone should feel comfortable obtaining information to help them make informed decisions about their comfort and health. Gender certainly doesn't play into that sort of question.

I do not respect any insinuation that women routinely go around lying about being on the pill to "trap men into fatherhood". Or that women can't be trusted to take the pill reliably, because taking a pill at the same time everyday is too hard (ignoring the millions of people in the world with chronic diseases requiring carefully timed medication). Or whatever. I don't think that the poster was doing that, but some responses have come dangerously close.

If the poster was looking for advice about STD testing or facts about the likelihood of pregnancy just using the pill, he has gotten those. If his questions have more to do with being unable to trust the woman he's having sex with, I don't think they are answerable here. If that is the problem he's having, whether due to videos he saw in junior high or horror stories in the internet about men being "trapped into fatherhood", he might be better off consulting a therapist rather than Metafilter.
posted by hydropsyche at 5:40 AM on August 2, 2008 [2 favorites]


I was just quoting from the Mayo page, which says in more detail:


A blood test may also help detect a herpes infection, but, again, results aren't always conclusive, particularly if you're not experiencing signs and symptoms of an active stage. Some blood tests don't distinguish between types 1 and 2 of the herpes virus. Type 1 is the virus that more typically causes cold sores, although it can also cause genital sores. Type 2 is the virus that more typically causes genital sores. You may ask for a "type-specific" IgG blood test, which differentiates between the two, measuring antibodies to the viruses in your blood. Still, the results may not be totally clear, depending on the sensitivity of the test and the stage of the infection. False-positive and false-negative results are possible.

And the FDA page you link seems to emphasize the use of the tests for confirming an outbreak, rather than just getting tested for the sake of getting tested:

The standard testing procedure for herpes is to obtain a viral culture of a sore within the first 48 hours after symptoms appear. Beyond 48 hours, there is a risk of the culture yielding a "false negative" result because the sore may have begun healing and there may not be live virus present. Blood tests can be used to confirm a negative viral culture result or to help determine herpes infection in a person with no visible symptoms.

Here is a detailed discussion of the different testing options from ASHA; both useful and less useful tests appear to be on the market, so you would need to be an informed consumer and specifically request the desired test by name.

I've had a number of STD screenings over the years, as did my partners, and no one ever suggested or offered a herpes test as part of those screenings. Some clinics may do them (perhaps as a money-maker and to meet demand from people who want every test they have heard of), but it is not yet part of a standard STD screening if no symptoms are present.
posted by Forktine at 6:08 AM on August 2, 2008

If you don't feel comfortable going condom-less, you shouldn't do it. Furthermore, she shouldn't be asking you to do something that makes you feel uncomfortable.

Why does she care, anyway? Doesn't it make more of a difference to you, sensation-wise, than it does to her?
posted by Afroblanco at 6:41 AM on August 2, 2008

As a counter point, I am 35, have been on the pill since I was 19, and have had three relationships where we used the pill only (totalling about 9 years). I've never even had a pregnancy scare.

I think this all comes down to trust. I think the "failure" rates of the pill especially among married folk have to do with a little deception on the part of the wife. But that's just my guess. Anecdotally, my friends who didn't want to get pregnant, and were on the pill, didn't.
posted by kimdog at 6:45 AM on August 2, 2008

Do what makes you comfortable. Talk to your doctor, her doctor, an ob/gyn from your health insurance or a counselor at your local planned parenthood about failure rates for hormonal birth control only. Your question does not mention fears of cheating (either STDs or entrapment-by-pregnancy), so get some adult-to-adult talk about the risks of pregnancy on hormonal birth control and forget the middle-school scare tactics. Then do what works for both of you.

as an aide, like hydropsyche says, I'm taken aback by the suggestion that women are too incompetent to use birth control or too shady to be trusted with it or whatever. In over 20 years of--sometimes imperfectly taken--hormonal birth control, I've never even suspected I might be pregnant. Among all the women I know, who are now at the point where they've been on pills of some sort their entire adult lives, none have gotten pregnant while taking birth control pills. When I volunteered with a help-I'm-confused-about-sex service in Austin in college, the issue never came up. The expected failure rate of properly used injectable hormonal birth control is less than 1 pregnancy per 100 women using that method per year. For oral hormonal birth control it shoots to less than 2 pregnancies. But note, the FDA calculate failure rates during the first year of the method only. I can't find a web source to link to, but every gynecologist I have ever had says that although some women resume normal ovulation and get pregnant in the first full cycle after stopping hormonal birth control, most do not. It can take up to 18 months for the body to begin ovulating normally again. So, that first year failure rate is probably less applicable to a woman who has been properly taking hormonal birth control for years,
posted by crush-onastick at 6:55 AM on August 2, 2008

If the concerns are about conception, get educated on women's fertility cycle. Consider a compromise, wear a condom during her most fertile times and go without when she is most unlikely to conceive (birth control or not). You can find more information than you ever wanted to know about this topic in Taking Charge of Your Fertility. This will require open and honest communication between you and your girlfriend and it'll have to be on-going. I think it would be good for you two.

Also, I kind of scratch my head over people saying, "what if the genders were reversed -- then what advice would you have?!" I don't know, I think things are a little different in that situation. We're just not operating in a gender blind society where the consequences are the same. In any case, I think you guys can work this out but you will really need to address the issues which may be uncomfortable. However, you're already not comfortable with the situation so might as well dive in and get into it.
posted by amanda at 7:01 AM on August 2, 2008 [3 favorites]


He didn't say or imply that she's pressuring him, just that she suggested it. She's not a mind-reader, so of course she can ask for something that turns out to make him uncomfortable. And then he can say, "That suggestion makes me uncomfortable. Let's talk some more about our options here." And then he can take some personal responsibility for exploring their options and not just resorting to frantic handwaving on the internet.


So I guess you missed [ixia]'s comment about sex without condoms being better for some women? And then you missed small ruminant's comment to the same effect?

Just in case it might have any effect on the "OMG! She secretly wants your baby!@!!" crowd, I can add a third woman's opinion that sex with condoms can frequently be unpleasant and sometimes painful. I hate the damn things.

OP, get educated about all the forms of birth control out there and TALK to your girlfriend about your options as a couple.
posted by Squeak Attack at 7:30 AM on August 2, 2008

There are issues here beyond (or at least in addition to) the question of safety and pregnancy.

You're 30, and you've never had sex without a condom. Good on you, but you it's time someone gave you a reality check.

As you get older (if you stay single), you are going to find yourself increasingly involved with women who are used to not using condoms in monogamous relationships. Your girlfriend, like many adults in this modern world, probably always assumed that at some point in your relationship, you would stop using them.

If you refuse, then she is going to wonder where the relationship is headed. She's going to wonder if you trust her. She is going to wonder if you are trying to put limits on your intimacy with her. When she tells her friends that her boyfriend insists on condoms, they are going to wonder the same thing. And ultimately, it is going to occur to her that the big wide world is full of guys who share her philosophy on this subject.

You absolutely have the right to continue using condoms every single time you have sex for the rest of your life, regardless of the circumstances. You also have the right to wear a propeller beanie. In either case, many people are going to not want to have sex with you.
posted by bingo at 7:47 AM on August 2, 2008 [2 favorites]

You definitely need to get tested. Although it sounds like you've been really into condoms in the past too from the tail end of your post, there's a pretty high chance you have HPV--it's the common cold of STDs in America--and don't know it. It's no big deal for men, but if you give it to your girlfriend she's going to have a higher risk of cervical cancer, which sucks. So get tested, and maybe she could get the HPV vaccine too (though it doesn't screen out all HPV).

This isn't sound medical advice, but you should also consider how often you do it (of course it only takes one time to get pregnant, but every time you do it is on more gamble), if she tends to want to do it more when she's in the super fertile part of her cycle (it's not PC to say this, but I've found the desire to get riskier and engage in more intimate sex on the girl end of things is often correlated to fertility peaks both menstrual cycle wise and life cycle fertility wise--is she between 25 and 30? She may subconsciously be trying to get pregnant--obviously not REALLY, but her body might be), and how precisely she uses her birth control pills. Pills are super easy to not take with perfect use. And remember, if she takes antibiotics anytime in the future, her pills will temporarily stop working.

If you stop using condoms you need to have had the pregnancy talk--if she got pregnant, how would you deal with it, etc. Be honest with each other. Ditto the STD talk.
posted by ifjuly at 8:10 AM on August 2, 2008


That's not quite true, but people telling these sorts of stories as if they are facts are a big part of why people can be reluctant to trust the pill. From the Mayo clinic:

The effects of antibiotics on birth control pills may be overstated — except in the case of one antibiotic, rifampin. Studies clearly show that rifampin decreases the effectiveness of birth control pills in preventing ovulation. However, rifampin isn't a widely used antibiotic. Chances are you wouldn't be taking it unless you had tuberculosis or had tested positive for the disease.

Hypothetically speaking, other antibiotics, particularly penicillin and tetracycline derivatives, could impair the effectiveness of birth control pills. However, no large studies have proved such an effect.

Researchers can't rule out the possibility that a small percentage of women may experience decreased effectiveness of birth control pills while taking an antibiotic. And if you're taking a newer, extremely low-dose oral contraceptive, you could be more susceptible to these potential effects from antibiotics. If you're concerned, consider using a barrier method of contraception for the duration of your antibiotic prescription.

So sure, you can choose to double up your protection and get that additional margin of safety, but it's not like taking an antibiotic flips a switch and causes the pill not to work.
posted by Forktine at 8:22 AM on August 2, 2008

Bingo's response is more in line with my thinking on this. From my personal experience, the sock is on the other foot, so to speak. One relationship comes to mind, where she was always fastidious about taking her pill as directed, but only relented on the CONDOMS ALWAYS plan if I promised to pull out first. My point is that the OP has every right to keep wearing a condom if that makes him more comfortable, but he might consider asking his S.O. why she trusts latex the OP can pick up (without a prescription) at convenience stores and drug stores, but doesn't easily trust medication prescribed by her doctor.
posted by emelenjr at 8:30 AM on August 2, 2008

There's a whole lot of denial in here about the consistency with which people take their medication. The terms of art for this are adherence and compliance, and people suck at it:

Among women using the patch, the percentage with perfect compliance was 88.7%, compared with 79.2% with the oral contraceptive. Perfect compliance rates were similar across all age groups with the patch but were reduced in younger subjects in the OC group.

16% of women have birth control pills left over at the end of the month
58% of women forget to take the birth control pill every day
72% of women do not take the birth control pill at the same time every day

Only one third of adolescents are properly taking prescribed birth control after one year.

And it's not just birth control:

Over the past 50 years, periods of intensive clinical and research interest in medication-taking have coincided with breakthroughs in drug development, such as antibiotics for infectious diseases in the 1950s, medications for hypertension in the 1960s and 1970s, and highly active antiretroviral therapy for HIV infection in the 1990s. Hundreds of studies have found that only 50% to 60% of patients consume their medications for chronic diseases as prescribed, yet intensive, multimodal interventions often only marginally improve medication-taking or therapeutic outcomes.

Of all patients who get a prescription, 24% either do not pick it up or don't begin using it.

Among those who begin taking their medication:
- For those with diabetes, the average adherence is 78.9%;
- For those with high blood pressure, the average adherence is 83.7%; and
- For those with high cholesterol, the average adherence is 84.7%.

Looking at it another way:
- For those with diabetes, 4 out of 10 patient comply less than 80% of the time;
- For those with high blood pressure, 3 out of 10 patient comply less than 80% of the time; and
- For those with high cholesterol, 3 out of 10 patient comply less than 80% of the time.

The real world outcome of people's real world medication-taking is unintended pregnancy for 8.7% of women on oral contraception.
posted by NortonDC at 8:30 AM on August 2, 2008 [6 favorites]

My recommendation, which I'm surprised to see hasn't been mentioned already, would be to try it once. (After you've both had STD testing, of course.)

If you're really, really worried about a possible pregnancy, try it in the day or two before she gets her period (since she's on the pill, you have a pretty good idea of when this would be) when she's least likely to be fertile.

If you feel uncomfortable and freak out that the pill isn't reliable enough as a form of birth control - go back to using condoms. Easy as that.

I'd also like to weigh in as a woman that sex without a condom does indeed feel quite different and yes, I prefer it au naturale.
posted by grapefruitmoon at 8:32 AM on August 2, 2008

For the flip side:
I've been married 14 years and have had un-protected sex the entire time, and my wife isn't on birth control.
We have 0 children. Apparently one of us is defective.
posted by whoda at 8:34 AM on August 2, 2008

Well that was dumb. I guess the one to ask about the trust issues is himself, not the S.O.
posted by emelenjr at 8:35 AM on August 2, 2008

If you are putting your sperm into another person, you both should be prepared for what to do in the event of pregnancy. The pill is very effective, except when it's not.
posted by Rock Steady at 9:01 AM on August 2, 2008

I don't think it's a bad idea to use two forms of contraception. Maybe you can talk to your girlfriend about using a spermicide OR (and I suspect this will be an unpopular suggestion) you can try withdrawal in addition to birth control pills.

Now, I know, I know that withdrawal isn't a really valid birth control method on its own. However, it does let you contribute to the contraceptive process, and makes it even less statistically likely that she'll get pregnant when combined with the pill. It can be tricky at first to have the self control, but--speaking from years of experience (I have a really really bad physical reaction to my partner's semen--it burns!) you do get used to it after awhile. Plus, delaying prolongs the lovemaking experience. All that jazz. Obviously, YMMV.
posted by PhoBWanKenobi at 9:21 AM on August 2, 2008

Yes you are being paranoid. It's weird to use a condom when you are in a actual relationship with a woman who is on the pill. Sex without a condom feels better for both parties, and there is evidence that sperm has anti-depressant effects that she may be missing from her previous relationship.
posted by w0mbat at 10:09 AM on August 2, 2008

I'm another IUD fan. They're really not discussed enough as an option alongside the pill. It ends up being cheaper than the pill over the life of the IUD (5+ years depending on type)- I got Kaiser to pay for my Mirena IUD, and now I don't pay $10/mo x 12 mo x 5 years for my pill. That means I'm saving $600.
They also drastically shorten your periods, and most importantly for the poster, they're MUCH more effective than the pill and just about the most effective birth control out there, aside from total abstinence.
There is really no distinction between typical failure rate and perfect use failure rate with an IUD, because it doesn't depend on the woman remembering a pill or patch or whatever. Mirena, the hormonal IUD, claims that less than 1 in 1000 women will get pregnant while using it. The biggest risk of an "accident" with the IUD is if it becomes dislodged from the uterus, but it's always possible for the woman to check it to see if it's still in place. Make sure your girlfriend at least knows about this as an option. It might put you both more at ease, and the perks for her might be reason enough to switch.
posted by slow graffiti at 10:14 AM on August 2, 2008


What's so terrible about suggesting that a lot of women don't use the pill perfectly? It's not misogynistic to say that people are forgetful, and that combined with "taking a pill every day around the same time"... I've forgotten many times, and a quick poll of many of my female friends says they have, too. NortonDC's data support this.

The point is, maybe this women does maybe she doesn't. We don't know anything about her, really. We're just urging the OP to take that into consideration.
posted by Solon and Thanks at 11:16 AM on August 2, 2008 [1 favorite]

If you're not comfortable, keep using condoms. You have every right to say no without a negative consequence. It's your body, it's your decision, and if I were a guy I would wear a condom every single time unless I was actively trying for a pregnancy to begin. As others have said: once that sperm leaves your body, you have zero control over what happens next.

I wish you'd mentioned why she's asked you to stop! I don't like condoms at all, but it comes across as strange to me that it would be a direct request. The idea that she's probably trying to get pregnant crossed my mind, and while I know that's wrong, if you think that's at all possible and you don't want that to happen, you know what to do.

Good luck.
posted by saturnine at 12:16 PM on August 2, 2008 [2 favorites]

I think schroedinger has it right. I haven't followed the male birth control pill progress, so I don't know where science is at with that. But, I know that if it was available I would be very happy that there was something that my (currently non-existent) boyfriend could take to prevent conception, BUT I would CONTINUE to use whatever form of contraception I had selected for myself.

If a woman doesn't want to get pregnant, she should use pills, iuds, etc, whatever form is available to her.

AND if a man doesn't want to become 'pregnant', he should do the same.

In a perfect world, there would be a perfect female contraceptive and a perfect male contraceptive, fool-proof, free of side effects. And both the guy and the girl would take their own contraceptives if they weren't ready to conceive.

Like launching a missile. No baby unless both partners turn their keys. His girlfriend is asking him to turn his key, saying don't worry, my key will stay locked forever. Maybe, probably, it will. BUT if not, he has to be able to accept the consequences, or he shouldn't turn his key.

If the gender roles were reversed, and my (still currently non-existent) boyfriend told me to go ahead and turn my key cause he's got it covered, I'd say NO way.
posted by marsha56 at 2:25 PM on August 2, 2008 [2 favorites]

His body, his choice. Let's not forget some antibiotics interfere with "The Pill". Also, if she has absorbance issues be careful (i.e. vomiting, diarrhea) it could be a concern.
posted by 6:1 at 2:31 PM on August 2, 2008

I think for the sake of the original asker, it'd be more helpful to debate the implied misogyny of some of the answers on MeTa.
posted by grapefruitmoon at 4:01 PM on August 2, 2008

nthing it would help to know why she's asking, and what kind of condoms are being used.

See, I have a significant ouchie-making allergy to nonoxynol-9. I am fine with unlubed ones and using a non-nonox lube, but I could understand asking to stop using them if I felt like the relationship was stable and my birth control issues were ironed out (but obvs IANYGF so I don't know what she's thinking, and also I have an IUD).
posted by catlet at 4:04 PM on August 2, 2008

[a few comments that were more argue than advice removed - please take fightiness to metatalk, thank you]
posted by jessamyn at 4:06 PM on August 2, 2008


Seconding that irritation from nonoxnol-9 is really, really, really common for women.

As for her wanting to quit with the condoms -- I think it's perfectly fair for her to think that two forms of birth control are unnecessary. Why go to all the trouble to consistently take the pill to prevent pregnancy and still have to put up with residual latex-taste during oral sex?
posted by desuetude at 4:34 PM on August 2, 2008 [2 favorites]

If the worry is pregnancy and not STDs, you could take low doses of Nifedipine (a calcium channel blocker) to reduce your sperm fertility levels, in addition to her birth control pills.

Personally, this is what I'd do.
posted by Auden at 10:34 PM on August 2, 2008

Condoms are, without a doubt, the crudest and most cumbersome form of birth control. If condoms are half as stifling for women as they are for men, you're being blatantly insensitive by using them on her when she doesn't want it. I'd personally use abstinence before I'd slog through condom sex.

If you're worried about STDs with your partner, a condom is a pitifully weak attempt at protection anyway. If you're worried that she will make you a father against your will in the event of an accident, don't wait: run away right now.
posted by mullingitover at 2:25 PM on August 4, 2008

I have twin daughters conceived while MrsBucket was on the pill. I also have a sister conceived while my parents were using the pill plus condoms.
posted by EarBucket at 2:32 PM on August 4, 2008

I'm your age, 30, and I've never had sex (with a male) without a condom. And I've had a lot of sex. Your age should have no bearing on your (very good) instincts. And I'm really surprised to see how many people in this thread aren't respecting your instinct. (I strongly agree with the people who've mentioned that if the genders were reversed [if you were a female whose male partner were pressuring her to not use condoms as a backup for hormonal birth control], you'd most likely be getting a heck of a lot more support.)

It's your body, your fertility, your right.
posted by kalapierson at 7:25 AM on August 5, 2008 [2 favorites]

posted by EarBucket at 4:32 PM on August 4

I'm not saying you are lying, but do you know how statistically unlikely that is? Given the failure rates of both, and the (relatively) few hours per month a woman is actually fertile, you are well into 1-in-hundreds of thousands chances.

It is more likely that a family legend has cropped up around your sister's conception. They probably were using both, except for those times your mother (like most humans, see above) didn't take the pill for a few days, and your dad was out and the pharmacy was closed but what they hey you're on the pill, right?

The only reason I mention this is that little anecdotes like that go a long way towards both frightening people who are being responsible, along with giving firepower to those who want to push abstinence only programs for youth.
posted by Ynoxas at 9:42 PM on August 5, 2008

I dunno if it's cool to pressure him that "it's time you go bareback, you're old enough to," etc. If he's freaked enough to want to keep using them for whatever reason (note all the stories of surprise STD's that you can't test well enough for, even if the pill is reliably taken), then girlfriend can suck it up, I think. I wouldn't in good conscience tell a guy to go bareback if he isn't comfortable- it's not like there's any other option for him for birth control/STD protection at once here.
posted by jenfullmoon at 11:09 PM on August 5, 2008

ok so, this is a week late, but I couldn't resist. Why hasn't anyone suggested trying a different brand or type of condom? I know you never specified why she wants to stop using them, but it might be that she finds them uncomfortable. I understand that. I don't really like them either. However, I have noticed a significant difference between various brands. If you don't want to stop using them (and she's still willing to stay in a sexual relationship while using them) than maybe suggest a sample pack or other method of testing out varieties to find something more mutually satisfying.
Also, before my husband and I agreed we were both comfortable relying on my patch alone (except when on antibiotics) I was definitely the one pushing condomless sex. I think I really resented paying every month for BC (which my Dr recommended as fine without condoms) and still using both. I agree with everyone saying do what you're comfortable doing; but please also consider her comfort as well.
That said... condoms make clean up a lot easier.
posted by purpletangerine at 7:06 AM on August 12, 2008

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