A: From what you are describing it would appear that your IUD is performing as it is intended. The Mirena IUD releases hormones into your uterus that are designed to reduce the amount of bleeding during a woman’s menstrual period in addition to preventing pregnancy. The reduction may not be 100%. If you are concerned or have any questions regarding your experience we recommend you discuss this with your physician directly as SFSI does not make medical diagnosis or substitute for medical professionals in any way.

Hope this helps. You can read up on it more on the Mirena website.

A: The withdrawal method works by keeping sperm out of the vagina. Very few (if any) sperm are contained in pre-cum, and none if he pees before sex. The only way you can get pregnant is if sperm gets inside you. So if your sex partner pulls out before ejaculation every single time you have sex, the withdrawal method is actually pretty effective as a form of birth control. However, if your sex partner forgets, gets carried away and doesn’t pull out, or only pulls out halfway through ejaculation, that’s when this method becomes ineffective. The withdrawal method relies upon your sex partner having good self-control and always remembering to pull out–and sometimes people make mistakes. Also, if you’re having unprotected sex you’re still at risk for STDs even he doesn’t ejaculate inside you.

A: The size of your body and the size of your vagina shouldn’t affect how hard it is to put the IUD in – it’s the size of your cervical opening that counts. Since you haven’t had children, chances are it’s small, but not impossible to put in. There is a new practice some doctors are doing now that can be very helpful – using a vaginal suppository of Mifepristone 24 hours before the procedure to dilate the cervix. Then by the time you go in, your cervix is as dilated as it can get and there is less cramping.

Having an IUD in should not be painful when having sex, although you may have some discomfort in the first few weeks to 1 month. After about a month if you can still feel it during sex, you should go back to your doctor and have it checked.

The IUD should not move from its position at all, no matter what activity you do. You should check the strings once a month to make sure it’s still there, but otherwise you won’t notice it at all.

In women who haven’t had children, it’s sometimes harder to put in initially, but the chances of it being expelled (generally during your period in the first few months) are very low.

Other things to know about the IUD: you generally have to schedule 3 visits: 1 to check for pregnancy and STDs, 1 to put it in, and a follow-up; you can have it in for up to 5 years, but it can be removed at any time up to then by your doctor. Also, if you’re concerned about hormones at all, there is a non-hormonal IUD available too, called Paragard.

There are a lot more answers on Mirena’s website.

A: Studies done on the subject put the average condom breakage rate at about 2% and user error accounts for most broken condoms rather that faulty condom construction.

It sounds like you are putting your condoms on correctly. We’re assuming that you don’t have sharp nails or somehow rip the condom (like opening the package with your teeth), but that could be a reason for breakage. Condom breakage could be due to several things, including the reason you mentioned. So, a few big questions to consider include:

Are you using a water based lubricant?
How much time are you doing active penetration/vigorous thrusting with a condom?
Where are you storing your condoms?
How old are your condoms?
How are you opening your condoms?

Family Health International has an interesting article on breakage and slippage of male condoms.

It could be that you’re not using enough lube or that you are using the wrong kind of lubrication. For instance, if you are using a latex condom with an oil-based lubricant, that will definitely break down the latex of the condom. There is a great website you could visit for all things condom; it’s www.condomania.com (and they also have a size guide there). Notice also that when you click on Lubes at the Condomania site, they don’t even have a listing for oil-based lubricants. That’s because oil breaks down latex.

There could be other reasons for the breakage including that you don’t have the right size condom for you, or the expiration date for the condom has passed, or the condom has been exposed to heat.

A: We agree with MTSS and do not recommend the use of condoms with Nonoxynol-9. It can cause irritation which can let viruses such as herpes, HIV and other STD’s enter the body more easily. This is a concern for both men and women. Our recommendation is using condoms without Nonoxynol-9.

You can find more information on WebMD and Gaylife.about.com.

For my peace of mind, is it really okay to go without condoms for the few weeks per month that I’m safely protected by birth control? Am I probably good to go? I’m sure most couples in our situation are fine, but just to calm me down, I’d love to get a “yes, go for it!” (or a “no way”) from people who know this sort of thing and are not going to feed me the same line about how my NuvaRing doesn’t protect against STIs and blah blah blah, because I know all that already!

A: Unfortunately, this is still a decision you’ll have to make for yourself. Many couples who are not concerned about STIs decide to stop using condoms when birth control is being used. Like most hormonal birth control, the NuvaRing is about 99% effective when used correctly. That means that per year, about 1 out of 100 women using the ring will become pregnant. In addition, as long as you are using the ring according to instructions, you are protected from pregnancy throughout the month. It is not required to use a backup method during the week that you remove the ring.

Here are some websites with more information about the ring. You can also contact your medical provider or pharmacist for more information.
NuvaRing Website
Planned Parenthood on the NuvaRing

You’ll have to decide if relying on your birth control alone would make you worry so much that it would affect your quality of life. You may also want to consider what you would do if you did happen to get pregnant. You may decide that an unintended pregnancy is not something you want to deal with right now, or you may decide that you could handle it just fine in the unlikely event that it happens.

A: We did some research about taking Aviane, and what we did find about the pill is that there is a certain amount of breakthrough bleeding during the first three months while you taking it. It says that if the bleeding continues or is heavy in any way that you need to contact your doctor. Also, we thought you should know also that you do need back up contraceptives during the first three months also while taking Aviane. It might be good if you used condoms and foam for the next couple months to prevent pregnancy. If you are still concerned please go to the clinic where you got the Aviane or to another clinic or doctor.

A: Thanks for sending us your question; we’re glad you’re taking the time to ask and learn a bit more about sex and the risk of pregnancy. While we can’t tell you for sure whether your girlfriend will get pregnant or not, we can tell you what to look for over the next few weeks. Anytime you put your penis inside your girlfriend’s vagina there’s a risk she will get pregnant, no matter whether you plan to pull out, or whether you wipe semen off your penis before you put it back in. But overall, the risk of pregnancy from a single sexual encounter isn’t all that high; it’s your long-term habits that count.

If your girlfriend has gotten pregnant, she may not have any symptoms for a while. She may not even miss her period; some women get a light period a couple weeks after they get pregnant. But many women begin to feel nausea and will miss their periods, so keep an eye out for those symptoms. If you want to be sure, buy a home pregnancy test. The earliest you can take it is a week after her next period, or after she misses her next period, depending on the pregnancy test. Make sure to read the instructions.

It sounds like this whole experience made you feel anxious about the possibility of pregnancy, so we want give you some information to help you decide if you want to use a birth control method in the future. After all, some activities are riskier than others. The highest risk is if you ejaculate inside, but pulling out, like you did, offers some protection. Over time, though, there is still a fairly substantial risk of pregnancy. For your typical couple using the withdrawal method (pulling out), there’s a one in four chance of getting pregnant over the course of one year. You can lower your risk if you use some sort of protection. A condom, for a typical couple, will give a one in ten chance of getting pregnant, and hormonal methods, such as the Pill, will give a one in fifty chance or lower.