“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 infestions (STIs), 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.
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 STIs. 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 STIs, 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.
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 STIs. 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 STIs are made of latex and fit over the penis.
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.”
- “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.”
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 have 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
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.
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 (including brands like Plan B One-Step, My Way, Next Choice, or Ella). A doctor needs to put the IUD in the uterus. You’ll have to act fast — within five days of unprotected sex.
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. Ask your doctor’s advice when you 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.
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.
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