I am afraid that there might have been some pre-ejaculate fluid before the condom was put on. Do I need emergency contraception? #208/11

My boyfriend and I use condoms every time we have sex, but sometimes we start without the condom for about 5 minutes and then he puts a condom on and we continue. That wasn’t a problem before, because he usually lasts about half an hour and sometimes even longer.  But last night he ejaculated right after I got up and went to get a condom and I’m afraid that he might have had precum. which he didn’t feel. Problem is, I’m in my fertile days. 


I’ve made 2 ovulation tests and they both show a very light second line. Which means my ovulation is due the next 2-3 days. I know sperm can survive a few days in the body, so I’m very stressed.  Should I use emergency contraception, even if he did not ejaculate inside me?



 

Emergency contraception might be wise, although your risk for pregnancy is very low.

 

You had sex using withdrawal in the time of your cycle when ovulation was most likely to occur.  Your chance of becoming pregnant is not known, but is most likely less than 1%. 

 

Your chance of pregnancy would fall to about 1 in 1,000 if you have ParaGard IUD inserted.  Today, 2/21/2011, and for the next 4-5 days you could have a ParaGard IUD inserted.  Below is a bit more information about this:

                                                           
                 ParaGard IUD

1.    So, in a quiet moment ask yourself how disruptive an unwanted pregnancy would be to your life

2.    And then consider the following 2 cases and the approach of the clinician below who routinely urges all women thinking about emergency contraceptive PILLS also to consider an emergency contraceptive IUD:

3.    Your risk of pregnancy after using emergency contraceptive pills is about 1 in 100.  If you wanted to lower this risk, you could go get a copper T IUD inserted and this would lower your risk of pregnancy to about 1 in 1,000 AND THEN YOU COULD CONTINUE TO USE THE IUD FOR CONTRACEPTION FOR AT LEAST 10 YEARS. 


Could you possibly become pregnant? Well, it is unlikely.  About 1% as I noted above, as you have been perfect in your response to this emergency in terms of emergency contraceptive pills. 

 

Here is something I wrote up to discuss the 2 emergency contraceptive approaches.  Please read this carefully thinking of what an unintended pregnancy would mean to you right now in your life:

 

When a woman has had intercourse and she is concerned that there is a chance of pregnancy she can use one of 2 approaches to emergency contraception. She can take emergency contraceptive pills.  She has about 5 days from her most recent unprotected intercourse to do this. Then her risk of pregnancy from one unprotected act of intercourse falls to about 1 in 100. If she uses Plan B she should take them as soon as possible and take both Plan B tabs at once.

 

A more effective approach would be to have a copper IUD inserted within 7 days of unprotected sex.  If she does this, the chance of pregnancy is just 1 in 1,000 AND SHE WILL THEN HAVE IN HER UTERUS AN EXTREMELY EFFECTIVE CONTRACEPTIVE AND A FULLY REVERSIBLE CONTRACEPTIVE THAT SHE CAN USE FOR 10 OR MORE YEARS.

 

Below are 2 examples of emergency copper T 380 A insertions (ParaGard insertions) for women who have had recent unprotected intercourse.  They are the 80th and 81st insertions by the same nurse practitioner in Charlotte, North Carolina


Case #80: A 22 year-old who has been pregnant once, having had an abortion (G-1 P-0 A-1). She had the termination on 2-1-08. The clinic did not start her on a birth control method after the procedure because her blood pressure was “too high”. She had used Depo-Provera injections in the past but gained too much weight. Her BMI is 34 (very overweight!) Her BP yesterday was 118/84. She was contemplating using the NuvaRing. She had unprotected sex 3/15/08 and did not know about emergency contraception. She also had had unprotected sex prior to 3/15 with no bleeding after the 2-3 wks. of bleeding from the procedure. Her pregnancy test was negative. She informed us that she “never wanted to be pregnant”. On exam, she had an apical pulse of 64/m and a very irregular heart beat without murmur or extra sounds. She had no prior history of heart problems. When I questioned her about activity she admitted that sometimes she got dizzy if she stood for a while and if she climbed steps. No history of syncope on exertion. I reviewed the range of birth control options, Emergency Contraception with Plan B and emergency contraception using a ParaGard IUD. She wanted Emergency Contraception and an ongoing birth control method that would protect her after leaving the clinic. She chose ParaGard. I referred her to an ambulatory care clinic where they will follow up on the arrhythmia.
Happy Camper # 80!


Case #81: 23 yr. old presented to our family planning clinic for initial exam on March 20, 2008. She had been pregnant 4 times, having had 3 abortions and she has on living child (G-4 A-3 L-1). Her last normal menstrual period was on March 10, 2008. She was not using a contraceptive method and was considering Depo-Provera injections or an IUD. Her last unprotected sex was March 18 (2 days previously). She did not know about Emergency Contraception. After reviewing her options for both Emergency Contraception and ongoing birth control she chose the ParaGard IUD.
Happy Camper # 81!


Good luck to you and
be sure to let me know:

a) whether you are at all interested in having a copper T IUD inserted

 

b) what happens in 2 weeks with regard to your period or pregnancy test(s)

 

To learn more about the advantages and disadvantages of the ParaGard IUD, go to our website: www.managingcontraception.com and click on Choices 2013 edition.  You can also order this wonderful new educational book from our website or by calling 404-875-5001.  Do you have your copy yet?  It is now available in English and Spanish.

 
                        

                                                                                                                                                         

Key Words:  condoms, sex, problem, ejaculated, withdrawal, precum, fertile days, ovulation tests, sperm, pregnant, stressed, emergency contraception, risk, low, reproductive years, vaginal intercourse, ParaGard IUD, disruptive, contraceptive pills

 

Skills

Posted on

September 11, 2014