Dear Sexpert,

My boyfriend and I have been have been having sex pretty regularly recently. He’s super great and caring and usually I think we are being pretty safe. He’s pretty good at pulling out, but last time he finished before he could! I’m kind of freaking out, how will I know if I’m pregnant?

–Insemin-Afraid

Dear Insemin-Afraid,

I’m happy that you and your boyfriend have a caring relationship and are enjoying each other sexually. You say you are being “pretty safe”, but that caveat leaves room for a range of risks. Pregnancy is only one of the risks that come with having sex; there are also sexually transmitted infections (STIs).  STIs are types of bacteria, viruses, or parasites that are transmitted during sexual contact. They can be transmitted via bodily fluids or via skin-to-skin contact. The bodily fluids include not just semen, vaginal fluids and blood, but also saliva.

While there is no such thing as 100% safe sex (except abstinence), there are safer practices that can reduce your risks, and some are more effective than others. When always done correctly, withdrawal or “pulling out” has a 96% success rate at protecting against pregnancy, but reduces to 78% when not always done correctly.  Its success rate is lower than using an external condom (99%) or other birth control methods (e.g., pill, implant, IUD) and it does not protect you from STIs.  However, to prevent pregnancy alone, you have a variety of options. These range from hormonal pills you can take daily to a small plastic device (IUD) that is inserted into your vagina and can prevent pregnancy for up to 12 years! However, only external and internal condoms can protect you from both pregnancy and STIs.

Because you are primarily concerned with pregnancy, let me say that the signs and likelihood of being pregnant can vary from person to person.  For example, your chances of being pregnant are significantly higher if unprotected sex occurred while you were ovulating, or midway through your menstrual cycle. Everyone is different and the way your body responds could be different from other’s experiences. Typically, women don’t experience symptoms of being pregnant until the second or third week of pregnancy.

A common misconception is that you will completely miss a period. While you will not have a real menstrual cycle after becoming pregnant, some of the initial signs that many women experience are spotting and cramping when the egg attaches itself to the wall of the uterus. That being said, if you do miss a period, not all missed or delayed periods are caused by pregnancy. It could be caused by stress, a thyroid condition, significant weight change, or medication, to name a few.  By the fifth week, most people begin to experience some of the stereotypical telltale signs of pregnancy such as fatigue, nausea or morning sickness, aching breasts, and mood swings due to changes in your hormones. If you want to have answers sooner, consider talking a pregnancy test. The results are typically accurate and can detect pregnancy as early as a week after unprotected sex.

To explore  your options or confirm pregnancy, make an appointment with Sexual Health and Wellness at UHS. The clinicians can provide you individualized information and help you figure out the next steps. If this was a recent event, going soon is very important because it keeps your number of options high. Additionally, the clinicians can answer any further questions you may have about practicing safer sex for the future.

Stay safe

~The Sexpert

Sources referenced include Centers for Disease Control and Prevention, Bedsider, and HealthLine.