Category Archives: Pregnancy

Communication, Contraception, Pregnancy, Relationships

Mistake Maker: Establishing boundaries in friendship

Dear Sexpert,

Last weekend, I hooked up with my friend, and now things are super awkward since they want to keep seeing each other. I really value this friendship, but I’m not looking for anything more right now and just want to be friends. How do I navigate this situation without ruining our friendship? 

— Mistake Maker 

Dear Student,

Navigating a friendship after a sexual encounter can definitely be challenging. It is natural to think that you may want “more,” and then eventually realize that you want a relationship to be platonic — or vice versa. Since you seem to be clear on what you do want (i.e., just friends), it is important to effectively and respectfully communicate with your friend, and do so soon. Leaving things unsaid or not engaging in an honest discussion can hurt your friendship.  

Before having that conversation, make sure you are certain about what you want. Sex involves feelings. Intimacy from physical touch or emotional connection triggers the hormone oxytocin, which can lead to feelings of attachment, even if unintended. It is normal to feel confused by conflicting emotions.

To address things with your friend, start by acknowledging what happened, and be reassuring. For example, you might say something like “Hey, I’ve been thinking about what happened last weekend, and I wanted to talk about it because I really value our friendship and I wouldn’t want anything to jeopardize that.” 

Clearly communicating how you feel about the situation is crucial, but so is making sure that you are not intentionally hurtful. Try to balance making it clear that you aren’t looking for anything more at this moment with the importance of your friendship. Emphasize that your feelings about the friendship haven’t changed and that you’d like to continue hanging out as friends. Be sure to give them space to share their feelings as well, and understand that it might take a bit of time before the friendship feels completely normal. 

While it may not be ideal to you, ease into the idea that maintaining your friendship may not be possible. Process through those feelings on your own or with a neutral party, such as a counselor. Just as you expect them to respect your wishes to just be friends, you may have to accept their disappointment or desire to no longer be friends. 

Hopefully, you engaged in safer sex by using contraception and/or barrier methods. If not, there are still ways to maintain your sexual health and wellness. 

Let’s say you did practice safer sex by using contraception and/or barrier methods, remember that even with protection, maintaining regular sexual health check-ups is still important! Consistent testing and communication are key to staying informed about your status and ensuring your long-term health and wellness. While it is better to have conversations related to sexual health before engaging in sexual activities, you can know your status and reduce the spread of sexually transmitted infections (STIs) by getting tested. STI testing recommendations vary and depend on multiple factors, including behavioral and identity-based risks. 

Finding out more about whether you need testing is a smart decision, and you should not feel embarrassed about it. Your MyUHS online portal features an online STI screening program for asymptomatic testing, designed to include evidence-based educational information and enable you to make an informed decision about the type of testing you wish to pursue. It also lets you schedule collection at a time that is convenient for you. Additionally, this testing is confidential, so you do not have to be concerned with other individuals, such as your family, finding out from UHS.

Depending on whether pregnancy prevention is a relevant concern, if you did not use contraception or remain uncertain, you and/or your friend are likely outside of the window of emergency contraception being effective. Pregnancy testing is also available at UHS. If you’d like to discuss ongoing contraception options that provide reliable protection without requiring preparation each time, consider meeting with a Sexual Health and Wellness clinician at UHS. They can help you find the method that best fits your needs and lifestyle, ensuring you feel informed and confident in your choice.

Lastly, if you both decide to maintain the friendship, it would benefit you to discuss boundaries moving forward. Will you discuss your romantic or sexual relationships with one another? What types of physical touch are okay? Maybe ease back into the friendship in group social settings only, rather than one-on-one. Depending on the circumstances of the initial hookup, try to avoid similar circumstances.

Good luck with honoring your needs and wants in your conversation, and remember to respect your friend’s feelings as well while navigating this sensitive situation. 

— The Sexpert

Information provided by University Health Services and Harvard Health. 

Contraception, Pregnancy, STDs/STIs

Summer Fling Seeker: Maintaining sexual health during the summer

Dear Sexpert,

I’ve been using McCosh’s services to remain diligent about my sexual health and have gotten used to the easy, accessible resources on campus. I’m going home for the summer in a few weeks, and I am worried about accessing resources at home, especially without my parents knowing about it. My home state is also extremely strict about abortions, and while I don’t plan to get pregnant, unwanted pregnancies could still happen and I’m not in a place to have a child right now. I could use some guidance regarding this matter.

Sincerely,
Summer Fling Seeker

Dear Summer Fling Seeker, 

Planning ahead and being cautious are certainly important goals! If you intend to be sexually active this summer — especially if you are engaging with new or multiple sexual partners, it is a good idea to have a plan in place to continue practicing safer sex. It’s also great that you’ve been able to take advantage of the services at McCosh while on campus. If you already have a provider at McCosh who you are comfortable with, you can message your provider through your MyUHS portal with non-urgent questions throughout the summer. They may also assist in getting you connected to resources near you. However, this should not be used for urgent or immediate care concerns or services.

If you are not connected with a care provider at home, Planned Parenthood has clinical locations across most of the United States. These clinics offer sexually-transmitted infection (STI) testing, contraception, physical examinations, consultations, pregnancy testing and prenatal services, abortion care, and sex education. Your local pharmacy may also offer consultations, evaluations, STI and pregnancy testing, and vaccinations or treatments, as needed. 

You note being concerned about unwanted pregnancies. If you do not have a consistent or reliable contraception method, consider making an appointment at McCosh with Sexual Health and Wellness (SHAW) to explore your options before your departure from campus. There are a ton of different methods — hormonal, non-hormonal, daily use, or ones that last years once inserted. Remember that external and internal condoms also prevent STIs, in addition to pregnancy.

Even with these options, no method  is 100 percent foolproof, other than abstinence. Should you suspect a pregnancy, it can be more cost efficient to get a test at a Planned Parenthood location (since they accept insurance or offer a sliding scale fee, if paying out-of-pocket) than to pick up an at-home testing at a pharmacy. But at-home testing does ensure more privacy. Just keep in mind that if you are on your family’s insurance plan and use it, an explanation of benefits (EOB) may be mailed to the policy holder. Learn about some strategies to navigate this.

If you find yourself pregnant and want to explore your options, you may want to learn more about state laws and restrictions (e.g., ultrasound and waiting period requirement, parental consent or notification) to know more about your options, including what you could expect at a provider’s office. You can also look to any of these resources for supportive talk or text lines regarding options to navigate pregnancy. Additionally, Hey Jane is a startup that connects menstruating people to healthcare providers who can educate and prescribe contraceptives and abortion medication. This company caters to those who are less than 10 weeks pregnant and over 18 years old, and in the states Calif., Colo., Conn., Ill., Md., N.J., N.M., N.Y. and Wash. (which may not be applicable to your situation). This service is private and will work with you to financially support your decision. Plan C is another resource that has up-to-date information about accessing at-home abortion pills. More than 54% of abortions in the United States are medication abortions, and they are often chosen over surgical abortions because of the desire for privacy.

Taking preventive measures to maintain your sexual health is incredibly important for your overall well-being, as well as to avoid STIs and unwanted pregnancies. Using condoms and other forms of contraception are the easiest ways to stay diligent about this, but the only way to definitively prevent STIs and unwanted pregnancies is practicing abstinence. If you choose to be sexually active, make sure you are on top of your self-protective behaviors, know your options, and can get connected to care. 

Stay safe,

The Sexpert

Information for this article is provided by the Guttmacher Institute, Plan C, Hey Jane, Bedsider and Reproductive Rights.

Masturbation, Personal Health & Hygiene, Pregnancy

Risky Business: Consuming Ejaculation

Dear Sexpert,

I hang around in the evening with friends and we sometimes have some beer. We were hanging recently and we all got a McDonald’s. I was with three guys and we were fooling about and they ejaculated into a shake and got me to drink it. I was like Eew at first but when I started drinking it I quite liked that they were all focused on watching me and the attention I got. I couldn’t taste their stuff and it was fine. Is this risky? I’m guessing they may want to try it again soon.

 -Risky Business

Dear Risky Business,

Let me start out by saying there’s no single definition as to what “risky” sexual behavior is. For example, risk can refer to the likelihood of getting pregnant or contracting a sexually transmitted infection (STI), your personal safety during an encounter, your comfort level and how close the encounter came to any personal boundaries you may have, or to potential social or interpersonal impacts of a sexual encounter. Additionally, some sexual activities can be legally risky or illegal. While legality, and the risk of getting pregnant or contracting an STI can be somewhat objectively interpreted (through the known effectiveness of different types of contraception and knowledge of your partners’ and your own sexual history and STI test results), your comfort and safety regarding a sexual encounter have to be interpreted through your own feelings. Let’s address each aspect of risk of your encounter in turn, but remember that many of the aspects solely rely on what you want to do sexually, and what you consent to.

First, you cannot become pregnant through drinking ejaculate (or through oral sex, for that matter). However, you can still contract STIs through contact with bodily fluids (i.e., blood, semen, vaginal fluid). Many of the most commonly spread STIs, including gonorrhea, chlamydia, and herpes, can be spread through oral contact with ejaculate. Without knowing the STI statuses of your friends, you were potentially incurring risk for STI transmission. Engaging in oral play is safer with use of barrier methods (e.g., condoms) and/or confirming negative STI status of partners involved.

Consent by all parties, and trust that your partner(s) will abide by the limits of your consent, is crucial for any sexual encounter. Consent must be affirmative (“yes, I want to do this with you”), specific (“I want to do ___ with you, but not ___”), ongoing (“I am still okay with what we’re doing”), and uncoerced. If someone pressures you to do something until you give in, that is not consent freely given. Additionally, if someone is incapacitated (due to drugs, alcohol, or mental or physical incapacitation), they cannot give consent. By your description of the encounter, it is unclear whether you fully consented to the activity, or may have felt pressured into it. You said that you were initially uncomfortable with it and it also sounds like you had not discussed ahead of time what you were going to do, and what you were comfortable with. If this is the case, it could suggest that future encounters with these friends are risky in the sense that they may again not listen to and respect your wishes. I encourage you to reflect upon how much you trust them, and whether you are comfortable with what happened and/or feel confident that you can be honest with them in the future about your boundaries.

Legality also factors into the risk of this experience. From your question, it sounds like you may still have been near the McDonald’s and in public when this occurred. In many states, including New Jersey, public sex acts are considered misdemeanors, and depending on the state and manner of the offense, they can count as sex crimes. It’s legally risky to have any kind of sexual encounter, including exposing one’s genitals, in public (N.J.R.S. 2C:14-4). As well, if you were drinking beer in public, this violates restrictions on public consumption of alcohol, and also underage drinking laws if you or any of your friends are under 21. If you were in a car at the time, it is also illegal to have an open container in a motor vehicle, and it is dangerous (and depending on age and level of impairment, possibly illegal) for anyone to drive after consuming alcohol. Finally, keep in mind that consent requires full competence; people who have been drinking to the point of incapacitation cannot consent.

Finally, it’s important for you to think about what exactly about your encounter you liked, and whether you want to repeat it. It sounds like you may have liked the way your encounter made you feel (paid attention to) more than you liked the encounter itself. If this is the case, consider whether you were actually happy and comfortable with what you did, or whether you were only comfortable with it because it had an emotional pay off. Doing things you’re not comfortable with sexually for an emotional payoff may leave you feeling cheated if you do the act and don’t get the reward. Don’t be afraid to consider other things that may make you feel the same way, like planning an event for your friends or finding another outlet for social exploration.

There is no sexual activity that is ultimately “good” or “bad”, but each has varying risks associated with it. In the case you described, there are many possible risks: contracting an STI, engaging in illegal acts, and/or of having your consent or boundaries violated. However, all of these can be prevented or addressed with some forethought. Consider the questions posed in this article, and if you still want to talk to someone about your sexual health, your feelings surrounding sex, or your thoughts on your emotional and physical needs, you can make an appointment with a counselor at Counseling & Psychological Services (CPS). McCosh Health Center also has STI testing, or can refer you to an outside testing facility for any of your friends that may not be students.

Best wishes,

The Sexpert

Information for this article provided by UK’s National Health Service and NJ State Legislature.

Contraception, Pregnancy

Forgetful

Hi Sexpert;

I’ve been on birth control the past 2 weeks, being new to it, I’ve either missed a day or taken them hours late numerous times. I’ve had unprotected/no pull-out sex about 5 times this week, including today which was my original ovulation day (before I started BC), am I at risk for pregnancy?

-Forgetful

Dear Forgetful;

Thank you so much for your question! With our busy lives, forgetting to take an oral contraceptive method of birth control (i.e., the pill) happens to lots of people. It is great that you are making efforts to reduce your risk of pregnancy by using contraception; however, not taking it consistently while engaging in unprotected penetrative sex can increase your risk of becoming pregnant.

Birth control pills like many other forms of contraception are not 100% effective at preventing pregnancy. If you use birth control pills perfectly, meaning that you take it every day at the same time, it is over 99% effective. In reality, the pill is 91% effective because people are not perfect and forget to take or miss pills. If you forget to take the pill more than two days, the chance of ovulation (when a mature egg is released from the ovary and has the potential for fertilization) increases, meaning your risk of getting pregnant also increases.

How soon birth control takes effect after starting it depends on what kind of birth control you take. Combination pills (containing estrogen and progestin) can take anywhere from five to seven days after the first dose to become effective depending on when you begin taking the pill. Progestin-only pills, also known as mini pills, are effective after two days of starting the pill. During this time, it is best to use a second form of contraception such as an internal or external condom to prevent pregnancy. Progestin-only pills are really most effective if you take them at the same time every day. If you take the progestin pill three or more hours late, it is recommended that you use a backup-method for the next two days. If you are taking a combo pill and miss a day, you can take two pills the next day to get back on schedule. If you miss two or more consecutive pills anywhere in a combo pill pack, a backup birth control method, such as condoms or a diaphragm, is recommended for seven days. If you are unsure of which kind of birth control you are taking, ask your primary care physician, gynecologist, or a provider at McCosh and they will be able to provide more information regarding the effectiveness of the birth control you use.

If you are concerned about being pregnant, it is best to take a pregnancy test which can be purchased at the University Store, CVS on Nassau Street, or at McCosh Health Center. If you have any questions regarding how to use a pregnancy test or which one to purchase, feel free to make an appointment with a provider at McCosh.

If you choose daily birth control as your preferred method of contraception, is it very important that you take the pill every day to ensure its effectiveness. Missing just one day increases your risk of becoming pregnant. Setting a daily alarm or opting for a text reminder service can be helpful. If you continue to miss pills, it may be advisable to speak to your healthcare provider to discuss other contraceptive options, such as an intrauterine device (IUD), birth control patch, implant, or shot – which are sort of “set it and forget it” methods. If you are ever in doubt in regards to the effectiveness of your birth control or if you want to explore other options of contraception, speak to your primary care provider, gynecologist, or a provider at McCosh Health Services. You can make an appointment online at www.princeton.edu/myuhs.

— The Sexpert

Information on birth control provided Planned Parenthood, WebMD, and Bedsider. 

 

 

Contraception, Pregnancy

Insemin-Afraid: What should I do if my boyfriend accidentally finishes inside me?

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

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