Let’s face it, guys hate condoms, including myself. And guess what? Women hate condoms just as much as we do! So, if nobody enjoys condoms, when is it ok to not use one? Today we will discuss the steps to take in order to reduce the risk of pregnancy and STDs as much as possible while going condomless with a trusted partner. Keep in mind I’m not a doctor, and you should discuss these kinds of decisions with a qualified medical professional.
Essentially you need a reliable form of birth control, STD testing, and a set of rules that the two of you discuss about what can and cannot be done outside of the relationship.
This is perhaps the most important part of the scenario. You need to have a reliable (over 99% effective) form of long-term birth control in place before doing anything else. This means a form of birth control that removes any kind of “user error” like forgetting to take a pill, forgetting to put in the Nuva ring, etc.
There are really only 3 forms of birth control that meet these standards; the IUD (mirena, paragard), an intradermal hormonal implant (Implanon, Nexplanon), or sterilization (tubal ligation, hysterectomy or vasectomy). The IUD is a small device that sits inside a woman’s uterus and prevents pregnancy for up to 6 years for the hormonal version (mirena), or 15 years for the copper version (paragard). You can read all about IUDs in THIS article. The hormonal implant is inserted under the skin in the upper arm and can prevent pregnancy for up to 5 years.
Sterilization is usually considered permanent in men and women, but in some cases the procedures can be reversed. There are a few different ways that Tubal Ligation is done, but essentially the fallopian tubes are blocked off, preventing any eggs or sperm moving past this blockage. These can be reversed but only have a success rate of 40%-80%. A hysterectomy is when the uterus is removed, and is permanent. Most guys know what a vasectomy is, but essentially the vas deferens, the tubes that carry sperm from your testicles, are cut and cauterized, preventing any sperm from leaving. Vasectomies are also reversible in many cases and the reported success rate is about 40-90%. If you’re considering vasectomy, read these articles HERE and HERE.
Once you know which type of birth control your lady is on, you should ask to see some proof. This could be in the form of a medical record printout from the hospital or clinic she attends. If you have a vasectomy, you should provide her with proof of this as well, fair is fair.
After you establish proof of contraception, most clinics say you should also be using a backup form of birth control. This could be condoms of course, the TIMING method (where you have a record of when her periods are and time when you ejaculate in her for the least chance of pregnancy to occur), or you could reduce your sperm count to zero by using TRT (testosterone replacement therapy) or buy my BOOK on how to do it at home. Using a backup form of birth control is a decision every couple needs to make for themselves.
When you’re doing all of your birth control research, each of you should get tested for STDs. When this is all done, show each other proof of your results either from your medical record, or from an app on your phone where you can access your test results. If either of you have anything come up positive, you have some serious conversations to get through together, and you should also speak with a physician.
How do I get Tested?
There are lots of options available but the first on the list is either your doctor or Planned Parenthood. If you have health insurance just make an appointment with your doctor and speak with them about getting tested for STDs. Many times health coverage plans have a number to call to set up lab tests without a doctor’s visit and often without any kind of co-pay (it’s usually free), so that’s also a good option and super quick. I have Kaiser, so all I have to do is call that special number, tell them what I want to get tested for, and they put in an order with my local lab. Then all I have to do is show up with my insurance card, pee in a cup, get some blood drawn and voila! I’m in and out in less than 20 minutes.
If you don’t have insurance or simply don’t want to go to your doctor for whatever reason, Planned Parenthood or STDcheck are great options. I LOVE Planned Parenthood and donate money to them frequently, they are doing fantastic work. There are many locations around the US and no, they don’t just do abortions. Call in and make an appointment or drop by, they will set you up and make sure you’re clean and being safe. I should let you know that they are only free if you have no insurance and cannot pay, in which case they can set you up with government funding for care, otherwise they use your health insurance. They are also very discreet. They don’t care who you are, where you’re from, or what you’re doing with your genitals, they just want you to be safe and healthy.
A third option if you don’t want to go out into public at all for whatever reason is Home Testing. There are many companies popping up that have home test kits. These are shipped to your house, you follow the instructions, pee in the cup, ship your bodily fluids back to the company, and they send you your test results. These kits are usually somewhat pricey, but are a great option if you don’t want to go to the doctor. I recommend myLab Box and know some people who have used them and like their service. Test kits start at $80 and you get your results in 3-5 days. But again, Planned Parenthood is FREE for many low income people… and I give them money… so basically I’m saying I’ll pay for your testing 😉
What should I get tested for???
Another good question! As men, we should be getting tested for; chlamydia, gonorrhea, trichomoniasis, syphilis, HIV, Hepatitis C, and possibly Herpes Simplex II (genital herpes). I only say possibly to HSVII because the testing is not entirely accurate yet. And unfortunately there is no test for HPV (human papilloma virus) for men yet, but it does exist for women and should be part of a pap smear.
This can be as simple as “We’re going to be monogamous, but we need to tell each other if we fucked up and had sex with someone else,” to something more complicated regarding various forms of open relationships. You should treat this very seriously and be open and honest. This is an exercise in trust, you’re trusting this other person with your health, and they are trusting you with theirs. Sit down, talk to your partner, and agree on some rules to keep you both safe.
Once you have all 3 of these things completely taken care of, congratulations! You are as safe as you can be without a condom! Of course doing all of these steps and wearing condoms would be even safer, but it’s unrealistic to expect that from most human beings as flawed and sex-crazed as we all are. Just be careful and reduce your risk as much as possible!