Myths about STIs and Different Types of Contraception

Sarah Bartlett, MD, FACOG

Myths Around Sexually Transmitted Infections (STI)

You can only get STI if you sleep around.
All people who have sex, no matter how many times or partners, are at risk for STI. This includes non-penetrative sex, use of shared sex toys, and oral and anal contact. This includes same-sex partners and people of all age groups.

Most of them are curable.
Yes, trichomonas, gonorrhea, and chlamydia can be treated when detected, but infections like herpes are forever. And don’t forget about things like hepatitis, syphilis, and HIV. For this reason, safe sex is critical, and discussing your sexual history with your partner is always a good idea.

Wouldn’t I have symptoms?
Not always. Some STI have no symptoms. Although vaginal discharge, sores, bleeding, and pain are concerning for infections such as trichomonas or herpes, other infections, like chlamydia, can have few or no symptoms. This is especially dangerous as they can quietly cause damage like a growing infection in the pelvis and even infertility. For this reason, doctors recommend routine STI testing for all women up to 26 year old during their routine exams, and frequent testing for anyone else who requests it.

Oral and anal sex are safe.
STI can be passed through vaginal intercourse, but also through anal and oral sex. These can be especially dangerous because people don’t think to get tested for this or to disclose this to their doctors.

Condoms prevent all infections.
Condoms prevent most STI when used perfectly, but not everything. They are most effective in preventing infections transmitted through body fluids. Any genital contact (including scrotum and vulva) can pass on infections like herpes. And condoms certainly break. Infections such as trichomonas can also live for a short time on other surfaces such as sex toys, so good hygiene practices are really important. Keep in mind that birth control pills and other contraceptive methods provide no protection from STIs, and using two condoms is not more effective than just one.

Different Types of Contraception

IUD (Intrauterine Device)
There are several IUDs available to patients, most containing different amount of progestin and one that is hormone-free (copper). They last between 3 and 10 years and can be removed easily at any time even before they are due out. They are more than 99% percent effective in most situations. Even women who have never been pregnant, and women of any age, can have an IUD. Significant side effects are rare.

Hormonal Implant
This is a small rod easily inserted under the skin in the upper arm. It contains a kind of progestin. It is a simple office procedure taking just a few minutes but the implant lasts for up to 3 years. It is also more than 99% effective.

Contraceptive Shot
This in an injectable progestin, given as a shot in the arm or buttock every 3 months. It is 96% effective.

Birth Control Pills (Oral Contraception)
The pill contains estrogen and progestin. It is 99% effective when used perfectly, though this drops to 93% with typical use (an occasional skipped pill, etc). Most are very low dose now and have very few side effects, though they are not safe for smokers over 35 or anyone at an increased risk of blood clots in their legs or lungs. It is often used for medical reasons (controlling heavy, painful periods, etc) in addition to preventing pregnancy.
The progestin-only pill has no estrogen, but it is especially important that it be used perfectly for pregnancy prevention.

Ring
This ring contains the same types of hormones as the pill (estrogen and progestin) but is a different delivery mechanism. It is a flexible vaginal device placed in the vagina like a tampon. It is left in for 3 weeks at a time, then removed by the user herself and left out for one week each month. It is typically 93% effective.

Patch
The patch also contains the same types of hormones as the pill (estrogen and progestin) but they are delivered through a patch on the skin. The patch is changed out by user every week for three weeks, then left off for one week, allowing for a period. It is typically 93% effective, like the ring.

Condoms
Male condoms are worn by the man and are mostly effective for preventing STI. The are typically only 87% effective due to imperfect use, breaks, etc. Female condoms are much less common. They are only 79% effective with typical use. They can prevent the spread of some STIs.

Emergency Contraception
There are different types of EC pills, some over the counter available without a prescription. They can be taken up to 5 days after unprotected sex but are more effective when taken as soon as possible. The are not abortion pills. They prevent conception from ever occurring. They can cause short-term changes in menstrual bleeding but are generally considered safe.

For more information on Dr. Bartlett, and her work for Christ Hospital, please visit here.

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