What to Do When You’ve Had Unsafe Sex

Face it, Accidents happen. One night a condom could break. Or you stupidly might not have used one at all. But don’t panic.

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There are few things more nerve-racking than waking up and remembering you had unprotected sex the night before. If  you haven’t experienced this dilemma yet, chances are you will, whether because the condom broke or you were so caught up in the moment that you threw caution to the wind and didn’t even use one. Because as it turns out, bedroom blunders happen with alarming frequency: Research coordinated by Group Health Cooperative, a nonprofit health-care system, found that within a three-month period, 19 percent of women surveyed experienced condom slippage or breakage. Moreover, this isn’t something your doctor’s going to prepare you for; a study by the Kaiser Family Foundation found that only 25 percent of gynos say they routinely talk about emergency contraception with their patients.

If you wind up in this nail-biting situation, don’t waste time cursing yourself out for not being more careful. You need to act quickly to prevent your biggest concerns from coming true. Whether you’re worried about an unwanted pregnancy or an STD infection — or both — we’ve mapped out a clear guide to get you through. You’ll want to print out these pages and keep them in your nightstand…just in case.

Your Damage-Control Timeline

The morning after: Get your gyno to phone in an Rx for emergency contraception to your pharmacy. Also — unless you know your partner is STD-free — make two appointments for testing, one in a week and the second in three months. One to five days later: Take emergency contraception as soon as you can get your hands on it (ideally on the first day, since the earlier you take it, the more effective it is).

One week later: Go to your gyno to get a preventive shot against hepatitis B and be tested for gonorrhea, trichomoniasis and chlamydia.

Five to seven days later: If you haven’t taken emergency contraception yet, consider having an IUD inserted and make an appointment for the procedure ASAP.

One week after your next period was due: If you haven’t had your period yet, take a home-pregnancy test to make sure the emergency contraception worked.

Three months later: Go in for your second round of STD testing — this time for HIV, herpes, hepatitis C and syphilis.

Your Pregnancy-Prevention Plan

The key to putting the kibosh on an unplanned pregnancy: Act fast. The morning after having unsafe sex, don’t even brush your teeth before getting the phone number of your local pharmacy, calling your gyno and asking him or her to phone in a prescription for emergency contraception.

Emergency contraception (or EC) is a higher dose of the same hormones found in regular birth-control pills and, depending on what’s happening in your body, will either stop an egg from being released by your ovary, stop an already-released egg from being fertilized or stop an already-fertilized egg from implanting in the uterus. The drugs can be taken up to 120 hours (five days) after unprotected sex, says Charlotte Ellertson, Ph.D., president of Ibis Reproductive Health, a nonprofit research organization in Cambridge, Massachusetts. But the ideal time to take them is within 24 hours, when they’re most effective.

There are two different brands of morning-after pills (Preven and Plan B). But they’re not your only emergency-contraception options: Taking a specific combination of regular birth-control pills within a particular window can also prevent pregnancy, as can a copper IUD if you have it inserted within seven days.

What Every Smart Girl Should Do
Instead of waiting until you’re in a bind and then scrambling for morning-after pills, keep a pack on hand. “You don’t wait until you cut yourself to buy bandages. It should be the same with emergency contraception,” notes Mitchell D. Creinin, M.D., director of family planning at McGee Women’s Research Institute. Ask your gyno for a prescription and get it filled. The pills are often good for three years.

Emergency Contraception

All the facts you need to know about your pregnancy-prevention options.

PLAN B

What it is: Two pills containing the hormone progestin
Effectiveness: Reduces your chance of pregnancy from 8% (without EC) to 1%
How to use it: You take one pill immediately and the second pill 12 hours later.
Side effects: Nausea, breast tenderness, dizziness and vomiting, but to a lesser degree than with Preven.
Cost: $8 to $20
The bottom line: Plan B should be your first choice in emergency contraception unless you want a long-term IUD.

PREVEN

What it is: Four pills that contain estrogen and progestin
Effectiveness: Reduces your chance of pregnancy from 8% to 2%
How to use it: You take two pills immediately, followed by two more 12 hours later.
Side effects: Nausea, vomiting and dizziness. About half of women on Preven experience nausea.
Cost: $8 to $20
The bottom line: Preven is less effective than Plan B and typically results in more side effects.

BIRTH-CONTROL PILLS

What it is: Most brands of pills taken in a specific combination can be used.
Effectiveness: Reduces your chance of pregnancy from 8% to 2%
How to use it: Depends on the pills. Go to ec.princeton.edu.
Side effects: Same as Preven: nausea, vomiting and dizziness.
Cost: Up to $35
The bottom line: Fast and convenient but less effective than Plan B.

COPPER IUD

What it is: A device that when inserted within seven days of sex can prevent pregnancy
Effectiveness: Reduces your chance of pregnancy from 8% to less than 1%
How it works: The IUD prevents a fertilized egg from implanting in the uterus.
Side effects: Expect cramping during insertion. Take an OTC pain reliever beforehand to ease the ache.
Cost: About $400
The bottom line: The most effective EC but only a good idea for women who plan to leave it in for at least a year.

Note: You should take an over-the-counter antinausea drug (like Dramamine II) an hour before your first dose of any EC pills, suggests Ellertson of Ibis. If you vomit within one hour of popping an EC pill, call your gyno for instructions. You may need to repeat the dosage. But if you vomit more than one hour after taking the pills, don’t worry — the drugs have already been absorbed.

Steps to Take if You Were Raped

  1. Write down any details you can about your attacker and don’t bathe or change your clothes.
  2. Call the National Sexual Assault Hotline at 800-656-HOPE. It is available 24 hours a day and will connect you to a rape-crisis center in your area.
  3. Go to the emergency room and ask for a rape-kit exam. Physical evidence of your assault will be collected and given to the police.
  4. Ask for emergency contraception and immune globulin to prevent hepatitis B (if you haven’t been vaccinated in the past). If you think your attacker may be HIV positive, discuss your next plan of action with the doctors.

What Tests to Get When

After one week: chlamydia, gonorrhea and trichomoniasis
These three STDs are all very common, often symptom-free and can do a lot of damage to your sexual health if left unchecked. Testing for gonorrhea and chlamydia involves a urine test or a vaginal or cervical swab test; for trichomoniasis, your doctor will take a vaginal swab. You’ll get results back in about a week, but don’t be nervous — all three diseases are easily curable with antibiotics.

After one week: hepatitis B
Ask to be given immune globulin for hepatitis B; the antibodies will keep you from getting the virus, says Dr. Creinin. Start the vaccination process at the same time. If you test positive, you can take drugs to reduce the effects of the virus. (Note: You need to wait three months to get a blood test for hep C.)

After three months: syphilis
Believe it or not, this disease — common in the 1800s — is still around. It’s a bacterial infection that if left unchecked can cause heart problems, dementia and eventually death. But luckily, it’s easily cured by penicillin, so ask to be given a blood test for it three months after you have unprotected sex.

After three months: herpes 
The virus herpes simplex 2 causes painful, fluid-filled genital blisters. The blisters can show up as soon as two days after exposure, but herpes can also remain symptom-free. If you do develop blisters, call your gyno ASAP, but if you have no symptoms, wait until the three-month mark to be tested. Although herpes is incurable, there are prescription drugs you can take (such as acyclovir) that reduce your risk of outbreaks and cut your chance of infecting others.

After three months: HIV
A test for HIV (the virus that leads to AIDS) may seem like the scariest of all, but don’t let fear take over and cause you to skip it. Although there’s still no cure for HIV, there are now medications that help infected people lead long, healthy lives. To determine if you have it, you’ll be given a blood, urine or mouth swab test and get results anywhere from the same day to 10 days later, depending on the type of test you’re given. If you test positive, your doctor can discuss drug therapy and help you get counseling to assist you in coping with the diagnosis.

 

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