Highly effective birth control methods, namely intrauterine devices (IUDs) and implants, have received a lot of well-deserved attention in recent years. They are as effective at preventing pregnancy as permanent sterilization, but can be stopped at any time, and can last from three to 12 years. They are the contraceptive of choice for female family-planning providers, who should know a thing or two about choosing an optimal birth control method. They are fantastic options for teenagers and others hoping to delay pregnancy for at least a few years. And the best news is that, for now anyway, these pricey birth control methods are still available at no cost to Americans covered by Medicaid or health insurance.
For the best protection against unintended pregnancy and STDs, combine condoms with IUDs or contraceptive implants.
If IUDs and implants prevented sexually transmitted diseases (STDs), they would pretty much be perfect — but, alas, like most forms of birth control, they don’t protect you from viruses, bacteria, and other bugs that can be passed from person to person through sex. To reduce their risk for STD exposure, sexually active people must employ other strategies, including (1) being in a mutually monogamous relationship with a person who does not have STDs; (2) being vaccinated before becoming sexually active to receive protection from hepatitis B virus and human papillomavirus (HPV), two sexually transmitted viruses; and, last but definitely not least, (3) condoms, condoms, condoms!
A study published this month looked at college students using IUDs and implants and found that most of them didn’t use condoms the last time they had vaginal sex — 57 percent of women who were not using IUDs or implants used a condom, compared to only 24 percent of women who were using IUDs or implants. That’s not too surprising if pregnancy prevention were the only concern, but condoms are an important addition for anyone seeking to reduce their STD risk.
The authors of the study drove home their point with a couple of premises and a conclusion:
- Young women are at higher risk for unintended pregnancy. More than 59 percent of pregnancies among young adults are unintended — higher than in other age groups.
- Young women are at higher risk for STDs. Compared to men and women from all age groups, women ages 20 to 24 have the highest rates of chlamydia and gonorrhea.
- IUDs and implants dramatically reduce pregnancy risk, and condoms dramatically reduce STD risk. Therefore, young women would reap incredible benefits from highly effective contraception like IUDs and implants and STD prevention tools like condoms — both, not just one or the other.
The take-home message here is that IUDs and implants pair fabulously with condoms, especially for people who might be at increased risk for STDs. That includes anyone who doesn’t know their partners’ STD status — yes, even many people in relationships, as STDs usually don’t have symptoms and can be transmissible for months, years, or a lifetime without treatment. (For those reasons, we recommend that partners be tested for STDs before having sex.)
Luckily, this study showed that women using IUDs or implants were more likely to add condoms to their routine if they were single or in relationships but not living with their partners. Women who were married or cohabiting with their partners were less likely to use condoms in addition to IUDs or implants — which makes sense, as people in long-term relationships are less likely to use condoms in general, perceiving themselves to be at low risk for STDs.
Long-term, monogamous couples might still consider incorporating condoms into their sex lives. First: They can’t know their partner’s STD status if they weren’t tested — regardless of time frames or symptoms. Second: Some STDs, such as HIV, take a while to show up on a test, meaning that someone with a new infection might get a false negative result. Third: There are many STDs that aren’t routinely tested for, such as herpes, HPV, and trichomoniasis. Fourth: Sometimes monogamous relationships are a little … less than monogamous. Fifth: Even in a truly monogamous relationship, a partner can still acquire sexually transmissible diseases like HIV and viral hepatitis through IV drug use, and can even get Zika virus through a mosquito bite. Sixth: Condom use might have beneficial effects on the vaginal flora — that is, the “good” microbes that colonize healthy vaginas. Seventh through infinity-eth: Some people prefer condoms for a wide variety of personal, subjective reasons.
While IUDs and implants aren’t as popular as the Pill, their popularity is growing by leaps and bounds. In 2002, only 2 percent of birth-control users relied on IUDs or implants. That number grew to 12 percent by 2012. IUDs and implants were most popular among women ages 25 to 34, a group whose risk for unintended pregnancy is not as high as it is for younger women. Only 3 percent of sexually active female teens used an IUD, while 55 percent of them relied on condoms — both numbers that could be higher in order to curb the high rates of unintended pregnancy and STDs among younger people.
To learn about IUDs, the implant, and other types of birth control, make an appointment at your local Planned Parenthood, where a health care provider can review your options with you and help find something appropriate for your lifestyle and preferences. While IUDs and implants offer fantastic pregnancy prevention, condoms are still the best way for sexually active people to protect themselves against most STDs! You can pick up condoms, or receive testing and treatment for STDs, at any Planned Parenthood health center.
Click here to check out other installments of our monthly STD Awareness series!