Q. I just finished a z-pack for strep throat and my doctor advised me that I won’t have the full protection of my birth control pills until I start my next pack…in three weeks. Three weeks with a backup method isn’t a big deal, but my partner can’t seem to come or even really enjoy sex if we’re using a condom. So, do you have any tips for either alternate alternate methods, or how to make a condom easier/sexier/better? I know sex isn’t solely about an orgasm, but three weeks of blue balls is unsatisfying for anybody.
A. Ah, precious one. On the one hand, I feel bad for your condom wearing companion. The thought of wrapping latex tightly around the dick I do not have is enough to make this little lady shudder. Condoms are weird. They smell weird, they feel weird, and sometimes, they taste weird. There is room for improvement on the condom market. However, that empathetically being said, tell your gentleman friend to get over it. To paraphrase my guardian angel, always try and come from a place of love, but sometimes, you just have to break it down for a mother fucker. If you aren’t on birth control and condoms are the only safe sex method you have access to at the moment, then three weeks of condom use is not going to kill him. Yes, it may agitate or not even feel as good, but this is a temporary stage and he should consider himself lucky that he has such a thoughtful, caring partner writing in to inquire about all the different ways to make sex with a condom feel good for him, especially when said thoughtful, caring partner whose own use of hormonal birth control can alter the enjoyment of sex. So baby girl, let him chew on that for a while…
Now onto the technical bits. The good news is, there are things you can do to improve your condom wearing experience. All will improve the sensation of wearing a condom but it’s tricks of the trade, not magic. Your friend will still be wearing a condom and will have to contend with that factor. Mind over matter! So here’s what you can do to take over the matter part:
Get Skinny Bitches: Dare I say, this might be the only time in my entire life where I will make the claim that thinner is better. Yes, thinner is better – in condom land. And in condom land, there is a bevy, a plethora, of thin condoms to choose from. I personally recommend Kimono condoms, especially since they pride themselves on being “America’s thinnest condom family.” With a title like that, how could one not be entranced? But kittens, there are plenty of brands out there, all dependent on what you have the best experience with. Find the one that works best for you. Most likely, your choices will run either latex or polyurethane. When in doubt, go with latex, unless you have an allergy.
Don’t Wear Magnum, If It’s A Mini-Van: Most folks will not make a mental note if they see a Triple XXX Magnum Horse condom package hanging out by the bedside. They will make note on this, if it is obvious that you are wearing a condom that doesn’t fit. Yes, welcome to discomfort station, population, find the right condom size. Too big, and that sucker is like swimming in latex and might pop off. Too small, and not only is it choking out your dick, it is more than likely to break. So find the right condom size – invest in it! You don’t buy clothes and shoes too big or too small and hope for the best– why do it with condoms?
Lubricate This: I imagine the sensation of raw, unlubricated latex, directly up on one’s genital skin to be akin to a form of torture. It makes me think of all those sad condoms I used to steal from the Health Department as a wee teen, only to bust them open and find out that they were better used as balloons. Lubrication is key to pleasure. Just a touch will do, no need to slather the dick like you are basting gyro meat, a lot of lube is going to cause slippage. But just a drop or two on the penis before the condom is put on will provide a better sensation, and a less “rubber” feel. Concentrate more lube on the tip of the penis, since thats where the bulk of sensation comes from. Once the condom is on, lube the outside and lube your partner – less friction, less irritation. And kittens, remember – water and silicone-based lube only! Oil based lubes break down latex and in general, are more likely to cause UTIs/yeast infections.

Put The Damn Thing On Right: Now, I know most of us are adults here, and at some point, put on a condom or watched a condom being put on. I like to call it, “the eternal struggle.” How a condom goes on can completely affect the comfort level of your partner, so lets remember a few truths about preparing. Roll condom over penis, making sure to not get any pre-cum on the outside of the condom. Pinch tip, and roll condom down the shaft, making sure to leave at least half an inch in the tip for sperm. You would be amazed to know that most condom discomfort and breakage comes from someone making that condom sit so tightly on their dick that it looks like an angry fist trying to break out. It’s a crucial step because if you have someone trying to get it on as fast as they can, or in a moment of frustration, it might not be put on right.
Mind over Matter: As I said previously, condom use never killed anyone. Since you both have been having sex sans condom for what may be a long period of time, I recommend to your darling companion that he just practice, practice, practice. Get him to masturbate with a condom – get him used to a condom. If you aren’t used to something, of course it feels odd and funny. So break the condom use in like you would a new pair of shoes – wear them often and always around the house. Now, again, it’s only three weeks – this is not a total lifestyle adjustment. Besides, this will make having sex even better once you are back into your normal groove of things. While condoms aren’t the life of the party, it’s kind of the price of admission right now. Sure, you can use a bevy of other non-hormonal products – female condoms, spermicides, diaphragms, sponges, shields, cervical caps, and…sigh,yes…even the following methods (I know), withdrawal, Rhythm method, or abstinence. In all honesty, the last three methods make me…uncomfortable, even if they are counted among the effective methods of non-barrier birth control. As a lady giving sex advice on the Internet, it’s not in my best interest to recommend them – at all, but they are there. But back to the original point, these other non-barrier methods may offer a bit more flexibility and freedom, especially if used in tandem with one another. Each of these methods have their own benefits and their own particular effective rates. When it comes down to it, you have to weigh the pros and cons of what is best for your situation. But honey, I digress and will say church, say it with me now): Condoms are over 95% effective when used with a spermicide. That’s a good rate.
So while your lovely partner might be bummed about the current condom state, just remember – this too shall pass. You will return from the birth control from whence you came and he will return to the state of an unsheathed penis. All will be well. So try a few tricks of this trade and see how it fares – and remember! Sex doesn’t always have to be capital P-in-the-V. This may also be a great time to explore other forms of sex and sexual pleasure. The world is your oyster, dearies. Just play it safe together, so you can be nasty together.
And report back cause we love a happy ending.
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6 replies on “No Glove, No Love: Yes, But Can We Get the Glove Feeling Breezy?”
Hey, I’m a gynecologist. Good news – your doctor is wrong, and you don’t need a back up method. People used to think that THEORETICALLY some antibiotics could affect the metabolism of ethinyl estradiol and decrease contraceptive effectiveness. But this has never been shown to be true, and the practice of backing up is not longer recommended. Not saying your doctor is an idiot – it’s just old school thinking, and what a lot of us were taught in medical school or just kind of “heard”, I actually had one of my practice partners ask me about it yesterday.  The only antibiotic that actually does affect birth control pills is rifampin, which is a rare one used mostly for tuberculosis.  So, skip the condom. You’ll be fine.
Fantastic ! This is the type of medical opinion we need round these parts (no seriously, can I consult you for the column in the future for medical questions I am not an expert on because I am not a legit doctor, just a lady on the internet giving advice?)
It can be super-conflicting as a patient as far as this goes. A few PP gyno’s ago, one of my doctors gave me a list of all medications that interfere with birth control (see below), but I’ve only had one doctor tell me that I shouldn’t worry (I was also on the Nuvaring). The majority of my doctors have always suggested back up methods, especially while I was on Bactrim and Macrobid for some hardcore UTI’s. Can I ask what it is that sort of changed the tides of thinking on this? I’m definitely curious to know and want to hear more about how it changed your practice as a gyno.
Trying not to get too technical, but here is some background and info:
The concern about decreased effectiveness can be attributed to 2 different pathways (or theories about them).
1. Certain medications are “enzyme inducers” or “enzyme inhibitors” – meaning they affect (either up or down) the production of certain enzymes in the liver-GI system which in turn affects how you absorb and process other medications that are dependent on those enzymes. Enzyme induction increases the enzyme, speeds up processing of other things, and reduces the amount you effectively absorb of an affected drug, leading to lower levels of the drug in the system. In this case, antibiotic is the enzyme inducer, speeds up processing of your birth control, you absorb less birth control, you are not protected against pregnancy.  These are the drugs that are known enzyme inducers in the same pathway as the estrogen in your pills: cabemazapine (seizure med), dexamethasone (a steroid) phenobarbitol (sedative/seizure) phenytoin (seizure med) and rifampin (antibiotic).   So, this is a legit, known concern, and if you are on any of those drugs, your birth control might not work. No other antibiotics are in this pathway, so they are NOT culprits by this method.
2. Gut flora: we have lots of bacteria in our intestines, and these interact with our digestion and processing of medications. THEORETICALLY anything affecting gut flora could somehow affect metabolization of medications, and could up or down absorption. But this is a theoretical concern, and has never been shown to actually have an affect on birth control pills.
The concern over this has largely been driven by the fact that rifampin antibiotics were shown to have the affect; people got worried about other antibiotics; case reports of individual people taking antibiotics with their contraceptives and getting pregnant get published, boom – everyone gets scared. In reality, several antibiotics have been studied and have been shown to NOT affect hormone levels (including on your list above: amoxicillin, ampicillin, metronidazole, tetracycline). Not every single one has been checked, but there is no plausible reason to think there would be an effect.  We have not checked every single other medication that a woman could possibly be on at the same time as her birth control pills to be sure that doesn’t have an affect either, but antibiotics are the only one we worry about – again, because years ago rifampin got everyone scared.
From a 2001 review of the literature on this topic published in Obstetrics and Gynecology: “These studies have not demonstrated any systematic interaction between antibiotics and OC steroids, and clinical pharmacokinetic evidence indicating that antibiotics alter blood concentrations of OCs is lacking.” From England, the Royal College of Obstetricians and Gynecologists has stated: “additional contraceptive precautions are not required even for short courses of antibiotics that are not enzyme inducers when taken with combined oral contraception”.
What makes this hard to study is that oral contraceptives are not perfect: The failure rate for pills in actual use is 2%-10%. People get pregnant on pills; some of them will be taking antibiotics when it happens. Does that mean antibiotics are the reason? No.  No doctor wants to be ‘responsible’ for an unplanned pregnancy, so even lots of MDs who know better still tell their patients to back up because if you have a patient who does get pregnant on a birth control/ antibiotic combo, that patient will be sure it happened because of the antibiotic.
Hope that helps!
and sure, consults are welcome!
This is what my GP (and my doctor friends) told me: use a back-up method if you like, but in all probability the pill is going to work if you take it properly, antibiotics or not.
On the gut flora theory: would that effect be removed if the pill was administered vaginally? I’ve seen that recommended if you have a stomach bug and may be vomiting.
I’m just very happy that I don’t have a condom-scaredy-cat partner. Or that he wants it enough to use one, same diff.