Dear Alice,

My girl takes the pill now but she's still worried when I'm ejaculating. I think there is no reason to be worried... am I wrong? What can I say to her?

— Lover

Dear Lover,

You're on the right track, however your partner's concerns are normal. When the pill is used correctly, the chance of pregnancy is pretty slim. Still, any possibility of parenthood, however small, may be worrisome to your partner. Talking about her concerns and considering a back-up method like condoms may ease her fears and make sex more fun for both of you.

In the heat of the moment, it's easy to sweep any uncertainty about sex under the rug. To better understand where your partner is coming from (no pun intended!), you may want to talk with her about why ejaculation makes her uneasy. For example, is she mainly worried about getting pregnant or is something else troubling her, like concern about sexually transmitted infections (STIs) or a reaction to semen (regarding the latter, check out Allergic to semen? in the Go Ask Alice! archives)? Once you're both on the same page, you can discuss ways to address her concern about your fireworks.

If pregnancy is the primary concern, the pill's low failure rate may provide reassurance. With "perfect use" of combined pills (the most common form pills that contain progestin and estrogen), one out of 1,000 women will become pregnant. The failure rate is slightly higher for the minipill (progestin only) with five out of 1,000 women getting pregnant. "Perfect use" means taking the pill at the same time every day, without skipping a dose. Setting an alarm on a watch or cell phone may help your partner remember to take her pill on schedule. For more information about the pill's effectiveness, visit Planned Parenthood.

A second birth control method would provide extra pregnancy protection — a good idea if your partner just started the pill or if she takes a medication that could make it less effective. As a back up, you might consider condoms, spermicidal foam, the sponge, or a diaphragm.  Condoms have the added benefit of guarding against STIs, including HIV. Some couples also like using condoms for visual proof that sperm stays in the bag, and out of the vagina. A back-up method may provide emotional reassurance so pregnancy is less of a worry.

If you haven't already, you and she may want to discuss your contraceptive options with a health care provider who can help you decide which method is right for both of you.

The pill is an effective form of birth control, but if your partner isn't totally comfortable, a back up method is a reasonable plan. Talking openly about safer sex precautions may ease her concerns and help both of you get off on the right foot!


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