First-time sex: How to choose the right contraception for you

Having sex for the first time can bring up all kinds of emotions, from excitement to questions about how it will feel and anxiety about how it’ll go. All of these feelings and more are completely normal. It’s a new experience, after all. 

If you’re thinking about becoming sexually active, then it’s a great time to consider when to start using contraception. Knowing the key facts about contraception may help you feel more confident and prepared for first-time sex.

Key takeaways

• Even when it’s your first time, you can become pregnant from having sex without contraception. 
• Contraceptives come in many different forms. You may choose a type that includes hormones or nonhormonal birth control. What’s best for you is a personal choice. 
• Condoms are the only contraceptive that can protect you from STIs as well as pregnancy. 
• Using condoms plus another type of contraceptive will give you extra protection. 

What is contraception?

Before we get into what might be the best birth control option for you, it’s good to understand what contraception is. It’s the umbrella term given to the medication, devices, or procedures that help you to prevent pregnancy. Some forms of contraception also help to prevent sexually transmitted infections (STIs). 

When it comes to contraception, there’s no such thing as one size fits all. The type that best suits you may not be the same as what suits your best friend. Understanding what your options are and how different methods of contraception work may help you to feel more in control when you are thinking about having sex for the first time. 

What’s the best contraceptive to use for the first time? 

You might be wondering what the best birth control option is if you’re having sex for the first time. Well, the answer isn’t so straightforward. “Everyone is different, and there is no ‘best’ contraceptive,” says Flo expert Dr. Jennifer Boyle, obstetrician and gynecologist at Massachusetts General Hospital, US. “Each person has to find the contraceptive that is best for them, and this will depend on their personal preferences and priorities.” 

It’s important to flag that condoms are the only contraceptive that can protect you from STIs as well as pregnancy. They’re also easy to get hold of: you can buy external or male condoms from pharmacies, supermarkets, online, and even at some gas stations and vending machines. However, the best birth control to use for your first time depends on you. 

You might look at things like how easy it is to access a certain form of birth control, how effective it is, and whether your doctor recommends it based on your personal health history when deciding what contraceptive is right for you. 

The most effective contraceptives are IUDs and the implant, which are both more than 99% effective at preventing pregnancy. One of the main drawbacks is that only a health care professional can insert or remove them. “We sometimes call these ‘place them and forget them’ methods because there is nothing more a person needs to do once they’re in,” says Dr. Boyle. However, you will need to get your IUD changed after between three and 10 years, depending on the type, and your implant changed after three years. There has been some research showing that these can be used for longer periods, but it’s always a good idea to discuss your options with your health care provider. 

Dr. Boyle continues: “On the other hand, some people prefer a method of contraception that they can start and stop on their own, like birth control pills, patches, and the ring. These methods can have other beneficial side effects, including helping with acne and making periods more regular, less heavy, and less painful. They don’t require a procedure to be placed, but they do require more work and attention on a regular basis.”

Let’s take a look at some of these options in more detail. And once you have all the facts, you can take a birth control quiz. 

Types of contraception

External condoms 

A condom (sometimes called an external or male condom) is a thin, rubber covering that’s worn on the penis to stop sperm from entering the vagina. With perfect use, they are 98% effective at preventing pregnancy, but with typical use, they’re just 87% effective. Typical use simply means that people don’t always use contraception perfectly all of the time, so there may be periods when it isn’t as effective. 

“As they are essential in preventing STIs, condoms are extremely important,” says Dr. Boyle. “It’s best to use another contraceptive with condoms to decrease your risk of pregnancy.” 

Internal condoms 

Internal (or female) condoms work in the same way as regular condoms, except they are put inside the vagina before sex. Like male condoms, they can also protect you against STIs. 

Internal condoms have a thick inner ring that goes inside your vagina and a thinner outer ring that sits outside it. Putting one in is a bit like inserting a tampon. Use your finger to place it as far up as it will go inside you, making sure it’s not twisted and that the outer ring stays in place. You might not even feel it. Once you’re comfortable, guide your partner’s penis inside you, and when you’re finished, remove the condom by gently twisting the outer ring. 

Intrauterine device (IUD) 

An IUD is a small, T-shaped device with strings attached that a health care provider places inside your uterus. Depending on the type, they can prevent pregnancy for up to 10 years without you having to do anything. Pretty amazing, right? 

There are two kinds of IUDs: copper and hormonal. Both work by either releasing hormones or copper into your uterus and make it more difficult for a sperm to meet your egg after sex.

Contraceptive implant 

A birth control implant is a tiny metal rod (roughly the size of a matchstick) that sits just under the skin on your upper arm. Once inserted by your health care provider, it’s effective for three years. 

The implant works by releasing a hormone called progesterone, which prevents pregnancy in three different ways:

• Stopping your ovary from releasing an egg (ovulation) 
• Thickening the mucus in your cervix to stop sperm in its tracks 
• Thinning the lining of your uterus to make it harder for a pregnancy to develop 

Contraceptive injections 

Also known as the birth control shot, the contraceptive injection is a type of medicine that’s injected into your arm or bottom. It can protect against pregnancy for up to 13 weeks. You can either book in to have your shot administered by your doctor or do it yourself. 

Like the implant, the shot contains a type of progesterone hormone and prevents pregnancy in the same three ways. It’s considered to be over 99% effective when used perfectly. 

Combination pill 

The combination pill earns its name by containing a combination of two different hormones: estrogen and progesterone. Together, they prevent pregnancy by stopping ovulation, thickening cervical mucus, and thinning the lining of your uterus. It’s over 99% effective when used perfectly. 

Different types of pills have different dosages of these hormones. Your doctor can help you decide which is the right one for you based on your health history. 

As well as preventing pregnancy, the combination pill can have other beneficial side effects, like improving acne, reducing excessive face and body hair, and lessening period cramps. The main downside is that whichever type you get, you’ll need to remember to take a pill every day. Setting an alarm on your phone might help you to remember. The combined pill also may not suit you if you have a family history of conditions such as blood clots, high blood pressure, or heart disease. It’s always best to speak to your doctor before starting a new type of contraception.  

Progesterone-only pill 

This type of birth control pill might suit you if you can’t have medicine with estrogen. Your doctor will let you know if this is the case for you. It works by thickening cervical mucus to stop sperm from reaching an egg, with some types also stopping ovulation. Like the combined pill, the progestin-only pill is over 99% effective if used perfectly. 

You might have heard progestin-only pills being referred to as “mini pills.” They generally come in packs of 24 or 28, and you should take one a day. If you have a 28-pill pack, it means that every pill has progesterone, whereas a 24-pill pack has 24 pills with progesterone and four placebo pills. You should take your pill at the same time every day. 

Contraceptive patch 

A bit like a square bandage, the contraceptive patch sticks onto your skin on either your bottom, upper arm, lower belly, or upper body. When used perfectly, it’s over 99% effective.

The birth control patch usually works in a four-week cycle. You need to change your patch weekly on the same day you started it — so every Sunday, for example — for the first three weeks. On the fourth week, you don’t need to apply a patch, and count this as your break week. Like the combination pill, the patch releases the hormones estrogen and progesterone to stop ovulation, thicken cervical mucus, and thin the lining of your uterus. You might like the idea of the patch if you have difficulty either remembering to take or swallowing birth control pills. 

Like any type of new birth control, your doctor will walk you through your health history to ensure that it’s suitable for you. It may not be recommended if you’re over the age of 35 and smoke cigarettes, have medical conditions like high blood pressure, have a history of blood clots, heart attack, or stroke, or have experienced migraines with an aura. 

Vaginal ring

Another one of the hormonal contraceptives, the vaginal ring, releases estrogen and progesterone straight into your vagina. It’s small and bendy and prevents pregnancy by stopping ovulation, thickening cervical mucus, and thinning the lining of your uterus. 

There are two different types of rings: one that you can use for three weeks at a time before having a break week and one that you can reuse for up to a year. If you opt for the ring, you can use it for up to a year. Then you’ll need to remove, wash, and store it safely when you’re not using it. 

If you use it correctly, the vaginal ring is more than 99% effective at preventing pregnancy. 

Sponge

The sponge is a form of nonhormonal birth control that’s placed into the vagina before you have sex. It’s a small, round piece of plastic foam that’s coated with spermicide — a substance that damages sperm. The birth control sponge also works by trapping and absorbing sperm, preventing it from entering your cervix and reaching an egg. It’s thought to be between 80% and 91% effective if you use the sponge perfectly. 

If you’d like to use a sponge, then you may need to do a little bit more preparation before sex. First, you need to activate the spermicide by running the sponge under water until it’s thoroughly wet. You then insert it by folding the sponge in half (away from an attached loop that’s there so you can remove it easily) and put it deep inside your vagina. Once inside, it should fold back out to cover your cervix. You can always check that it’s done correctly using your fingers. 

After sex, you shouldn’t remove the sponge for at least six hours. You can even leave it in for a total of 30 hours, and during this time, you can have as much sex as you like.

Cap or diaphragm 

The contraceptive cap or diaphragm works similarly to the sponge by blocking sperm from entering your cervix. It’s shaped like a circular dome, made of thin, soft silicone, and you need to use it with a separate spermicide. This can make things a bit more fiddly, as you have to reapply spermicide each time you want to have sex while it’s in.

Like the sponge, leave it in for at least six hours after having sex. If you choose a cap, you can leave it in for 48 hours in total. Diaphragms are around 94% effective at preventing pregnancy when used perfectly, and there’s no data for how effective caps can be when you use them alone. So, these options aren’t as reliable as some of the other forms of birth control, but they’re still pretty good options if you’d rather not use hormonal contraception. 

What happens if you don’t use contraception?

It’s great that you’re thinking about contraception now because you can get pregnant the first time you have sex. “Your chance of becoming pregnant is not lower or higher just because it is your first time,” says Dr. Boyle. “Not all people having sex for the first time are young, but many are. When you are young, your fertility is generally higher. Your body might be ready for pregnancy even though you are not. So being extra careful is really important.”

You may have heard of the withdrawal method, where, rather than using a device or medication to avoid pregnancy, a man pulls out of the vagina before he ejaculates. It’s not as effective at preventing pregnancy as other methods of contraception. 

“The risk of pregnancy when using withdrawal is about 20% over one year of use,” says Dr. Boyle. “It is very hard for a man to pull out every time before he ejaculates. And he has to make sure that he doesn’t ejaculate even on your vulva or at the opening of the vagina. That’s a lot of pressure! The more sexually inexperienced a man is, the harder it will be for him to pull out in time.”

It’s also possible that there’s sperm in pre-ejaculatory fluid, or pre-cum, a fluid from the penis that comes out before ejaculation. “This is controversial, as some studies have seen sperm in this fluid, and some haven’t,” says Dr. Boyle. “But while we’re not sure if this fluid contains sperm, we are sure that it can contain STIs. So condoms are much, much better than withdrawal.”

You should also use birth control if you have sex on your period, as it’s still possible to get pregnant. Tracking your cycle may help you understand your body better and help you feel more aware and in control. 

Where and how to get contraception

So now that you’re well informed about the different types of birth control, where can you get some? “It depends on where a person lives and what type of access to health care they have,” says Dr. Boyle. Some examples of the types of places that offer contraceptives are: 

• Special contraception clinics
• Your health care provider
• Pharmacies
• Your obstetrician and gynecologist 

Dr. Boyle adds: “Online clinics are becoming a more popular way to access prescription birth control such as pills, patches, and the ring.” 

While it’s great to read up on birth control, you don’t need to do lots of research, as your doctor can talk you through all the different options. And if you’re at all nervous about attending your appointment alone, you can take a friend or family member with you for support.