Can You Have Unprotected Sex on Birth Control?

Written on November 24, 2023 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• Efficacy of Birth Control
• Sexually Transmitted Diseases
• Sexual Healthcare With Everlywell
• Related Content

You may know that birth control decreases your risk of pregnancy, but can you have unprotected sex on birth control? Pregnancy isn’t the only possible outcome of unprotected sex, so let’s talk about what you should think about before deciding whether to take additional protective steps.

But wait, isn’t birth control a form of protection? For the purposes of our discussion, we’ll define unprotected sex as sex without a barrier form of contraception, such as condoms.

Efficacy of Birth Control

There are many different forms of birth control, and they have different levels of effectiveness.[1] Whether you’ve chosen the pill, patch, shot, or a longer-term form of birth control such as the implant or IUD, no form of birth control is 100% effective at preventing pregnancy. With perfect use, most prescription forms of birth control are more than 90% effective at preventing pregnancy.

According to a study from 2010, if you combine prescription birth control use with condoms, an estimated 80% of unplanned pregnancies in women on birth control alone could be prevented.[2] So, if pregnancy prevention is very important to you, using a condom can further reduce your risk.

Sexually Transmitted Diseases

While all forms of birth control decrease the risk of pregnancy to a varying degree, most forms of birth control don’t protect against sexually transmitted diseases. The only forms of birth control that protect against sexually transmitted diseases are those that provide a barrier between the penis and the vagina, such as condoms. What types of sexually transmitted diseases are you at risk for if you have unprotected sex, even on birth control?

Human Papillomavirus

Human papillomavirus, or HPV, is a virus that is associated with genital warts and some types of cancer. It is the most common sexually transmitted infection in the world.[3] There are over 100 strains of this family of DNA viruses. Around 40 of these strains are associated with genital warts and cervical cancer. Studies have shown that latex condoms may reduce the risk of genital infection associated with HPV.[4] Condom use has been associated with increased rates of clearance of precancerous changes in the cervix associated with HPV.

Chlamydia

Chlamydia is a very common sexually transmitted disease that affects both men and women.[5] This bacteria can affect the genital region as well as the throat. It can even cause eye infections in babies if it is present during birth. Chlamydia doesn’t require ejaculation to be transmitted. Chlamydia can cause symptoms such as discharge from the vagina or penis. It can also cause painful urination, pelvic pain, or pain during sex. If the chlamydia infection is in the rectum, it can cause pain, bleeding, or discharge. In some cases, chlamydia can cause an infection called pelvic inflammatory disease (PID) in women.

If left untreated, chlamydia can result in severe complications such as scar tissue in the fallopian tubes that can cause ectopic pregnancy, problems getting pregnant, or long-term pelvic and abdominal pain. If chlamydia is untreated, it can also increase your risk of other sexually transmitted diseases. Chlamydia is easily treated with antibiotics. The best way to prevent chlamydia infection is to regularly use condoms and to limit the number of sexual partners. Regular testing for this infection is recommended in certain groups.

Gonorrhea

Gonorrhea is a bacterial infection that affects the cervix, uterus, fallopian tubes, urethra, mouth, throat, eyes, and rectum.[6] Like chlamydia, this infection is transmitted through contact with an infected body part and doesn’t require ejaculation. This infection is frequently asymptomatic but can cause abnormal discharge, abdominal pain, joint pain, pain with urination, irregular vaginal bleeding, or testicular or scrotal pain.

Gonorrhea can infect babies if it is present during delivery. It can cause severe complications in the newborn. If it’s left untreated, gonorrhea can result in a widespread, or disseminated, infection that can cause arthritis, tendonitis, and skin rashes. This is a life-threatening infection. It can also cause PID and infection of the spermatic cord called epididymitis. Infections in these areas can cause infertility. Gonorrhea can be treated with antibiotics. Regular testing for this infection is recommended in certain groups. The best way to protect against STDs is to use regular latex condoms and to minimize the number of sexual partners.

Human Immunodeficiency Virus

Human immunodeficiency virus, or HIV, is the virus that is associated with AIDS.[7] This virus attacks certain parts of your immune system. HIV is a lifelong infection, and there is no cure. Medications can decrease the risk of transmission. HIV is frequently asymptomatic until late in the infection, so you can have it for a long period of time and not know it.

HIV is transmitted through exposure to bodily fluids such as blood, semen and seminal fluid, rectal and vaginal fluids, and breast milk, so it is most commonly spread by unprotected sex or through injected drug use. The best way to protect yourself from HIV infection is through regular use of condoms and avoiding drug use. If you have HIV, being on suppressive medication and regular use of condoms is the best way to prevent it from spreading to your partner.

Syphilis

According to the Centers for Disease Control and Prevention, Syphilis is causing growing concern amongst healthcare providers because it is on the rise. Syphilis is a bacterial infection that is spread by direct contact with a sore through vaginal, anal, or oral sex.[8] Syphilis can spread to an unborn baby and cause significant abnormalities in the developing baby.

Syphilis is an infection that has four primary stages. The first stage of syphilis is when a single or multiple sores develop in the location where the bacteria enters the body. During the second stage, more widespread sores or rashes can occur. The disease can then go dormant for years. If the disease reactivates, it can affect multiple organ systems and cause death. Condoms can prevent the spread of syphilis by preventing contact with the sore. If the sore is in an area that isn’t covered by a condom, it is still possible to spread the infection. Regular testing for syphilis is recommended for certain high-risk groups.

Sexual Healthcare With Everlywell

STDs are serious and can have a long-term impact on your health. If untreated, STDs can be life-threatening. Birth control can help prevent you or your partner from getting pregnant, but in most cases, it doesn’t prevent you from getting sexually transmitted diseases.

Take charge of your sexual health. If you are concerned about STDs, Everlywell offers at-home STD testing to evaluate for STDs (sample collection is done at home, and you then mail the sample to a laboratory for processing). We also have clinicians who can provide STD telehealth visits to discuss your situation and give you advice on how to protect yourself, and who may prescribe medication if applicable.

Related Content

Does Showering After Sex Reduce Chances of STDs?

Are Crabs An STD?

What Causes Pain During Sex In Females?

References

1. Effectiveness of birth control methods. American College of Obstetricians and Gynecologists. https://www.acog.org/womens-health/infographics/effectiveness-of-birth-control-methods. Published April 2023. Accessed November 15, 2023.
2. Pazol K, Kramer MR, Hogue CJ. Condoms for Dual Protection: Patterns of Use with Highly Effective Contraceptive Methods. Public Health Rep. 2010; 125(2): 208-217.
3. Juckett G, Hartman-Adams H. Human Papillomavirus: Clinical Manifestations and Prevention. Am Fam Physician. 2010;82(10): 1209-1214. https://www.aafp.org/pubs/afp/issues/2010/1115/p1209.html.
4. Condoms and STDs: Fact Sheet for Public Health Personnel. https://www.cdc.gov/condomeffectiveness/latex.html. Published Feb 2, 2022. Accessed November 15, 2023
5. Chlamydia – CDC Basic Fact Sheet. CDC. https://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm. Published April 12, 2022. Accessed November 15, 2023.
6. Gonorrhea – CDC Basic Fact Sheet. CDC. https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm. Published August 22, 2022. Accessed November 15, 2023.
7. What are HIV and AIDS? HIV.gov. https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids/. Published January 13, 2023. Accessed November 15, 2023.
8. Syphilis – CDC Basic Fact Sheet. CDC. https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm. Published February 10, 2022. Accessed November 15, 2023.