Pregnancy Risks and Contraceptive Options After Intimacy

Pregnancy probability

Hello Doctor: I would like to ask, on March 1st, I had intimate contact with my boyfriend, but I noticed that he touched himself before using his hand on me (he has secretions when he is aroused).
What is the likelihood of pregnancy in this situation? We only engaged in foreplay without a condom, but we used condoms for the rest of the time.
Also, today (March 5th), I am experiencing lower back pain and occasional dull pain in my lower left abdomen.
I am really worried that it might be pelvic inflammation (since I have had pelvic inflammatory disease before).
Could this be a possibility? Additionally, I do not plan to have children, and my menstrual cycle is irregular, so I would like to take birth control pills.
However, my gynecologist advised against it because I have a lump in my breast (which has been checked and is not serious).
Given this situation, is using condoms alone sufficient for contraception? Or are there other contraceptive methods available? Thank you for your help, and I appreciate your hard work.

Danxin de nǚzǐ, 30~39 year old female. Ask Date: 2019/03/05

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On March 1st, I had intimate contact with my boyfriend, but I noticed that he touched himself before using his hand on me (he has secretions when he is aroused).
What is the likelihood of pregnancy in this situation? Answer: The likelihood of pregnancy is low since we only engaged in foreplay without a condom, but we used condoms for the rest of the time.
Then today (March 5th), I am experiencing lower back pain and occasional dull pain in my lower left abdomen.
I am really worried that it might be something like pelvic inflammation (since I have had pelvic inflammatory disease before).
Could this be a sign of pelvic inflammatory disease? Answer: Lower back pain and occasional dull pain in the lower left abdomen do not necessarily indicate pelvic inflammation; it would be best to monitor the symptoms and consult a doctor if it persists.
Since I do not plan to have children and my menstrual cycle is irregular, I want to take birth control pills.
However, a gynecologist advised against it because I have a lump in my breast (which has been checked and found to be benign).
Given this situation, is using only condoms sufficient for contraception? Answer: Is it sufficient, or are there other contraceptive methods? Answer: Consider getting an intrauterine device (IUD).

Reply Date: 2019/03/05

More Info

Understanding pregnancy risks and contraceptive options is crucial for individuals who are sexually active and wish to manage their reproductive health effectively. Based on your situation, let's break down the concerns regarding potential pregnancy, pelvic pain, and contraceptive methods.

Pregnancy Risk Assessment
From your description, you engaged in intimate activities on March 1st, where there was some contact with pre-ejaculatory fluid (also known as pre-cum) before any penetration. While the risk of pregnancy from this type of contact is generally low, it is not zero. Pre-ejaculatory fluid can contain sperm, and if it comes into contact with the vaginal area, there is a possibility of sperm entering the reproductive tract, especially if there was any subsequent penetration without a condom.

Since you mentioned that you used condoms for the majority of your intimate activities, this significantly reduces the risk of pregnancy. However, it is important to note that no contraceptive method is 100% effective, and the failure rate of condoms can be influenced by factors such as improper use or breakage.

Symptoms of Pelvic Pain
Regarding your symptoms of lower back pain and left lower abdominal discomfort, these could be attributed to various causes. While pelvic inflammatory disease (PID) is a possibility, especially given your history of it, the symptoms you describe are not definitive indicators of PID. Other potential causes could include ovulation pain, muscle strain, or even stress-related discomfort. If the pain persists or worsens, it would be advisable to consult a healthcare provider for a thorough evaluation, including a pelvic exam and possibly imaging studies if necessary.

Contraceptive Options
Since you have expressed a desire to avoid pregnancy and have concerns about taking hormonal contraceptives due to a breast lump, it is essential to explore alternative contraceptive methods. Here are some options:
1. Condoms: As you are already using condoms, they are a reliable method of contraception when used correctly. They also provide protection against sexually transmitted infections (STIs).

2. Non-Hormonal IUD: The copper intrauterine device (IUD) is a highly effective, long-term contraceptive method that does not involve hormones. It can prevent pregnancy for up to 10 years and is reversible.

3. Diaphragm or Cervical Cap: These barrier methods can be used in conjunction with spermicide to enhance effectiveness. They require proper fitting and use.

4. Fertility Awareness Methods: Tracking your menstrual cycle and identifying fertile days can help you avoid intercourse during ovulation. This method requires diligence and understanding of your cycle.

5. Emergency Contraception: If you are concerned about a potential pregnancy after unprotected intercourse, emergency contraception (like Plan B) can be taken within 72 hours to reduce the risk of pregnancy.

6. Consultation with a Specialist: Given your concerns about hormonal contraceptives due to the breast lump, it may be beneficial to consult with a gynecologist or a reproductive health specialist. They can provide personalized advice based on your medical history and current health status.

Conclusion
In summary, while the risk of pregnancy from your described activities is low, it is not entirely absent. Monitoring your symptoms is essential, and if you experience significant discomfort or changes, seek medical attention. For contraception, consider non-hormonal options and discuss your concerns with a healthcare provider to find the best method for your needs. Remember, effective communication with your partner about contraception and sexual health is also vital in managing your reproductive choices.

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