What to Do After Having Unprotected Sex—Or If the Condom Breaks

What Not to Do After Unprotected Sex

One thing you shouldn't do after unprotected sex is to try douching.

"Douching will not increase the risk of pregnancy, but it may increase the risk of pelvic infections," said Lisa Perriera, MD, MPH, former assistant professor of obstetrics and gynecology at University Hospitals Case Medical Center, in Cleveland. "Douching in general is a bad idea."

Why? It alters the normal balance of yeast and bacteria in the reproductive tract, which could lead to an infection.

What to Know About Plan B

Plan B was the first hormonal product approved in the U.S. specifically for emergency contraception. It can prevent ovulation and fertilization if taken within three days of having unprotected sex. The sooner you take it the better, according to The CDC.

Anyone can buy Plan B and its generic counterpart over the counter, meaning you don't need a prescription (although you may have to ask the pharmacist). Plan B costs between $10 and $70, according to Planned Parenthood.

Christopher Estes, MD, obstetrics and gynecology specialist at Miami Beach Comprehensive Wellness Center, recommended keeping it on hand in case of emergency.

Side effects can include nausea, tiredness, headache, and breast tenderness.

What Is Ella?

Ella (or ellaOne) is an emergency contraceptive approved by the FDA in 2010. It works in generally the same way as Plan B except that it's effective if taken as many as five days after unprotected sex.

(Plan B contains the hormone progestin while Ella is ulipristal acetate, which has some progestin-like qualities.)

So far, Ella appears to be safe. Still, said Dr. Estes, it doesn't have the same length of follow-up as Plan B, which has been on the market for more than a decade.

Side effects are similar to Plan B, and include nausea, tiredness, headache, and dizziness.

Copper IUD After Unprotected Sex

Another type of emergency contraception is a copper IUD (ParaGard), which needs to be inserted by a doctor within five days after unprotected intercourse.

"It seems to work by increasing cervical mucus and repelling sperm," said Beth Jordan, MD, former medical director for the Association of Reproductive Health Professionals. Unlike the two emergency contraceptive pills, the copper IUD—if you keep it in—is effective for 10 or more years.

It could be costly, however, if your insurance doesn't cover it: $500 to $1,000, according to Planned Parenthood. Side effects include cramping and bleeding between periods; they usually go away after the first few months.

Get tested for STIs

There's little you can do to prevent sexually transmitted infections (STI) after the fact, but you can still treat and manage them.

It's a good idea to get tested for gonorrhea, chlamydia, syphilis, HIV, and hepatitis B and C virus within a couple of weeks of unprotected sex. If the HIV and hepatitis results are negative, you'll need to get retested in another six months to be absolutely sure.

If you think you've been exposed to HIV, you can take a prophylactic course of antiretrovirals. However, this is generally reserved for high-risk scenarios (for example, a health-care worker stuck with a needle or a rape victim). Make sure that you follow up on your STI tests to find out the results.

You Can Get Pregnant After Unprotected Sex

Taking morning-after pills doesn't guarantee that you won't get pregnant. A large review study published in 2019 in the Cochrane Database reported that women who took Plan B had a 1.1% and 2.4% chance of getting pregnant. The same study reported that these rates were slightly lower for Ella.

That means you'll still need to keep an eye on things, bearing in mind that a morning-after pill can cause spotting and may alter the flow of your period, which can make it hard to tell if you are pregnant.

You can also get pregnant after unprotected sex while you're on your period, though it's less likely. Sperm can live anywhere from 3 to 5 days inside your body, and ovulation, the time where you're most likely to get pregnant, is several days away from the end of your menstrual cycle. The window of you getting pregnant is significantly smaller during your period, but that doesn't totally eliminate the risk.

If your period is more than a week late, take a pregnancy test.

Preventing Pregnancy and STIs After Unprotected Sex

• The morning after is a good time to carefully consider your future birth control options. Make an appointment to speak to your healthcare provider so you can figure out which are the safest and most effective choices for you.
• Emergency contraception can have side effects and may or may not prevent pregnancy, so don't rely on this type of birth control as regular after-the-fact protection.
• Also make sure you know how to use condoms correctly.
• "Many condom failures are just due to improper use," Dr. Estes said. "It's not put on the right way, it's not worn the right way, you roll them inside out. When putting on a condom, you need to know exactly how to place it, from start to finish."