What I'm curious about is exactly how effective condoms are, what causes them to be reduced in effectiveness- when are they not 100% effective? and does purchasing condoms with a spermicide lubricant help in preventing pregnancy? Also, what about birth control medications? Are side effects common? Do they affect fertility in the longterm? are there any other ill effects we should be aware of?

Finally, how worried do we need to be about unwanted pregnancies if one or both of these methods of birth control are used?

Thank you very much for your time, much appreciated.

First, condoms are not 100% effective but they are more effective than many of the other non-hormonal methods. They can be in the 90% range, and often are considered 97% effective. They do break occasionally and are probably more effective if used with a water based lubricant to keep the friction on the latex down some. Spermicidal lubricant on them is considered helpful as a back up if they break, but a better back up would be using even more spermidice as found in the gels or foam.

As for the hormone Pills, I'm sorry that your girlfriend has only heard the negatives about them. They are the most studied medicine (over Aspirin and any other popular medication)that there is. The Pill has been used since 1960 and is now used more than almost any other method except sterilization (which is most popular because of its permanency for women who have completed having their families). The Pill is actually considered a healthy medication and is only unhealthy for those who smoke cigarettes (and that is unhealthy for a woman or anyone as well), who have serious problems with blood clots or stroke.

The Pill is such a healthy alternative and has been written about in recent times as a good method for young women who want to delay having a child for several years. There are many types of the Pill out there so there are very few negative side effects in taking them. By side effects I am refering to those most often brought up when girls talk among themselves, such as weight gain. The weight gain they have with a pregnancy is FAR greater, and very few women gain weight on the Pill. Just as many lost weight, but the media never picks up on that.

I would really like your girlfriend to see a good doctor and talk to him/her about using a better method so that she can enjoy your sexual relationship and not be so worried all the time. I know that in Canada you have good family planning clinics and surely she can go talk to them about the different methods available to her.

Please feel free to write back or have her write to me if you want more information on any of this.

Reviewed by Sexual Health Editorial Team