Maybe you’ve been there: You’re having penetrative sex and enjoying yourself immensely. But when it’s all over, you and your partner realize that the condom has somehow... disappeared. While not common, this isn’t unheard of: One study of 544 cis men found that, over one year, 4.4% experienced condom slippage.
While you might be feeling panicked, there are actions you can take to reduce the risk of pregnancy and HIV transmission. Here’s what to do.
Find the condom
It might seem obvious, but first things first: Find the condom, because if it’s not between the sheets, it might still be in your vagina (or anus, if you were having anal sex). And like any other foreign object left inside you — a tampon, a jade egg — a lost condom can lead to an infection if not removed.
First, try “gently sweep[ing] it out,” Nicole Bullock, DO, FACOG, an ob/gyn in Abilene, TX, previously told Refinery29. Reach inside your vagina with clean fingers. Keep your pelvic muscles relaxed, or try to bear down gently. If you suspect the condom is still inside you and you can’t get it out, head to your gynecologist, who will be able to find and remove it easily with a little help from a speculum. And no need to be embarrassed. Trust us, they’ve seen it all before.
Reduce the risk of pregnancy
If you were having penis-in-vagina sex and your partner came inside you (or even if they didn't), you can take emergency contraception to reduce the risk of pregnancy. According to Columbia University’s healthcare resource Go Ask Alice, the chance of pregnancy from a single act of unprotected sex during ovulation is 20-30%, and 2-4% at other times in the menstrual cycle. If you track your cycle, you can estimate how close to ovulation you are, but keep in mind that the app you use might not be entirely accurate, especially if your periods are irregular.
If you’re at all concerned, emergency contraception can help prevent pregnancy. You have a few options: a morning-after pill with either levonorgestrel (Plan B, Take Action, My Way, or AfterPill) or ulipristal acetate (Ella); or a copper IUD (Paragard).
The first option is available over-the-counter. Levonorgestrel is a synthetic hormone that works like the hormone progesterone to prevent ovulation — so if you’ve already ovulated, it won’t be effective. "The sooner [you take it], the better, because it’s going to then prevent the release of that egg," Ashton Strachan, DNP, CRNP, of the Student Health Services at University of Alabama at Birmingham, previously told Refinery29. "If you wait too late, your body may release that egg before [Plan B] has the time to stop that release."
Ella, another type of morning-after pill, uses a progesterone receptor modulator to prevent ovulation; this medication may also make it harder for a fertilized egg to implant. Ella has a longer time period of effectiveness than levonorgestrel pills, up to 120 hours (five days) after sex. You need a prescription for Ella, and you can’t buy it over-the-counter, which can make it a less convenient choice.
Finally, you could head to your gynecologist to get a copper IUD. If you get one within five days of unprotected sex, it lowers the chance of pregnancy by 99.9%, according to Planned Parenthood. Plus, weight doesn't affect how well it works. However, a copper IUD is a long-term method of birth control: it prevents pregnancy for up to 12 years, until you have it removed.
How to reduce the risk of HIV
If you had unprotected sex and you think you may have been exposed to HIV, you can talk to your doctor about possibly beginning post-exposure prophylaxis (PEP). This is a round of medicine taken soon after possible exposure to HIV, reducing the risk of contracting the virus. It’s taken once or twice daily for 28 days and should be started within 72 hours.
How to detect STIs
If you think you may have been exposed to another STI, schedule a test at least two weeks after the incident. At this point, some common STIs, including chlamydia and gonorrhea, will be detectable. If you were exposed, you can then begin antibiotics to treat them. Other STIs, including syphilis, HSV, and genital warts, may appear later on. If you experience symptoms such as itching, unusual discharge, pain during urination or sex, a rash, or blisters, head to the doctor to get things checked out.
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