Whether you got carried away in the moment or a condom broke, finding you’ve had unprotected sex can be worrying. Stay calm and take it one step at a time, but don’t ignore it – early action is important.
1. Pee straight after sex. This simple first step can’t keep pregnancy at bay – urine is released from your urethra, not your vaginal canal where sperm is ejaculated, and has a separate opening. But peeing can help flush out bacteria found on skin, that can enter your urethra and cause a urinary tract infection (UTI). Signs to watch for later include pain or burning when you pee, the need to pee frequently (even when your bladder is empty), blood in your urine, and pressure or cramps in your groin or lower abdomen. See your health provider if you experience any of these symptoms.
2. Get emergency contraception. The “morning-after” pill levonorgestrel is a hormonal medication that is available over the counter at pharmacies. It prevents pregnancy by preventing or delaying ovulation, fertilisation or implantation of the fertilised egg in your uterus, depending on where you are in your menstrual cycle, says Clicks pharmacist Waheed Abdurahman.
It’s different to the abortion pill, RU-486, which is designed to terminate an established pregnancy, where the egg has implanted and started to develop.) “The morning-after pill needs to be taken within 72 hours (three days), and the sooner the better,” says Abdurahman. It can be sold only to you, not to a third party, and is not advised if you have certain medical conditions, such as a blood clotting disorder or liver impairment. Alternatively, an IUD can be used to prevent pregnancy if it’s inserted within 120 hours (5 days) of unprotected sex.
3. Get protection against HIV with post-exposure prophylaxis (PEP). This is a course of daily low-level ARVs (antiretrovirals) that needs to be started within 72 hours of exposure – again, the sooner the better, Abdurahman says – and continued for 28 days.
4. Get tested for HIV and other sexually transmitted infections (STIs), such as chlamydia, gonorrhoea and syphilis. Speak to your health provider or clinic. (Clicks does not offer STI testing at its clinics yet, says Bronwyn Macauley, Healthcare Services Manager.) It’s best to wait two weeks after unprotected sex, as STIs can take time to become active in your body, and testing too soon can give inaccurate results. If you have symptoms such as itching, burning or pain, get tested straight away, but STIs can be symptomless for a long while.
5. Take a pregnancy test to make sure you are not pregnant. Home tests are available over the counter at Clicks pharmacies. It’s best to wait about three weeks for your body to develop the hormone pregnancy tests rely on. If you find you are pregnant, your decision on what you do about an unplanned pregnancy is personal. Talk with your partner, a trusted friend and your health provider about options. Get counseling if necessary.
6. Take steps to stay safe in future. Speak with your health provider or pharmacist about reliable barrier contraceptive options, including male and female condoms, and lubricants that can help reduce friction and prevent tearing and leaking. Also discuss birth control options, short term and long-term, including implants and injections (they can be given at Clicks Pharmacy Clinics). Consider keeping emergency contraception on hand, but monitor the expiration date. Discuss regular screening for STIs with your health provider. This should be done at least once a year. If you change partners, get tested before you start having vaginal, oral or anal sex, and discuss the results with your partner. If one of you tests positive for an STI, you will both need to get treatment.