Sexual Health and Contraception: Guide to Options, Safety and Next Steps

Maybe it started with a change you did not expect. A birth control question you have been putting off, an erection that is not what it was, a worry after a new partner, or a body change that is making sex harder.

Most people sit with that for a while before they ask anyone. You do not need a perfect question to start.

What is sexual health? It is how sex affects your physical and emotional health, and knowing how to form healthy relationships and make decisions about sex that are right for you, according to MedlinePlus. When a symptom keeps coming back, a visit with a clinician is the right next step. This guide sorts out what is going on, your real options, how to stay safe, and what to do next.

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Step 1: Work out what is going on

You are probably trying to name the problem before you can decide anything. That is the right order.

Some concerns have a clear physical link. The NIDDK says changes in sexual function or bladder habits may be a sign of diabetes. It also says men with diabetes are more than 3 times more likely to develop erectile dysfunction than men without diabetes, and that good diabetes management may help prevent and treat ED caused by nerve damage and circulation problems.

If erections are the concern, the erectile dysfunction guide covers causes, tests and options. Vulvar and vaginal changes are a different question, and the vulvar health guide explains normal variations, irritation and when symptoms need a visit.

Once you know what kind of concern you have, the next question is who can look at the cause.

Step 2: Get a clinician to look at the cause

You may be wondering whether a symptom is worth a visit. For problems with sex or bladder function, the NIDDK says to see a health care professional, because these problems can be signs that diabetes needs managing in a different way.

Treatment depends on the cause. The NIDDK says a doctor can treat erectile dysfunction with medicine or with a change to the diabetes care plan. It also says low testosterone may be behind some men’s erectile problems, and that a doctor may suggest a prescription gel, injection or patch. The same page notes that testosterone therapy may have serious risks and may not be safe for all men.

A missed period is another reason to book. The missing period guide covers causes and how they are evaluated.

Bring a short list to the visit: when the concern started, what has changed, every medicine and supplement you take, and your questions. The guide on preparing for a reproductive-health visit covers what to bring and how privacy and records work.

With a clear picture and a plan for the visit, the next step is choosing protection that fits your body.

Step 3: Compare contraception that fits your body

You want to prevent pregnancy, and you want a method you can keep using. The terms birth control and contraception are used for the same thing: methods that prevent pregnancy.

Effectiveness is reported two ways, typical use and perfect use, and the gap between them matters for planning. The contraception effectiveness guide explains the difference.

Sexual side effects are a common worry. A 2022 review in Therapeutische Umschau said hormonal contraceptives usually have no significant effect on sexual health, though some women report better sexual experience and others report dysfunction. A 2019 position statement from the European Society of Sexual Medicine found that only a minority of women change in sexual functioning, and that there is not enough evidence for a clear algorithm to manage it.

A narrative review in the Journal of Women’s Health said that sexual dysfunction that starts around the time you begin a contraceptive may be addressed by trying an alternative method. It also said that not using contraception was associated with sexual dysfunction and dissatisfaction too.

Weight is another common question. A 2015 review in Best Practice & Research Clinical Obstetrics & Gynaecology said evidence is reassuring that most modern contraceptive methods are safe and effective in women with obesity, while noting that many were not originally studied in that group.

Planning ahead helps too. The guide on avoiding gaps in birth control covers refills, travel and backup questions, and the birth control methods comparison sets out effectiveness, control, reversibility and STI protection side by side.

If you are asking about birth control options for a male partner, condoms are the method covered in the STI section below. Ask a clinician what else is available for your situation.

Method choice and STI protection are linked, so the next chapter covers both.

Step 4: Protect yourself from STIs and pregnancy

You may be worried about an infection, or about a condom that did not hold up. Both are worth a clear plan.

MedlinePlus says there are more than 20 types of STIs, and that they do not always cause symptoms, so you can have one without knowing it. The only way to know for sure is to get tested. Condoms are the only birth control method that protects against STIs, but condoms alone are not the most effective form of birth control, so MedlinePlus advises using them with another method.

MedlinePlus also says the HPV vaccine can be given between ages 9 and 26, and that talking with a partner about STIs and getting tested before sex both lower your risk. The guide on HPV vaccination questions covers what to bring to that conversation.

At-home tests are one option. The at-home STI test guide explains what a result can and cannot tell you, and what follow-up it may need.

If you had unprotected sex and need emergency contraception, the emergency contraception guide covers timing and access. If you take an HIV or tuberculosis medicine, ask a clinician about emergency contraception. A registered study on ClinicalTrials.gov looked at whether a double dose of levonorgestrel overcomes interactions with efavirenz-based HIV treatment and rifampicin-containing TB therapy. It is listed as completed with 122 planned or enrolled, and a registration describes a study rather than reporting its result.

Urgent symptoms need quick attention. The ectopic pregnancy guide covers warning signs.

Protection covers the body. The next chapter looks at how sexual health changes with age and menopause.

Step 5: Understand what changes with age and menopause

Your body changes over time, and so do the questions you ask about sex and contraception.

A 2024 review in Best Practice & Research Clinical Endocrinology & Metabolism said sexual symptoms become more frequent as women age, but they do not always become a dysfunction diagnosis, because a diagnosis requires distress. It also addressed contraception across the menopausal transition, including risks and benefits.

Vaginal dryness and changes in desire are common topics at this stage. The menopause sexual health guide covers vaginal dryness, libido changes and treatment options. If your cycles are becoming less predictable, the perimenopause guide covers common changes and how to track symptoms.

If you are over 40 and still need contraception, the guide covers options and risks around perimenopause.

Some of the questions you bring may be about products, which is the next chapter.

Step 6: Look at products and supplements with clear eyes

You may have seen an ad or video promising a fast result. Claims like that are the maker’s claims, and you can check them before you spend money.

Start with safety. A 2017 systematic review in the Journal of Dietary Supplements looked at 26 published supplement studies of heart-rhythm effects. Eight found a significant change in QT/QTc intervals, and more than 30% showed some degree of ECG changes. The review said this suggests the need for continued cardiovascular safety assessment of supplements.

Oversight is another question. A 2023 narrative review in Innovations in Pharmacy argued that FDA regulation of dietary supplements falls short. It counted 79,071 adverse events reported to the FDA between 2004 and 2021, and named herbal products including yohimbine and kava as ones linked to reported harms.

If you are looking at a specific product, read the seller’s claims as the seller’s own statements, then check the price and ordering terms, the side effects and the complaints. The Where to Buy DirectMax guide and the DirectMax sexual health review are two starting points for that check.

To judge a study yourself, the plain-language guide to reading a clinical study explains what to look for.

Privacy and consent come with every product and every conversation, and the last chapter covers both.

Step 7: Protect your privacy and get support

Privacy and consent shape every step, from the app on your phone to the conversation with a partner.

MedlinePlus describes healthy relationships as ones with respect, trust, honesty and good communication, where neither person pressures the other. It lists jealousy, control, pressure and violence as signs of an unhealthy relationship, and says that if you do not know how to end a violent relationship, you should get help.

If you experienced sexual assault or harassment during military service, the VA says it provides free treatment for physical and mental health conditions related to military sexual trauma. You can ask to meet with a clinician of a particular sex. In a crisis, call 988 and select 1 to reach the Veterans Crisis Line.

Privacy also reaches your phone. The app privacy guide covers permissions, sharing and deletion questions. The consent guide covers respectful conversations with a partner.

Your next step

1. Write down the concern, when it started, and what has changed.
2. Book a visit with a clinician if a symptom keeps coming back, and bring your list of medicines and supplements.
3. Plan contraception with a clinician, and check refill and backup questions before any travel.
4. If you want STI testing, prepare your questions and check what an at-home result can and cannot tell you.
5. Before you buy any product, check its price, ordering terms, side effects and complaints, and ask a clinician if it could interact with a medicine you take.

Every guide on this topic

Sexual function and men’s health

• Erectile dysfunction at 30: causes, tests and options
• Male Enhancement Supplements: Evidence, Safety and Red Flags
• Watery sperm and pregnancy questions

Birth control and pregnancy prevention

• Birth Control Methods Compared
• Contraception Effectiveness Numbers
• Avoiding Gaps in Birth Control
• Emergency Contraception Options
• Contraception After 40

STIs, testing and vaccination

• STI Testing Checklist
• Preparing for an STI Testing Conversation
• At-Home STI Tests: Results and Limits
• HPV Vaccination Questions
• Vaginitis Testing Differences

Cycles, ovulation and fertility

• Tracking Ovulation: Signs, Tests and Fertile Days
• Fertility Awareness Calendar Guide
• Improving Sperm Count: Food and Next Steps
• Supplements for Sperm Motility Research
• Male Fertility Supplements Research
• Missing Period Causes and Evaluation

Life stages and menopause

• Sexual Health During Menopause
• Perimenopause: Common Changes and Symptom Tracking

Products and sellers

• Where to Buy DirectMax: Price, Safety and Ordering Guide
• DirectMax Sexual Health Review
• DirectMax Complaints: Billing, Refunds, Shipping
• Stallion Power Gummies: Ingredients, Price and What to Expect
• Ordering SodaTide: What to Check Before You Buy
• Dr Anna Cabeca Feminine Review

Pregnancy and urgent care

• Ectopic Pregnancy: Urgent Warning Signs
• Cervical Insufficiency: Diagnosis and Cerclage
• Premature Birth Risk Factors and NICU Care
• Group B Strep Pregnancy Screening

Pelvic and vulvar health

• Vulvar Health: Normal Variations and Irritation
• Vulvodynia Diagnosis and Treatment
• Interstitial Cystitis: Diagnosis and Daily Life
• Pelvic Organ Prolapse: Symptoms and Treatment
• Pelvic Floor Basics and Physical Therapy

Privacy, consent and visits

• Sexual Consent and Communication
• Reproductive Health Apps and Privacy
• Preparing for a Reproductive-Health Visit
• Reproductive Health Preventive Care Map

By ReproductiveHealthCtr.com Editorial Team

This article is for general information purposes only and does not constitute medical advice. Consult your doctor or qualified healthcare provider before making changes to your health routine.