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So you had unprotected sex. Maybe you forgot about the whole condom thing in the heat of the moment, or maybe the condom slipped or broke.
These things happen, and they can be scary AF. You might be worried about pregnancy or a sexually transmitted infection (STI) or both.
That's why having a morning-after game plan is essential. Here's what you need to know to take charge of your health after sex without a condom.
Were you sexually assaulted?
First, a note about sexual assault: If you've been sexually assaulted, your first consideration should be your immediate safety. If you're in danger, leave the location and call 911 if possible.
And if someone removed a condom during intercourse without your consent, that's “stealthing.” Lawmakers are pushing to have it classified as sexual assault.
We've put together a list of resources for sexual assault survivors to seek immediate crisis counseling, help with next steps, and other forms of assistance.
What to do right after unprotected sex
In the moments after unprotected sex, understandably you might be nervous about an STI or unplanned pregnancy. But it can help to focus on the actions you can take.
Take a trip to the restroom
Although it won't reduce your risk for an STI, peeing may reduce your risk for a UTI.
“Some women are simply more prone to the infection, but one of the most effective ways for anyone to avoid a UTI is to pee shortly after sex,” says Kat Van Kirk, PhD, licensed marriage and family therapist and clinical sexologist.
It clears out the urethra, sweeping bacteria along with it. Drink water to encourage your need to go.
Make a plan for the next day
You might have engaged in an afternoon delight, but unprotected sex often happens after dark. That means you may not have access to a pharmacy or your doc right away.
Although a long night ahead might bring on worry, tamp down anxiety by taking back some control. One way to do that is to make a plan. Set a notification on your phone to call your healthcare provider as soon as possible.
You can also keep an eye out for anything different down there. Write down how you feel so you can monitor any changes and report them to a healthcare provider if necessary.
For women, this includes unusual discharge. Has it changed in volume, consistency, or color? Does it have an unusual odor? Do you feel itchiness or pain?
Most STIs are asymptomatic, but infections like UTIs, yeast infections, and bacterial vaginosis cause symptoms like these anywhere from 24 hours to a week post-hookup.
Symptoms of STIs for women can be found here. Guys, check any unusual symptoms against this list. Report any issues that arise to your doctor.
What to do the morning after unprotected sex
Your next steps will depend on your situation and whether you're on birth control.
Consider emergency contraception
If pregnancy is a concern and you're not on birth control, now's the time to prevent conception.
One option is to get the morning-after pill. Over-the-counter choices include Plan B One Step, Take Action, My Way, AfterPill, and more.
These types of emergency contraceptives are most effective when you take them within 72 hours of unprotected sex, but you can also take them up to 120 hours (5 days) after sex. Sooner is always better.
Another morning-after pill, called Ella, is available with a prescription, and according to Planned Parenthood, it's the most effective. Plus, it works just as well whether you're taking it within 24 hours or up to 120 hours post-sex.
If you goofed with your regular hormonal birth control method - hey, it happens - over-the-counter options, rather than Ella, will be your best choice to avoid any interactions.
The morning-after pill, whether over-the-counter or prescription, does show a slight decrease in effectiveness in women who have a BMI of 30 or greater. Festin MPR, et al. (2017). Effect of BMI and body weight on pregnancy rates with LNG as emergency contraception: analysis of four WHO HRP studies. DOI: 10.1016/j.contraception.2016.08.001
A copper IUD will also work as emergency contraception. The Paragard IUD is 99.9 percent effective at preventing pregnancy if you can get it inserted within 5 days of your encounter. Goldstuck ND, et al. (2015). Practical advice for emergency IUD contraception in young women. DOI: //dx.doi.org/10.1155/2015/986439
You'll have to make an appointment with your healthcare provider or a Planned Parenthood clinic. As a bonus, Paragard will continue to prevent pregnancy for up to 12 years.
Talk to your doctor about STI exposure
If you think there's any chance you've been exposed to HIV, alert your healthcare provider or a doctor at an emergency room or walk-in clinic.
You might be prescribed post-exposure prophylaxis (PEP), a 28-day treatment that may prevent an HIV infection from taking hold.
Although more research is needed, one 2017 study also associated a single dose of PEP taken within 24 hours of unprotected sex with a reduced risk of bacterial STI. Molina J-M, et al. (2017). Post-exposure prophylaxis with doxycycline to prevent sexually transmitted infections in men who have sex with men: An open-label randomised substudy of the ANRS IPERGAY trial. DOI: 10.1016/S1473-3099(17)30725-9
Take stock of your mental state
It's not unusual to feel a little down after having unprotected sex. If you're feeling blue, talk it out with a trusted friend. Chances are they may have gone through a similar experience.
Only about 20 percent of men and women ages 15 to 44 report using condoms every time they've had sex over the course of a month. Copen CE. (2017). Condom use during sexual intercourse among women and men aged 15-44 in the United States: 2011-2015 National Survey of Family Growth. //www.cdc.gov/nchs/data/nhsr/nhsr105.pdf
Don't let worry override important next steps like getting tested for STIs or pregnancy. If you're reeling from the incident, it might be helpful to talk to a counselor or therapist.
What to do 2 weeks after unprotected sex
If you've taken the steps above, you've done your due diligence. The next steps might be waiting for your period to show up or following up on any STI concerns you have.
Take a pregnancy test
While an at-home pregnancy test is most accurate 1 week after your missed period, many brands offer tests that are more than 99 percent accurate even sooner.
The First Response Early Result test, for example. will give you an answer 6 days before your missed period.
But if you want to know for sure - and ASAP - schedule an appointment with your doc, who can test for the markers in your blood. You can also get services at a Planned Parenthood, usually on a sliding fee scale and sometimes for free.
See your OB-GYN or primary care physician
It's a good idea to get tested 2 weeks post-hookup, says Fahimeh Sasan, DO, assistant professor of obstetrics, gynecology, and reproductive science at Mount Sinai Health System in NYC. That's when you can get a preliminary all-clear on STIs.
Most STI tests look for antibodies, and your immune system may not have necessarily developed these at 14 days, but a clean result provides a little peace of mind to get you through to your follow-up a few weeks later.
Watch for symptoms
Many STIs won't be obvious. But one sign to look out for is a herpes sore outbreak. This could occur any time from 10 days to 10 years after being infected, but it's crucial to get to the doc as soon as you spot one, Van Kirk says.
“You have to actually swab an open lesion to confirm that it's herpes, so once the sore heals - which can be within just a few days - there's nothing to test for,” she explains.
If a questionable bump pops up down there or around your mouth, call your doc that day. Most clinics will squeeze you in if you tell them you're worried you have a herpes sore, she adds.
Any unusual discharge, painful urination, genital itching, or bleeding not related to your menstrual cycle is also a reason to contact your doc.
What to do 1 month (and beyond) after unprotected sex
Several weeks or months after unprotected sex, the incident may feel like nothing more than a pothole in your rearview mirror, especially once pregnancy test results are in.
Unfortunately, you may not get the same quick answer about STIs. “People can have contact, get exposed to an STI, but not have it manifest,” Sasan says.
If your tests are clean at your 2-week visit, going back a month later will confirm these results. And while you're probably fine, it's a good idea to get another check.
It takes longer for your body to create antibodies against HIV in particular. More time increases the likelihood that, if the virus is in your body, your immune system will have reacted enough for a test to pick up on it.
The earliest an antibody test will detect HIV is 3 weeks. And if you get the all-clear at the 3-month mark, you can be confident you don't have it. HIV testing overview. (2018). //www.hiv.gov/hiv-basics/hiv-testing/learn-about-hiv-testing/hiv-testing-overview
When do you get confirmation that you're free and clear of any and all worry? You don't, really. (Sorry!) Since some STIs stay dormant in your system for years, it's crucial to get checked for them at every annual visit and to use condoms with all future partners.
Before your next rendezvous
So, what should you do differently next time?
It may be helpful to keep the morning-after pill on hand in case of another mishap. It has a long shelf life - just check the expiration date.
Plus, always have condoms handy - here's a size guide - and know the best practices to avoid breakage or slippage. Never hesitate to insist on using a condom to keep yourself and your sexual partners safe.
And here's more help: We have some excellent text templates you can use to have the STI convo with your future partners.