What are the guidelines for safe sexual practices in female patients?

From the Guidelines

Safe sex for female patients involves using barrier methods like condoms, dental dams, or female condoms during all sexual activities to prevent sexually transmitted infections (STIs) and unintended pregnancy. Condoms should be applied before any genital contact and used consistently with every sexual encounter. For additional pregnancy prevention, consider hormonal contraceptives like birth control pills (taken daily at the same time), patches (changed weekly), vaginal rings (replaced monthly), injections (every 1-3 months), implants (effective for 3-5 years), or intrauterine devices (effective for 3-10 years depending on type) 1. Regular STI testing is recommended every 6-12 months or with new partners, especially for nonpregnant women who engage in high-risk sexual behavior or are younger than 25 years 1. Communicate openly with partners about sexual health status and boundaries. If a condom breaks or contraception fails, emergency contraception like Plan B (levonorgestrel 1.5mg) is available over-the-counter and most effective when taken within 72 hours of unprotected sex. These practices are important because many STIs can be asymptomatic while still causing long-term health complications, and barrier methods provide the only protection against both STIs and pregnancy when used correctly.

Some key points to consider:

• The US Preventive Services Task Force recommends intensive behavioral counseling for all sexually active adolescents and for adults who are at increased risk for STIs 1.
• Patients should be advised to use condoms consistently and correctly to be effective in preventing STIs 1.
• Comprehensive care, including prevention of STIs, is recommended for lesbian and bisexual patients, and education about the risks for STIs can help these patients make informed decisions 1.
• Practitioners should provide risk-reduction counseling to prevent STIs in women participating in noncoital activities, such as mutual masturbation or anal sex 1.

From the FDA Drug Label

• Only barrier methods (such as condoms) can protect you from STD. • You should tell your healthcare provider(s) that you are taking Opill® • If you are worried you may have a Sexually Transmitted Disease (STS) including HIV (AIDS), see your healthcare provider as soon as you can. • When to use a condom (or another barrier method) • every time you have sex for the next 2 days (48 hours): • after you start your first pack of this product • if you take a tablet more than 3 hours late or miss a tablet on 1 or more days • if you vomit or have a severe diarrhea within 4 hours of taking a tablet

To practice safe sex as a female patient, it is recommended to:

• Use condoms (or another barrier method) every time you have sex during the first 2 days of use (48 hours) after starting the product, because it takes 2 days for the product to start working 2
• Use a condom (or another barrier method) every time you have sex for the next 2 days (48 hours) if you take a tablet more than 3 hours late or miss a tablet on 1 or more days 2
• Use a condom (or another barrier method) every time you have sex for the next 2 days (48 hours) if you vomit or have severe diarrhea within 4 hours of taking a tablet 2
• Continue to see your healthcare provider(s) for routine healthcare visits and inform them that you are taking Opill® 2
• Get tested for STDs, including HIV, if you are worried you may have been exposed 2

From the Research

Safe Sex Instructions for Female Patients

• To practice safe sex, female patients should be aware of the various contraceptive methods available and their effectiveness in preventing sexually transmitted diseases (STDs) and unwanted pregnancies 3, 4.
• Condoms, both male and female, provide the best documented protection against STDs such as gonorrhea, herpes simplex virus (HSV), hepatitis B, HIV, and chlamydia 3, 4.
• Female-dependent barrier methods also provide protection against most STDs and possibly HIV 3.
• Hormonal non-barrier contraceptives, such as oral contraceptive pills (OCPs), provide excellent protection against unwanted pregnancies but offer little protection against STDs 3, 5.
• In fact, OCPs may increase the risk of infection with human papillomavirus (HPV) and cervical infections of chlamydia 3.
• Individuals at high risk for both unwanted pregnancy and STDs should consider using both a hormonal and barrier contraceptive method 3.

Contraceptive Methods

• Available contraceptive methods include hormonal options such as OCPs, contraceptive patches, implants, injections, intravaginal devices, and intrauterine devices 6.
• Barrier products, such as condoms, prevent pregnancy by creating a physical obstacle to fertilization 6.
• Each contraceptive method has its benefits and potential complications, which should be considered when selecting a method 6.

Hormonal Contraceptives and STDs

• Some forms of hormonal contraception may increase women's risk of non-HIV STDs 7.
• Depo-medroxyprogesterone acetate (DMPA) may reduce the risk of trichomoniasis and increase the risk of HSV-2 7.
• Oral contraceptive pills (OCPs) may be associated with a reduced risk of trichomoniasis, but the evidence is inconclusive for other STDs 7.
• More research is needed to understand the relationship between hormonal contraceptives and STDs 7.