Dear Roe,
I’m a 22-year-old male and whenever I have sex, for the following few weeks I get panic attacks about a possible pregnancy occurring. It is always protected sex, I know the people who I am having sex with well, and all precautions are taken. But I still can’t shake this fear because I know there is always that slim chance no matter how many precautions one takes that a pregnancy could occur. This has also made me want to have sex less as I fear the possibility of an unplanned pregnancy.
Let’s get this out of the way: Yes, barring the obvious caveats around medical reasons and fertility etc, if you have penetrative sex with a woman, there is always a chance that a pregnancy could occur. Contraception isn’t 100 per cent effective even when used correctly – and contraception is not always used correctly, or consistently.
Last year, a survey carried out by the Irish Family Planning Association and Durex revealed that 30 per cent of Irish couples relied on the high-risk "withdrawal method" for birth control (which is particularly worrying given the rising rate of STIs in Ireland, many of which can only be prevented by using condoms). And while the survey revealed that condoms were the preferred method of birth control among the 18 to 34 age category, standing at a rate of 41 per cent, only 37 per cent of those who use condoms used them every time they had sex.
When you add in user error around condoms – using the wrong size, not putting it on or taking it off correctly, not checking for damage, putting it on or taking it off too late, using the wrong lubrication or none, for instance – and the chances of an unwanted pregnancy rise. Which is possibly part of the reason that 24 per cent of the women surveyed had experienced an unintended or crisis pregnancy.
I’m sure none of that assuaged your anxiety, which is why I’ll stop throwing scary statistics at you now. I had to, of course, mention the very real risks of unplanned pregnancies and acknowledge the reality of them. But your problem right now is not an unplanned pregnancy; it’s that you are currently experiencing an anxiety so acute that you are not just being careful, you are having panic attacks and beginning to avoid sex. And while there are going to be some people who will dismiss this as normal, and even blame you for this anxiety, saying it’s a necessary part of sex, I disagree. Because there’s a difference between being aware of risks and being careful, and being consumed by anxiety.
Many things in life come with risks – every time you get in a car, you are taking a risk. But if you knew that you were a careful driver, that you wore your seatbelt, had your car checked regularly, but still experienced severe anxiety around driving to the point where you were having panic attacks and began to avoid driving altogether, I doubt many would dismiss that as a normal or necessary part of the responsibility of driving – they would take your anxiety seriously. Sex is no different. You need to be responsible, careful, and aware, but debilitating anxiety does not have to be part of the equation.
And it shouldn’t be, simply because anxiety just doesn’t do anything: you can’t worry away a pregnancy, after all. What obsessive worrying does is damages your physical and emotional health, and prevents you from being able to enjoy life. It also prevents you from thinking clearly and will affect your ability to handle a crisis, should one arise.
So my first piece of advice would be to seek out a therapist who could help you talk through your anxieties. This could be helpful in one of two ways. Firstly, it could help you explore whether this anxiety around pregnancy could be stemming from an underlying issue, such as a generalised anxiety disorder; anxiety or shame around sex itself, which is manifesting as a belief that sex will always have negative consequences; a fear of commitment, intimacy or an unhealthy relationship dynamic that is crystallising around the idea of an unwanted pregnancy; or something similar.
Second, a therapist could also advise you about coping mechanisms for dealing with your anxiety when it arises, or help you decide if visiting your doctor and exploring anti-anxiety medication could help your panic attacks.
I also suggest taking a break from partnered sex, so that you can focus on addressing this issue. Whatever the reason for your anxiety, having panic attacks for weeks after sex isn’t only damaging for your physical and mental health overall, but it could cause some lasting anxiety around sex as you begin to associate it with stress and panic attacks, instead of the pleasure and fun and intimacy you should ideally associate with sex.
You say you always know the women you are having sex with well, so open up a conversation with them around their own feelings about an unwanted pregnancy
If you don’t take a break from partnered sex, there are some actions that could be helpful. It would be worth reading up about contraception and pregnancy from reputable sources. Many young people in particular can absorb some fear-mongering ideas about how pregnancy can accidentally occur, which can often be unrealistic. Reading up about contraception will also help you feel confident that you are using condoms correctly.
If you’re not doing this already, you should also have some very open conversations with your sexual partners about contraception, to see if they are or would be comfortable using an extra form of contraception as well as condoms, such as spermicide, the contraceptive sponge, or more long-term contraception methods such as the Pill or an IUD. (This should go without saying, but this is to be a conversation, not a demand; many women can’t or don’t want to use these forms of contraceptives. You can decide not to have sex with them, but they get to decide what to do with their bodies.) You could also not ejaculate during penetrative sex as an extra precaution.
You say you always know the women you are having sex with well, so open up a conversation with them around their own feelings about the prospect of an unwanted pregnancy, and what they imagine they would do if the situation arose. Discussing this together might be helpful, so that rather than careening down the anxiety abyss of the unknown, you have an idea of what would actually happen if a pregnancy occurred.
Remember, however, that the risks and stakes of an unwanted pregnancy will always be higher for women, so be careful about prioritisng your anxiety in these conversations at the expense of your partner’s feelings.
But remember that your sex life in the immediate future will never be more important than your mental health in the long-run. Prioritise that for now, so you can eventually enjoy both.
