Period Sex and the Risk of STDs

What both partners should know

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Here's a delicate question: Should a couple who has sex while the woman is having her period use a condom?

The short answer: It's probably not a bad idea.

First off, a heterosexual couple is still at risk of conceiving while the female partner is menstruating. So if you're trying to prevent pregnancy and neither you nor your partner is using another form of birth control, a condom is an effective form of contraception.

But using a condom also is important when it comes to safe sex—in other words, protecting both partners from a sexually transmitted infection (STI) or a sexually transmitted disease (STD). Here are some theories why.

Why Period Sex May Be Risky

Between 3 percent and 30 percent of women choose not to abstain from sex while menstruating, according to research published in the Archives of Gynecology and Obstetrics. Unprotected sex is just as risky when it comes to STDs and STIs while a woman is menstruating as when she's not. In fact, there's a scattering of research that suggests sex during menstruation may increase the risk of certain infections. 

This certainly makes sense in the case of bloodborne pathogens such as human immunodeficiency virus (HIV), since a woman's sexual partner obviously will be exposed to her menstrual blood. Research shows this is only a concern if a woman with HIV is not taking antiretroviral therapy medication to suppress the virus.

But it also may be true for other viruses and bacteria. Researchers aren't sure why, but there are some interesting theories:

  • Blood flow acts as a carrier for pathogens. Menstrual blood also may increase the growth of bacteria. 
  • A woman's cervix is more open during her period. The theory here is that it may be easier for some pathogens to reach the upper cervix and the uterus. In fact, this may help to explain why pelvic inflammatory disease (PID), an inflammation of the upper reproductive tract that's often caused by many STDs, is associated with sex during or near menstruation. 
  • Menstrual blood may cause skin irritation and inflammation that makes it more susceptible to infection. Also, menstrual blood tends to dilute both natural and artificial lubrication, increasing the risk of tearing and other types of skin damage as well, so you may want to be especially generous with any lube you use along with a condom.

Using a Condom Properly

For a condom to prevent pregnancy and reduce the risk of infection, it has to be used correctly. Check the expiration date, open it carefully (don't use sharp fingernails or scissors, for example), roll it on properly, and be sure you or your partner holds onto it when it's withdrawn.

Sources:

Lurie S. Does Intercourse During Menses Increase the Risk for Sexually Transmitted Disease? Arch Gynecol Obstet. 2010 Dec;282(6):627-30. 
Rodger, Alison J., Cambiano, Valentina, and Brunn, Tina. "Sexual Activity Without Condoms and risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner is Using Suppressive Antiretroviral Therapy." Journal of the American Medical Association
2016;316(2):171-181.
 

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