Julie Medical Advisor
A doctor answers your sex questions
14 Sex Questions answered by a doctor
Got sex questions? We got answers. We sat down with Dr. Tessa Commers, Julie’s Head of Medical Education, to set the record straight about the sex questions we wonder about most. We’re covering everything from what to do after sex, symptoms, emergency contraception, masturbation, and more. Have more questions? Join our After Sex space where you can ask one of our doctors a question and chat with others about sex and preventing pregnancy.
Do you need to pee after sex?
If you have female anatomy, peeing after sex can be an important factor in preventing urinary tract infections (UTIs). The reason is that the female urethra (tube that connects the bladder to the outside of the body) is very short and is found very close to the vagina. With vaginal penetration (inserting something into the vagina like a penis, finger or dildo) there is a risk of bacteria coming close to and traveling up the urethra to the bladder. Add in friction and rubbing and the risk is even higher. This isn’t the situation for everyone, but many individuals find that peeing after sex flushes out any bacteria that may have found its way into the urethra, thereby preventing a UTI.
Why am I bleeding after sex?
There are a variety of reasons that someone with female anatomy might experience bleeding after sex. If they are relatively new to sex, bleeding after penetration may be tearing of the hymen. Another common cause of bleeding is friction, which is generally caused by lack of lubrication (natural or applied). Other things that irritate the vaginal canal and cervix, like sexually transmitted infections, can also cause bleeding. For more details, check out Bleeding after sex.
How to practice safe sex?
“Safe sex” means different things when talking about different types of sex. In general, safe sex indicates that participants are protecting themselves against catching or spreading sexually transmitted infections (STIs) and, when applicable, protecting against unwanted pregnancy. Protection against catching or spreading STIs includes regular STI testing and treatment, vaccinations against STIs (like HPV and hepatitis B) and barrier methods (like condoms for penetrative vaginal or anal sex and dental dams for oral sex). Protection against unwanted pregnancy includes birth control (like pills, the implant or IUD), ovulation tracking or other natural family efforts and/or condoms. To learn more, check out What is safe sex.
Can you have sex on your period?
Yes, you CAN have sex on your period. It will obviously carry a little extra cleanup and there is still a small risk of pregnancy, but orgasms can actually relieve cramps!
Can you get pregnant without having sex?
Technically, yes. Plenty of individuals get pregnant without sex. This is through processes like sperm donation and IVF (in vitro fertilization). The other way that someone can become pregnant is through penis-to-vagina sex.
There are many myths and misconceptions about how pregnancy happens. Kissing, mutual masturbation, dry humping, sharing towels or wiping after giving a hand job will not cause pregnancy. Even “higher-risk” things like genital rubbing and anal sex carry no risk for pregnancy UNLESS ejaculate (semen) comes in contact with the vagina. And when in doubt, use a condom.
If you have sex with a yeast infection, can it spread to your partner?
Yeast infections cause a thick, white discharge and significant itchiness in or on the vagina and cause a red, itchy or painful rash on the penis. They are not considered an STI but you can spread a yeast infection through sex. Best to treat before having sex without a condom.
Can you get an STI from oral sex?
Absolutely. Gonorrhea, herpes and the human papillomavirus (HPV) are the most common STIs that can be spread between the mouth and genitals.
Gonorrhea may cause sore throat, enlarged lymph nodes of the neck, exudates of the throat or no symptoms at all.
Herpes is known to infect both the mouth (generally caused by herpes simplex virus type 1) and the genitals (generally caused by herpes simplex virus type 2). However, it’s possible to spread type 1 to the genitals or to spread type 2 to the mouth. Both cause episodic flares of painful ulcers and can be spread even when an ulcer is not present.
There are many strains (subtypes) of HPV, and only a handful of those cause significant problems including head and neck cancer. If one of the cancer-causing strains of HPV is spread to the mouth, it will remain “silent” for many years (meaning that there are no immediate symptoms or signs that someone has been infected). The most common sign that someone has cancer caused by HPV is a neck mass, which generally occurs at least 10 years after infection. Fortunately, there is a vaccine that provides protection against HPV and is offered to individuals aged 9 to 45.
For more information on STIs, including symptoms of vaginal or penile infection, check out What are STDs.
Can you get an STI from anal sex?
Absolutely. Both mouth-to-anus and penis-to-anus sex can spread STIs. Mouth manifestations of STIs are similar to symptoms as described in the previous section. Nearly all bacterial and viral STIs can be spread from penis-to-vagina sex, including gonorrhea, chlamydia, herpes, HPV, syphilis and HIV.
Gonorrhea and chlamydia of the anus can cause changes to bowel movements (like constipation) and anal pain, discharge or bleeding. However, they can often be asymptomatic. Furthermore, females can get these infections without anal penetration but instead via local spread from a vaginal infection.
Herpes causes painful ulcers of the skin surrounding the anus. Once infected, herpes lives on the skin and causes episodic flares of ulcers with periods of no symptoms.
HPV infection of the anus can cause two issues: warts and cancer. Warts are small growths that are generally not painful but can cause irritation based on their location. Anal cancer generally presents many years after infection and often presents as anal bleeding, pain or skin growths.
Infections like syphilis and HIV are also spread via anal sex. The signs of HIV infection can take weeks to months to present, and often feel like a bad illness (fever, fatigue, body aches, weight loss, sore throat, rashes and headaches). The most common sign of a syphilis infection is a painless ulcer around the location where infection occurred. In the case of anal sex, this might look like an ulcer by the anus that shows up a few weeks after infection and lasts for another few weeks.
For more information on STIs, including symptoms of vaginal or penile infection, check out What are STDs.
How effective is the pull-out method?
It’s estimated that the pull-out (or withdrawal) method is about 78% effective, meaning that if 100 couples used this method for any period of time, 22 of them would become pregnant.
The idea behind the pull-out method is that the penis is removed from the vagina prior to ejaculation. However, there are two ways this can go wrong. The first way is that pre-cum (the small amount of fluid that comes out of the penis prior to ejaculation) can contain sperm, especially if the individual has ejaculated recently. The second way is human error – some people simply don’t pull out in time.
Why does my vagina hurt after sex?
There are a few things that can cause vaginal pain after sex. If it’s one of your first times having sex, you may experience pain or soreness after the hymen tears. Sex may have caused some friction if there wasn’t enough lubrication, which can also cause some soreness after sex. Even anxiety or nerves can cause vaginal muscles to tighten and remain a bit achy once the penis is removed. Any soreness caused by the hymen, friction or aches should resolve within a day.
While other things like STIs, cervical cancer and endometriosis can cause pain after sex, pain is more commonly described DURING sex.
How to have sex without getting pregnant
There are many ways to have sex without getting pregnant. First, not all types of sex come with pregnancy risk. Oral sex and sex between two individuals with the same anatomy (penis and penis, vagina and vagina) carry no risk for pregnancy. Anal sex carries a small risk IF ejaculate (semen) comes in contact with the vagina. Otherwise, the only form of sex that really carries the risk is penis-to-vagina sex.
There are many ways to protect against getting pregnant during penis-to-vagina sex. Birth control is the most reliable. Pills, the patch, the ring, Depo shots, the implant and IUDs are forms of contraception that someone with female anatomy can use, while condoms are very effective at preventing pregnancy when fitted appropriately on a penis. Many individuals prefer to avoid hormonal birth control, so ovulation tracking is another option (link to article). Lastly, if unprotected sex does happen, emergency contraception, like the morning-after pill, like Julie and IUDs, is an option.
How long after sex can you take Plan B One-Step or Julie?
The morning-after pill (like Plan B One-Step and Julie) is most effective if taken within 72 hours (3 days) after having unprotected sex. The sooner it is taken, the better.
Can you take Plan B One-Step or Julie before sex?
It is not recommended to take the morning-after pill (like Plan B or Julie) BEFORE sex. This is because the pill delays ovulation long enough for sperm (which can live in a uterus for up to 5 days after ejaculation) to die off. However, if taken too soon, there’s a risk that sperm will still be present after the pill has worn off and ovulation starts up again.
How much masturbation is too much?
Experiencing sexual pleasure by yourself is healthy. While there isn’t a single number to say what is “too much,” there are a few signs that someone is spending too much time masturbating. If they are experiencing skin changes (like rashes or chaffing) as a result of too much friction, if they are sacrificing normal activities (like spending time with friends or family) to spend time alone or if they are masturbating in inappropriate places (like in public) then they are likely masturbating too much. If you’re concerned that you might be addicted to masturbation, talk with your doctor. There are also online organizations like nofap.com that provide guidance and support.
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Plan B One‑Step is a registered trademark of Foundation Consumer Healthcare.
Although the information above may be useful, it shouldn’t replace the advice of your healthcare professional. For questions about birth control and other women’s health issues, please talk to your healthcare professional.
Emergency contraceptives like Julie work when you take them after sex. That’s because emergency contraception prevents pregnancy by delaying when you ovulate. By taking emergency contraception before sex, you may not be delaying ovulation long enough.
No. Julie is not what is commonly called “the abortion pill” or “medication abortion”. The active ingredient in the abortion pill is mifepristone. Pregnancy needs a hormone called progesterone to grow normally. Mifepristone blocks your body’s own progesterone, stopping the pregnancy from growing. Julie does not and will not impact an existing pregnancy, and works by delaying ovulation before there is a pregnancy.
The FDA recently made an update in December 2022 to remove any language suggesting that Julie may prevent implantation of a fertilized egg. We are currently working on removing this outdated disclaimer but you may still see it present on some of our packaging in the meantime. Please disregard these statements because they are out of date. Julie will not impact an existing pregnancy.
Julie is an emergency contraception you can take after:
- You didn’t use any form of birth control or had unprotected sex
- There was an issue with your regular birth control method (eg, the condom broke or slipped)
- You missed a dose (or more) of your regular birth control pill
Taking Julie will not impact your ability to get pregnant.
After taking Julie you can continue on with your regular birth control method if you have one (for example, continue taking birth control pills).
You will know Julie has been effective when you get your next period, which should come at the expected time, or within a week of the expected time. If your period is delayed beyond 1 week, it is possible you may be pregnant. You should get a pregnancy test and follow up with your healthcare professional.
Julie is a backup or emergency method and should not be used as a regular birth control method. Consult with your doctor about a birth control method that makes sense for you.
Please know that taking a dose of Julie will only protect you from one instance of unprotected sex, it will not prevent pregnancy from unprotected sex over the coming days or weeks. If you have unprotected sex in the future and want to prevent pregnancy, be sure to take a new dose of Julie and talk to your doctor about the best birth control options for you.
Your menstrual bleeding patterns may change temporarily after using levonorgestrel. If you find that your period is more than a week late, take a pregnancy test to confirm whether the contraceptive has worked.
Julie can be used by all women, regardless of weight but women with BMIs above 29.9 have a pregnancy risk of 5.8% - meaning that out of every 100 women who take Julie, 6 may become pregnant. We advise that you speak with your doctor for further information on how this may affect you personally.
Take Julie tablets orally (swallow it). It is preferable to take it with water, and you can take it with or without food. Do not insert Julie vaginally.
Julie is not an abortion pill and will not harm an existing pregnancy nor will it be effective if a woman is already pregnant.
Julie is a progestin‑only emergency contraception product that helps prevent pregnancy before it starts when taken within 72 hours after unprotected sex.
Julie is a backup method of preventing pregnancy and should not be used as regular birth control. Use as directed.
Julie is effective up to 72 hours (3 days) after unprotected sex. The sooner it’s taken after unprotected sex, the better it works.
Julie can significantly decrease your chances of getting pregnant. When used as directed, about 7 out of every 8 women who could have gotten pregnant will not become pregnant after taking Julie. The most important factor affecting how well Julie works is how quickly it is taken. When taken as directed within 72 hours after unprotected sex or birth control failure, Julie can significantly decrease the chance that a woman will get pregnant. In fact, the earlier Julie is taken after unprotected intercourse, the better it works.
Emergency contraception is not 100% effective, which is why it is critical that women have a regular birth control method. If you have any further questions, we encourage you to talk to your healthcare provider.
Since emergency contraception can affect the length of your menstrual cycle, your period might come about a week later or earlier than usual after taking Julie. If your period is more than one week late, consider the possibility of pregnancy.
No. No one needs a prescription to purchase Julie or EC. However, some insurances require a prescription for reimbursement. Some pharmacies and places where EC is sold may tell you that you need a prescription. You do not.
You do not need to see a doctor before or after taking Julie. You do not need a prescription from a doctor. We do encourage you to speak to a doctor you feel comfortable with about sex, reproductive health, and contraception.
No. We know this is a common misconception so let’s break it down. Using Julie (no matter how many times you take it) does not affect your fertility — and it will not prevent you from becoming pregnant in the future. You should feel free to use Julie whenever you think it’s necessary. Julie (and all EC) is not recommended as an ongoing form of birth control because it’s not as effective at preventing pregnancy as birth control methods like the IUD, patch, pill, ring, or shot. Also, frequent use of EC may cause periods to become irregular and unpredictable. That’s it!
Yes. You are not alone. Often times, people who buy EC are feeling stressed out, concerned, embarrassed, confused or ashamed. The important thing to remember is that you are not alone, you have nothing to be ashamed about, and the Julie community is here to support you. By taking Julie after unprotected sex, you are taking control of your future and taking a safe, effective, approved method of preventing pregnancy.