I remember the day of my wedding…when I started feeling my contraception ring coming out of my vagina. I had only recently started using the ring even though I was more used to taking the pill. There I was in the bathroom stall with one of my bridesmaids, and she was literally helping to guide my ring back up into my vagina because I could feel it slipping out of me. Although quite embarrassing, let's just say that we're forever bonded by that experience. So, have you ever tried a new birth control method that wasn't the best for you but it seemed to work well for others?
During a recent interview with Board Certified Obstetrician & Gynecologist, Dr. Chimsom Oleka, she provided a list of all of the birth control methods currently available, which can potentially serve as a starting point for those of you who may be exploring new contraceptive methods.* As you continue reading, you'll notice that the list is organized based on what Dr. Oleka refers to as Short-acting (hormonal and non-hormonal), to Long-acting, to Barriers of Protection.
Before we dive into the list, let's first clarify specifically what birth control does. As. Dr. Oleka explained, for most methods, birth control releases certain hormones in your body which contributes to the ultimate end goal: block ovulation or keep an egg from being released, thicken the mucus in the cervix so that sperm can't pass through, and/or thin the lining of the uterus, which decreases chances of implantation. Each birth control method is designed to do each or all of these things, but depending on the method, they will either do them better, worse, or not at all.
Choosing The Best Birth Control Method For You
SHORT-ACTING BIRTH CONTROL METHODS
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Note: Throughout this section, you will notice references related to "continuous" or "extended" usage. As Dr. Oleka explained, many of us have a false idea of what the period is supposed to do. Contrary to popular belief in terms of what our menstrual cycle does and why it's "necessary" every month, ultimately its main purpose is for pregnancy. That's it.
As Dr. Oleka expertly pointed out, "It's the birth control's period, not your period. Your birth control will start stimulating the lining and doing all of the things that cause you to bleed." So, as long as you have a hormone that's assisting with protecting and keeping your uterus lining thin, and as long as you've consulted your physician beforehand, then you don't have to necessarily worry about shedding the lining every month (i.e. having a period).
Consider, for example, women who have bleeding disorders (i.e. their bodies bleed too much or won't stop bleeding), female athletes, as well as those who may suffer with things such as menstrual migraines…situations like these support the case for continuous or extended methods.
Method: Birth Control Pill (Hormonal - Estrogen and Progesterone)
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How It's Administered: Self-ingested orally, daily
Efficacy: 7 to 9% failure rate (i.e., approximately 1 in 10 will get pregnant)
Description & Overview:
Birth control pills usually come in 28-day pill packs (four rows of seven pills) including a week of placebo, non-active pills. There are different variations as well, but it's critical that you take it every day at the same time.
The most commonly used pill has both estrogen and progesterone. With estrogen, it tends to help provide more stability of the lining. However, some people may not want estrogen or they may have an underlying medical issue that conflicts with the estrogen. There is a risk of blood clots, although fairly low, but the risk of this goes up when you're pregnant. With the pill, it helps regulate the bleeding, which in turn, helps make it predictable. It's known to have protective benefits such as helping to decrease risk of certain cancers and it can help reduce symptoms related to fibroids.
Also, you can use this method, as well as other methods, continuously or in an extended way so that you can delay or skip the bleeding (i.e. going on vacation). For example, if you wanted to try an extended use, then you could delay the withdrawal bleeding (period) for a set number of weeks or months by skipping the last row for let's say two months. Then, you would take the last row of inactive pills the third month, so that you would only bleed approximately every 10 weeks.
On the other hand, if you're someone who decides "I don't want to bleed at all," then you could skip the last row of inactive pills and move forward with starting the new pack each month. Keep in mind, if you don't bleed or you bleed too heavily already, there may be other medical issues going on, so as always, you'll want to consult your physician about this.
Side effects can vary, but some of the most common side effects include: nausea, breast tenderness, and initial irregular bleeding.
Method: Birth Control Pill (Hormonal - Progesterone Only)
How It's Administered: Self-ingested orally, daily
Efficacy: 7 to 9% failure rate
Description & Overview:
This method basically works pretty much the same as the first pill mentioned above, but it doesn't include estrogen. It only includes progesterone.
Progesterone-only pills can be harder for some women to use because you have to be really consistent. If the daily pill ingestion time is missed by as little as three hours, then it loses its efficacy. Hence, it's critical that you take the pill every day at the same time.
With the progesterone-only pill, there's also a greater chance of irregular bleeding. Hence, this method is usually recommended by the physician if there are estrogen-related conflicting medical issues.
Method: Vaginal Ring (Hormonal – Estrogen and Progesterone)
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How It's Administered: Self-inserted through Vagina
Efficacy: 7 to 9% failure rate
Description & Overview:
The vaginal ring is a soft, flexible ring approximately two inches wide and four centimeters thick that is self-inserted and removed in/out of the vagina. Some women will tie a string to the ring and there's also an applicator that can be used to assist with insertion and removal.
The vaginal ring stays in for three weeks and releases hormones every day. Once removed for seven days, it allows withdrawal bleeding (period) to occur. Then, a new ring is inserted every four weeks. This method can be used continuously if you bypass the seven days and move forward with inserting the new ring every three or four weeks, or in an extended way if you bypass the seven days every few months or so.
The ring has been known to cause breakthrough or irregular bleeding. Not to mention, there are times when the ring can slip out during sex, which of course can directly impact the efficacy.
Method: Progesterone-Only Shot (Hormonal - commonly referred to as “Depo”, short for Depo Medroxyprogesterone Acetate)
How It's Administered: Injected in arm by physician
Efficacy: 6% failure rate
Description & Overview:
The progesterone-only shot is usually injected every three months (or every 11 to 13 weeks). Although the failure rate is approximately 6%, that's also related to the fact that patients are late with getting their scheduled shot.
Depo is known to decrease bone mineral density (contributes to the risk of fractures) within the first two years, but you start to recover it within 30 months after you stop taking it.
Also, because the shot can linger in your system up to nine months after your last shot (not the efficacy), it has the propensity to delay the return to your normal fertility state.
Some of the most common side effects include weight gain with research showing that it can act as an appetite stimulant.
Method: The Patch (Hormonal – Estrogen and Progesterone)
Michael Kraus/Shutterstock
How It's Administered: Self-adhesive
Efficacy: 7 to 9% failure rate
Description & Overview:
The patch is a small, square-shaped band-aid like adhesive or patch that can be applied to your upper arm, abdomen, or butt. You receive a new patch every three weeks and the fourth week is when you're patch free to allow for withdrawal bleeding.
This method is not recommended for extended or continuous cycles like with the pill and ring because it has higher levels of estrogen, which means increased risk for blood clots. Also, if you have sensitive skin or you're prone to breakouts and rashes, then you may want to avoid this method as well.
The patch can cause irregular or breakthrough bleeding or no bleeding at all depending on the individual. During the first few months of use, you may experience that as well as nausea, but it usually improves over time.
Method: Family Planning (Non-hormonal)
How It's Administered: N/A - Personal planning and scheduling
Efficacy: Up to 40% failure rate
Description & Overview:
There are a variety of options as it relates to family planning including: use of calendars, basal body temperature, cervical mucus, and more. There are a lot of useful tracking apps that can help with these methods as well.
Family planning can be taught and is a pretty well-accepted method. However, it can only be used if you have a regular cycle. Also, it has a very high failure rate because it requires extensive tracking and managing certain records such as time, ovulation, and temperature. So, you have to be extremely detailed-oriented, organized, and highly motivated to be successful with family planning. Otherwise, it can be extremely overwhelming for some people.
Due to the excessive planning and stringent scheduling, it can potentially decrease sexual spontaneity and/or convenience.
LONG-ACTING BIRTH CONTROL METHODS
Method: IUD (Hormonal - Progesterone Only)
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How It's Administered: Inserted vaginally by physician (through opening of cervix, into the uterus)
Efficacy: Less than 1% failure rate
Description & Overview:
The IUD has varying brands (Mirena has been around the longest), costs, and dosages. The IUD is a small, t-shaped plastic piece, approximately 3 cm in size, although the size can vary as well. In addition to women who have had children, the IUD can be used in teenagers as well as women who have not have had babies.
Remember, this is a longer-acting method, so this is ideal for someone who wants to hold off on having children for a longer period of time.
Some of the most common side effects include insertional discomfort (I'm a personal witness to this) and irregular bleeding although it tends to help those who suffer from painful periods and heavy flow. The longer you leave it in, the less likely you'll bleed.
Method: Copper IUD (Non-hormonal)
How It's Administered: Inserted vaginally by physician (through opening of cervix, into the uterus)
Efficacy: Less than 1% failure rate
Description & Overview:
Similar to the IUD previously mentioned, the copper IUD is a latex-free, t-shaped, plastic piece but it also includes areas of exposed copper. By releasing copper salts into your body, the copper tricks the uterus into thinking something foreign is inside, creating an appearance of a "chaotic" environment in your system, which ultimately blocks sperm and prevents reproduction. It can last for 10 years, but it has been known to be effective for up to 12 years.
The copper IUD is ideal for someone who doesn't want to deal with hormones, or someone who is certain they don't want children for a long time. There are instances where it can be used as emergency contraception but it won't work if something has already been implanted.
Because this method doesn't affect ovulation, this method is also ideal for women who want to continue bleeding or women within certain cultures where the idea of contraception isn't readily accepted. This can serve as contraception method without anyone else truly knowing that you're taking it because you will still have a period as normal.
The most common side effects usually include more painful cramping or heavier bleeding.
Method: Contraceptive Implant (Hormonal – Progesterone Only)
Michael Kraus/Shutterstock
How It's Administered: Implanted in arm by physician
Efficacy: Less than 1% failure rate (the most effective method)
Description & Overview:
The contraceptive implant is a flexible, plastic rod that's placed inside the upper arm. It's small and thick - approximately 4 cm long and 2 mm thick. It releases hormones daily, and lasts for three years, although recent data shows it may last longer than that. After three years, you get a new one if you choose to do so. Otherwise, you will return back to your baseline fertility.
Some of the most common side effects can include irregular bleeding, no bleeding (approximately 6%), or heavier bleeding. For those who experience irregular bleeding, there are ways to decrease it and make it more manageable. Also, there are rare occasions where, if placed improperly, it can shift or migrate.
BARRIERS OF PROTECTION** BIRTH CONTROL METHODS
The most common effects for any of the following methods can include vaginal discharge and irritation. After the use of these, the return to fertility is usually fairly quick.
As it relates to a lot of these barriers of protection, Dr. Oleka likes to think of it this way, "Condoms should be used more so for STD and HIV/AIDS protection, and less for pregnancy prevention." Nevertheless, they are still considered methods for both pregnancy and STD/HIV prevention.
Method: Male Condom (Non-hormonal)
Michael Kraus/Shutterstock
How It's Administered: Applied by male on his penis
Efficacy: 15% failure rate (research across the board states this although it seems quite questionable by both the expert and the writer)
When to Apply: Right before sex
Description & Overview:
Condoms are usually latex or you can opt for lambskin if you're allergic to latex. However, anything non-latex has been known to be less effective in preventing pregnancy as well as STDs. With condoms, common things like inconsistent use, slippage during sex, and the risk of it tearing are a few factors that can directly impact the overall efficacy.
Method: Female Condom (Non-hormonal)
How It's Administered: Self-inserted vaginally
Efficacy: 21% failure rate
When to Apply: Right before sex
Description & Overview:
Similar to the male condom, the female condom has a thick ring that's used for placement within the vagina along with the pouch that goes in when it's time to have sex. There's also a thin ring that goes outside of the vagina. With this method, proper placement is just as important because it helps prevent condom slippage during sex. Also, the male condom should not be used when the female condom is used because it can cause tearing.
Method: Diaphragm
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How It's Administered: Self-inserted vaginally
Efficacy: 16% failure rate
When to Apply: Up to six hours before sex.
Description & Overview:
The Diaphragm is reusable silicon disk that's self-inserted through the vagina. Similar to the cervical cap, it should be inserted up to six hours before you have sex and should remain in your vagina at least six hours after sex. A spermicide should also be used in conjunction with the diaphragm to help ensure efficacy. It's also possible for the diaphragm to become dislodged during sex.
Method: Cervical Cap (Non-hormonal)
How It's Administered: Self-inserted vaginally
Efficacy: 14 to 20% failure rate
When to Apply: Up to six hours before sex
Description & Overview:
The cervical cap is a reusable silicone rubber cup that sits on the cervix while you're having sex. Think of it as a "hat" that comes in different sizes and sits on your cervix. It's usually inserted into the vagina up to six hours prior to sex, it should remain in there for at least six hours after sex (and can remain there up to 48 hours). Of note, it only works if used with a spermicide. There's usually only one brand available in the United States.
One thing to consider is proper placement of the cap, and making sure you're comfortable with putting it in your vagina. Also, if you've already had a baby, then you'll have a higher risk of contraception failure.
Additionally, here are a few things Dr. Oleka suggests women should consider before choosing a contraceptive:
- What are your chances of getting pregnant with this method (efficacy)?
- What do you want your bleeding profile to look like (i.e. how often do you want your "withdrawal bleeding" or menstrual cycle to occur)? How will this affect my bleeding profile?
- What does your lifestyle look like (i.e. will it be difficult to remember to take the pill every day versus another option that may not require as much involvement)?
- What are your priorities? What does the timeline for trying, starting, or growing your family look like?
- How long do you want it to be in effect or control?
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As always, Dr. Oleka reminds everyone to be sure and consult your physician* when deciding on a method because hormones affect individuals differently. Not to mention, there's certain criteria and health/risk factors that doctors review and consider when determining contraception needs for their patients.
With most methods, efficacy is usually effective within a week or so, but to be safe, Dr. Oleka suggests giving the new contraception at least a month or two to allow enough time to confirm efficacy on your side and to see how well your body reacts to it.
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Shonda Brown White is a bestselling author, blogger, life coach, and brand strategist. When she's not jumping out of a plane or zip lining, she's living the married life with her husband in Atlanta, GA. Connect with her on social @ShondaBWhite and her empowering real talk on her blog.
Exclusive: Dreka Gates Talks Farm Life, Self-Mastery, And Her Wellness Brand
Dreka Gates is making a name in wellness through authenticity and innovativeness. Although we were introduced to her as a music manager for her husband, Kevin Gates, she has now carved out her own lane outside of music as a wellness entrepreneur. But according to Dreka, this is nothing new.
In an xoNecole exclusive, the mom of two opened up about many things, including starting her wellness journey at 13 years old. However, a near-death experience during a procedure at 20 made her start taking her health more seriously.
“There's so many different levels, and now, I'm in a space of just integrating all of this good stuff that I've learned just about just being human, you know?” Dreka tells us. “So it's also fun because it's like a journey of self-discovery and self-mastery. That's what I call it. So it's never-ending.”
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If you follow Dreka, then you’re familiar with her holistic lifestyle, as she’s no stranger to promoting wellness, self-care, and holistic living. She even lives part-time on a Mississippi farm, not far from her grandmother and great-grandmother’s farm, where she spent some summers as a child.
While her grandmother and great-grandmother have passed on, Dreka reflects on that time in her life and how having a farm as an adult is her getting back to her roots. “So the farm was purchased back in 2017, and it was like, ah, that'll just be a place where we go when we're not touring or whatever,” she said.
“But COVID hit, and I was there, and I was on the land, and I just started remembering back to going to my grandmother's during the summertime and freaking picking peas and going and eating mulberries off the freaking tree in the bushes.
“And she literally had cotton plants. I know some people feel weird about picking cotton and stuff. She had cotton plants and I would go and pick cotton out of her garden. And she had chickens, and I literally just broke down in tears one day when I was on the farm just doing all the things, and I'm like, ‘Oh my gosh. I'm literally getting back to my roots.”
"I literally just broke down in tears one day when I was on the farm just doing all the things, and I'm like, ‘Oh my gosh. I'm literally getting back to my roots."
You can catch glimpses of Dreka’s farm life on Instagram, which shows her picking fruit and vegetables and loving on her animals like her camel Eessa. Her passion for growing and cultivating led her to try and grow all of her ingredients for her wellness brand, Dreka Wellness. However, she quickly realized that she might be biting off more than she could chew. But that didn’t stop her from fulfilling her vision.
Watch below as Dreka talks more about her business, her wellness tips, breaking toxic cycles, becoming a doula, and more.
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Is It 'Sex On The First Date' If You've Been Virtually Talking For A While?
Aight. Even if the title of this article seems a bit…odd at first, hear me out. For starters, let’s begin with some data. Did you know that, reportedly, somewhere around 53 percent of people under 30, 37 percent of people between the ages of 30-49, and 20 percent of those between the ages of 50-64 either have used or are currently using dating apps (for the record, and I think this will come as no surprise, Gen Z actually prefers meeting people online)?
As far as the dating apps that led to some type of long-term success, a survey from The Knot says that Hinge leads the pack (with 35 percent) followed by Tinder (with 25 percent). Then, if you take into account a Lovehoney survey of 2000 people, which revealed that 60 percent of men and 42 percent of women have admitted to having sex on the first date — uh-huh, now do you see why a piece like this is both relevant and necessary?
Virtual dating isn’t going anywhere any time soon, and although “first date sex” used to be somewhat taboo, clearly, that isn’t even close to being the case anymore. So, since both are a big part of our culture, let’s explore how to approach merging the two (if you’ve been wondering if you should…that is).
What’s the Purpose/Agenda of a First Date?
GiphyOkay, so let’s start by laying a bit of foundation because, personally, I am a big believer that when we don’t know the purpose of something, it’s almost guaranteed that on some level and in some way, we are going to either misuse or abuse it — dating is no exception. And what’s the purpose of a first date?
To get to know if there is more of a connection than just an initial attraction or surface-level chemistry (check out “What's The Difference Between Chemistry And Compatibility?”). And honestly, that’s why all of the social media debates about women expecting a $200 date off the rip and men expecting sex in return if that does indeed go down are nothing short of nauseating to me. ON BOTH SIDES, all it sounds like is a transactional hustle.
Nothing about that type of motive says, “I’m trying to see if there is something real here;” both are about nothing more than how much juice is in the squeeze (and that’s putting it politely — SMDH).
Although there are dozens of reasons why I think dating has become so chaotic for a lot of people these days, here are two of the main ones as it relates to this article in particular:
1) More people need to remember what author M. Scott Peck once said, "Until you value yourself, you won't value your time. Until you value your time, you will not do anything with it." When it comes to first dates, specifically, that’s why I don’t get what all of the drama is behind coffee dates. While TikTok is telling you that agreeing to those means that you are settling, if you value your time, you absolutely aren’t — especially if there have been no real conversations prior to the initial meet-up.
A coffee date or drinks after work doesn’t say, “He’s cheap,” so much as, “If there’s something here, then we can build on that. If there’s not, you got 30 minutes of my time; no harm, no foul.” Time is something that you can never get back, so why waste it? Besides, if you feel the need to brag about going on an expensive dinner, go out with some of your girls, and y’all split the tab.
At least you’ll know that you’re going to have a good time because you actually know those people (by the way, if that triggers you, that already reveals a lot, as far as your motives are concerned). No one should need a date to validate them — especially a first date. If they do, there’s some stuff going on that a date, a man nor a relationship is going to fix (just sayin’).
2) Talk to the long-term couples who are 50+ (if they’re 50, that now means they were in college in the early 90s, by the way). Ask them about what dating was like when they were younger and single. I’m wiling to bet that, for one thing, expensive ass first dates weren’t even on their radar, and two, it was rare that they went out with someone before talking to them, at least a couple of times on the phone.
Yep, as semi-antiquated as it may sound in the world that we live in now, it was pretty standard that if you saw a stranger who caught your attention, you would get their number, talk on the phone to see how the two of you vibe and then some successful conversations down the line, if you both believed that something was there between the two of you, you would mutually decide to go on a date.
And because some type of foundation was already laid, if the first date did end up going beyond just coffee or drinks, it was because the two of you had already invested time — you already knew that you wanted more. And honestly, to me, that is one of the benefits of virtual dating or talking on the phone for a couple of weeks before going on a first date — you can actually get to know someone…beyond what you can get out of them.
“Sex on the First Date” Has Levels to It
GiphyAnd when you take into account all of what I just said, it seems to me that there are two kinds of “sex on the first date” scenarios that should be pondered. One is the kind where you meet someone, text each other about a place to meet up, get to know each other for 1-2 hours max, and then go back to somebody’s place to get it in. The other is when you meet someone and, whether online or by phone, you both decide to ease into things by talking first…for a while. Then, after an awesome first date, sex comes naturally to both of you.
And how long is a while? I mean, because this platform is for women — until you feel safe. Until you have asked the kind of questions that make you feel like you want to spend more time with him on a deeper level. Until you get that his intentions aren’t just shallow…or physical. Until you know that you aren’t just attracted to him — you know that there are things about his personality and character that you actually like. Until you want to go on a first date.
And unless the two of you are talking for 2-3 hours a day, every day, for a week straight, you can’t really come to this kind of conclusion in record time. It may take a few weeks or even a few months — and that is perfectly fine. Someone who wants to know you for you is going to be okay with communication being set as the foundation of the relationship that the two of you are potentially building anyway, so…by the time that you both decide to meet up for a first date, it will be the icing on the cake.
And, because you actually like him for him, the kind of date that he plans, you won’t be grading it based on nothing more than the price tag; it’s a win for all parties involved.
Okay, so if you do decide to go the route of a “slow build,” you do take your time before a first date, and then you do decide to have sex with him — does it constitute as “first date sex”? I mean, technically, probably. However, the reputation of first-date sex is someone is getting to know everything about you (you know what I mean) without knowing much about you at all. On the other hand, when you opt to communicate for some time before a first date (and the sex that follows), it’s not so casual…and yes, that makes it — different.
3 Questions to Ask Yourself Before Sleeping with Anyone New
GiphyNow that I hope I’ve brought some peace of mind to if it’s a standard “sex on the first date” type of situation if you’ve been virtually hanging out with someone for a while, let’s talk about some of the main things that you should consider before having sex with anyone who you are beginning to interact with on a physical level.
What is the energy like?
One day, I’m going to write about how true it is that energy is exchanged during sex. A big part of the reason is that we are sources of energy — and honestly, the kind of energy that you experience with someone when you’re not in their physical presence vs. when you actually are? It tends to be quite different.
Therefore, it’s a good idea to intentionally “tap in” to see what kind of vibes are exchanged when you’re around each other before deciding to take it there because there is a possibility that how you feel about someone in person may be different than how you do online or over the phone.
What type of sexual accountability conversations have you had?
One of the biggest mistakes that people make is thinking that real life is a soap opera or a rom-com — for instance, you can have sex, and there be no real consequences. Chile, please.
Don’t ever put yourself in the position where you think that the two of you connect so well that you shouldn’t talk about how often you both get tested, what your approaches are to birth control, what your sexual deal-breakers are, and what your sexual expectations may be.
And listen, if all of this seems like too much for a first date, then you already have your answer about if you should have sex after the first date…RIGHT? Because how is it that you don’t want to get into his mind, yet you’re okay with him getting inside of you? Nope. Uh-uh. Nada.
What would sex on the first date accomplish?
Back when I used to mentor teen moms in public schools here in Nashville, I would always call them out whenever they told me that unprotected sex “just happened.” NO. IT. DOES. NOT. There are so many steps involved, from calling the person, setting up a plan, meeting up, pulling off clothes, etc. — all of us have plenty of opportunities to rethink what we are doing. Same goes for first-date sex.
Listen, no matter how much you are feeling the guy from communicating before the date and even more once you meet him, take the time to ask yourself, “What will sex right now accomplish?” An accomplishment is something that brings about credibility. An accomplishment is something that makes you feel fulfilled. An accomplishment is something that causes you to believe that you achieved something great.
That said, if all you’re after is a good time and maybe an orgasm, perhaps sex on the first date will be an accomplishment for you. However, if after starting off solid with this new guy, if you’re not sure what sex will accomplish, in the grand scheme of things, pause until you know. There is absolutely nothing wrong with that — and the right guy for you will agree.
____
Bottom line, if it’s a first real date and you do have sex after it, yes — you just had sex on a first date. Although, when there has been a foundation built prior to it, via healthy communication…it’s less risky and something that you (typically) can feel more confident about — especially if you take all of what I just said into (serious) account.
Sis, when it comes to giving any of yourself to someone new — online or not — please make sure that you do.
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