Susan: I that probably the most pressing issue would be to find contraceptive choices that are effective, with low side effects, and easy for couples to use, but, at the same time, protect couples against the transmission of STDs.

Tripod: Tell me the best way to make contraception more exciting.

Susan: I would think that what makes contraception exciting is to find a contraceptive method that works with the personality of the couple involved. So that if you find a method that you're comfortable with, usually you can then find ways to incorporate it into your life in a way that it isn't intrusive. Oftentimes, barrier methods can be incorporated into the process of foreplay, and all of that makes it easier and more positive to use.

Tripod: Give me your best line to use to bring up contraceptives with a new partner. Make up a motto or saying.

Susan: My recommendation to people is simply to be as honest and straightforward in the sexual relationship as they would be in any other relationship. To be able to feel safe and confident with speaking freely, works better than any special line.

Tripod: How would you handle a situation where you and your partner are very  ready for sex, but realize that you don't have any contraceptives? Do you take a chance?

Susan: I would definitely not advise it. The risks, not only of pregnancy, but of sexually transmitted diseases with one exposure are very real. If you're not ready to make a choice to protect yourself, you're not ready for sex.

Tripod: What if you or your partner were on the pill? Would you take a chance?

Susan: That still leaves you with a very real issue of STDs. That requires careful and candid discussion between the two partners. You have to have the intimacy that makes that discussion possible, before one should feel that they're ready for the intimacy of a sexual relationship.

Tripod: Is it possible to incorporate contraception into sexual role playing without losing the excitement?

Susan: Absolutely, and people do it all the time. The idea of women placing condoms on men. The idea of men putting contraceptive methods like diaphragms, or cream, or foam into the vagina. That can all be treated in a very erotic and pleasant way. It doesn't have to be viewed as a chore that has to be done out of sight. I think the more that both partners are involved in the contraceptive choice, the more positive it tends to be.

Tripod: Sexually, is there anything that shocks you nowadays?

Susan: Me? No. [laughs] I've been a gynecologist for too many years to be surprised by much of anything.

Tripod: I understand that with many types of contraceptives, it's good to use some type of spermicidal lubricant. Play out a situation for me, where getting out that ugly tube and squeezing out that junk becomes part of the buildup to sex.

Susan: Yeah. As I was saying before, the concept of incorporating your contraceptives into your foreplay can be exciting because it is a part of that buildup. And I think that anything that can be part of that anticipation of the event can improve the sexual act itself. I think you have to approach it with humor, and with intimacy.

Tripod: Do you use protection during oral sex? Why or why not?

Susan: I think that, obviously, pregnancy is not an issue with oral sex. Sexually transmitted diseases are still an issue. Oral gonorrhea happens. Oral transmission of other infections. Certainly, the risk of oral transmission of HIV virus is less than when you're dealing with vaginal or rectal penetration. But it's still and issue. One has to always take into consideration protection, but also open and frank discussion with your sexual partner, so you understand the risks you're taking before you have a sexual activity.

Tripod: From your experience, personal or otherwise, what is the most sensitive brand of condom?

Susan: Um. I don't know. I don't have any specific recommendation. What is sensitive for one person isn't necessarily the best for another.

Tripod: What do you think of the female condom?

Susan: I know it's out there. Personally, I have not had a lot of patients who are using it. It's a good idea, because it's nice for women to have choices. It's nice for women to have the sense that they have more control. And it probably protects the labia better against secretions. But I don't really know how well it works in a practical sense.