The existing API equation for internal leak predicts the internal pressure to overcome the pin-box contact pressure generated from the makeup interference plus the energizing effect of internal pressure which enhances the seal. For threaded connections, internal and external pressures close the connection and increase the leak resistance, whereas axial loads open the connection and decrease the leak resistance. These competing effects must be included to accurately assess the connection leak resistance under any combination of loads at any point in any string. Following the same approach used by API for internal leak, this paper obtains similar results for external leak. For API connections, the effects of combined axial force and backup pressure are then incorporated into the internal/external leak equations using results from the Mitchell and Goodman (2018) paper presented at the 2018 SPE-IADC Drilling Conference. Sensitivities of leak ratings to combined loads for API connections are presented for both tubing and casing sizes. An example design case shows the importance of considering combined loads.