When you are on birth control pills, it is easy to be lulled into a feeling of being fully protected at all times. Not without reason – the traditional contraceptive pill has a protection level of 99% and progesterone-only (POP) 92%, which is making it a very reliable form of contraception if used correctly.
Even though these give a very high level of protection, there are some factors that can tamper with the pills efficiency. Some of these might seem obvious and the medical professional that prescribed your contraception will probably have mentioned these to you. Some other things are not as overt, so it is a good idea to read up on the different ways you protection might be decreased.
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Can I get pregnant whilst on the pill?
The pill gives a great protection, but there are some flaws in the system. The majority of unwanted pregnancies that occur whilst using the pill are caused by some external factors that caused diminished protection – for example, having diarrhoea, vomiting or forgetting to take the pill (especially if it happens for several days in a row). If you’re in a situation like that, it is better to use extra protection, such as a condom until you’re certain the pills are at their full effectiveness again.
Below you can read about some of these factors that might decrease the pills efficiency partially or fully.
Forgetting to take a pill
This is something pill users often are well aware of, but it nonetheless deserves a mention. Forgetting to take a pill decreases your protection, especially if it is the first pill of the month. The pills at the end of the monthly cycle are generally decreasing your protection to a lesser extent, so the earlier in the cycle you forget a pill the more effect it will have on your protection. If you would forget more than two pills, you should use barrier contraception until you start your next pack of the pills.
Taking the pill the wrong time
Except forgetting to take a pill and starting a pack of pills too late, it is also important to take the pills at the same time of the day. This counts for all sorts of pills, but it is specifically true for progesterone-only pills (POP). They need to be taken within the same time frame of three hours every day, and the protection will be decreased if not.
Storage
The guidelines for storing birth control pills is that they should be stowed away from direct light, in a non-moist place and in stable room temperature, around 20-25 degrees Celsius. Many place their pills in the bathroom, but with the moisture and changes in temperature from showers and baths, this is not ideal.
Remember to do think about this also whilst travelling – if you, for example, are going on a flight and need to take you contraceptives with you, you should keep them in your carry-on luggage since the temperature changes in the cargo can be considerably colder than the recommended temperatures. Keeping your pills in a hot car in the summer is also a situation you should try to avoid.
IBS or Crohn’s disease
Conditions that compromise your natural uptake of nutrients and other things in your digestive system, such as Irritable Bowel Syndrome or Crohn’s disease, can also make it harder for you to take up the hormones from your pills. If you have diarrhoea as a result of this it will further impede your uptake, and you might not be protected at all. It is recommended that people that are suffering from these conditions use forms of protection that does not have to be orally administered.
Diarrhoea or throwing up
If you for some reason are sick or experience diarrhoea less than three hours from that you took your pill, you can treat it as if you had not taken a pill at all. Use other forms of protection.
Laxatives (and tea!)
In line with the previous section, your protection might be affected by laxatives, since they often trigger diarrhoea. If you have stomach problems and need to use laxatives, make sure that you also use extra protection during sexual intercourse.
One thing that one might casually not classify as a laxative, but actually is, is some forms of Detox tea. Be aware of your use of this whilst on birth control pills.1
Medication
Some other medications that you might be using can hamper the pill’s functions. These are some forms of medication treating:
- Depression
- HIV
- Fungus
- Seizures
- Insomnia
Make sure to tell your GP about any medications or drugs that you might be taking at the moment so that they can give you the most efficient protection from pregnancies.
Antibiotics
Earlier it was thought that most antibiotics would curb the pill, but we have since learned that it is mainly two forms of antibiotics that do this. These are rifampicin and rifabutin, designed to treat tuberculosis amongst other things. Be sure to talk to your prescriber to get advice on how to deal with your contraception during your treatment.
Herbal remedies
Some herbal remedies are not ideal to take if you are on the pill. St John’s wort has been proven to give adverse effects together with some other medications, and it is also known to decrease the efficiency of the pill. Saw palmetto and soy isoflavones can also damage the effect of the pill. Some other herbal supplements based on the foods mentioned below can also cause trouble.
Food
Some foods are to be avoided in large quantities whilst on the pill. Often they spur the breakdown of oestrogen, which makes it more likely for you to experience side effects. Some of these foods are2:
- Grapefruit
- Garlic
- Alfalfa
- Flaxseed
Nicotine
Using nicotine products such as cigarettes will increase your blood pressure, which gives you an increased risk of heart and cardiovascular diseases. Together with the pill, it can give you susceptibility to side effects from both smoking and from the pill and might make the pill less effective.
You can find more about contraception here.
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