When using oral contraceptives (oral pills), chances of getting pregnant do not exceed 1%. The duration of using oral pills does not affect the chances of getting pregnant. Therefore, women can take oral pills for many years, without worrying about unplanned pregnancy.
If you miss one oral pill, the chances of getting pregnant are increased, but not significantly. If more than 36 hours have passed after the missed dose of oral contraceptive, the chances of getting pregnant are increased several times.
If you miss two oral pills, the chances of getting pregnant will be the same as in women have never taken hormonal contraceptives. If you miss one or two hormonal pills, you can reduce the chances of getting pregnant by means of:
- Barrier contraception methods (hormonal)
- Emergency contraception methods (nonhormonal)
To reduce the chances of getting pregnant after the missed dose of hormonal contraceptive, most women ask their partners to use condoms.
If a man does not want to use such contraception method, a woman can replace male condoms by female barrier contraceptive, such as vaginal diaphragm.
Just as male condom, vaginal diaphragm is made from silicone. When vaginal diaphragm is properly installed, it covers the cervix and prevents the contact of sperm with the cervical canal.
Contraceptive effect of vaginal diaphragm is lower than that of male condoms. However, when oral contraceptive pill was missed and the man refuses using a condom, vaginal diaphragm helps to reduce the chances of getting pregnant by no less than 80%.
Male condoms are more reliable than vaginal diaphragms, but their contraceptive effect is lower than that of oral pills. When condoms are properly used, the chances of getting pregnant are equal to 6%, but in improper use – more than 10%.
When using oral pills without barrier contraception, the chances of getting pregnant do not exceed 1%. If the woman or man uses condom or diaphragm in addition to oral pills, the chances of getting pregnant is almost equal to zero.
It should be noted that the use of condoms helps to reduce not only the chances of getting pregnant, but also the risk of sexually transmitted infections.
The use of oral pills guarantees a reliable contraception and condoms use helps to maintain a good health of organs of the urogenital tract (genitourinary system).
Unfortunately, not all men and women try to reduce the chances of getting pregnant before sexual act. Some sexual partners try to prevent pregnancy already after unprotected sexual act.
The biggest thing that we know of, that affects the efficacy of the pill, is misuse by patients who do not follow the program as prescribed,” said Dr. Millicent Comrie, founder and director of the Long Island College Hospital Center for Women’s Health and vice chairman of the college’s Department of Obstetrics and Gynecology.
Here are five things that may cause the pill to become less effective or even fail:
1.) Not taking the pill at the same time every day
Because of health concerns, the level of estrogen in birth control pills has been significantly decreased since it was first introduced in the U.S. in 1960. Modern pills, often referred to as “low-dose” pills, contain about 20 micrograms of estrogen, which is less than half the 50 micrograms pills once contained. Because of this, it’s more important than ever that woman take their pills everyday at the same time, said Comrie.
2.) Missing a dose
Worse than not taking the pill at the same time every day is missing a day, said Comrie.
“Once you miss one pill, you should double up,” Comrie said. “And if you have any kind of breakthrough bleeding, you should use a condom. With the lose-dose pills, you have to be very careful when you miss a dose.”
That’s right, that glass of wine with dinner or that fruity alcoholic beverage you enjoy on a lazy summer day may reduce the effectiveness of the pill. Why? Because alcohol is metabolized by the liver and any drug that affects the liver may also affect the way the pill is absorbed by the body.
“This is especially true for heavy drinkers,” Comrie said. “Once you take something that affects the liver, you weaken the effects of the pill.”
4.) Antibiotics/seizure medication
Neurological medication, especially seizure medication, like Dilantin and carbamazepine, may reduce the effectiveness of the pill, said Dr. Jacques Moritz, director of gynecology at Roosevelt Hospital in New York City.
“Antibiotics are also a problem,” he said, “but more of a problem because the pill is now so low dose.”
But Comrie said antibiotics aren’t as big of a concern as they once were.
“There have been studies that show that although antibiotics affect the excretion of (the pill), the blood levels are not affected,” she said. “So this is almost becoming a myth.”
5.) Taking a generic form of the pill
Generic pills may save money, but “they do not contain the same amount of medicine as their name-brand counterparts,” Moritz said.
“The FDA allows for a 15 percent variation in generic medications,” he said. “Again this is a concern because the pills are now so low dose. So women should be especially cautious and use a back-up, such as a condom, if they are put on any medication that may interfere with the pill.”
Emergency contraception is used in exceptional cases:
- If a woman forgets to take an oral contraceptive,
- If there are doubts about the effectiveness of barrier or any other contraception method,
- If a decision on pregnancy prevention was taken already after unprotected sexual intercourse.
«Morning-after pills» containing a high dose of synthetic analog of progestogen hormone are used for emergency contraception. The most popular progestogen-containing pills for emergency contraception are Plan B (or Plan B One-Step).
The chances of getting pregnant after emergency contraception depend on when Plan B morning-after pills were taken.
- When using Plan B pills within 24 hours after unprotected sexual act, the chances of getting pregnant are equal to 5% (contraceptive effectiveness 95%).
- If Plan B morning-after pills were taken no later than 72 hours after unprotected intercourse, the chances of getting pregnant is equal 11%.
Thus, the efficiency of emergency contraception depends on how quickly a woman took Plan B pills. The chances of getting pregnant are lower in women who took Plan B pills a few days after the end of regular birth control pills.
It should be noted that the chances of getting pregnant depend not only on the type of oral pills, but also on the period of their use. If oral pills were taken at a time when the egg is not ready for fertilization, the chances of getting pregnant are zero.
It is noteworthy that many men and women believe that male or female sterilization is the most reliable method of contraception. This statement is not an accurate, because chances of getting pregnant after sterilization are the same as when using birth control pills.
A key feature of female sterilization is that its contraceptive effect is irreversible. Only one surgical sterilization procedure forever deprives a woman of the ability to give birth.
If pregnancy creates a serious risk to the woman’s health, sterilization is absolutely warranted. However, if a woman of childbearing age has a good physical, mental and reproductive health, she should not deprive herself of the chances of getting pregnant.
After all, at any age and at any period of the life, a woman can use well-researched, reliable and safe birth control options, the most effective of which are long-term and short-term hormonal contraception methods.
Success and failure rates of birth control pills
Birth control pills are 99 percent effective with “perfect use,” which means taking the pill at the same time every day without missing a dose. “Typical use” is how most women take the pill, and then it’s about 91 percent effective. Both combined oral contraceptives and progestin-only pills (also known as the mini pill) have a typical failure rate of 9 percent.
Many women accidentally miss a dose or forget to start a new pack of pills. When that happens, the chances for an accidental pregnancy go up.
What causes birth control to fail
Certain conditions or behaviors can increase the likelihood that your birth control won’t be as effective at preventing pregnancy.
If you can’t remember to take your pill at the same time every day, you increase your risk of pregnancy. Birth control pills are designed to maintain a constant level of hormones in your body. If you skip or miss a dose, you hormone levels can drop quickly. Depending on where you are in your cycle, this may cause you to ovulate. Ovulation can increase your chances of becoming pregnant.
Reckless alcohol consumption can also cause birth control failure. While under the influence, some women may forget to take their pill at the correct time. If you vomit too soon after taking your pill, your body may not be able to absorb any of the hormones. This can result in a drop in your hormone levels, which could trigger ovulation.
Taking another medication or supplement at the same time as your birth control pill can also affect the pill’s effectiveness.
How to prevent birth control failure
Keep these tips in mind if you’re on birth control and want to prevent pregnancy.
Time it right
If you take progestin-only pills, you should be especially careful about taking the pill at the same time every day. If you’re late with a dose or skip one altogether, your hormone levels can drop very quickly. This could cause you to ovulate and that greatly increases your chances for getting pregnant.
If you miss a dose, use a backup method or avoid sex for the next week. To be extra cautious, use a backup method, such as a condom, or avoid sex for the next month.
Take the placebo pills
If you choose to skip the placebo pills, there’s a chance that you may be late in starting your next pill pack. This can interrupt your body’s expected level of hormones and cause you to ovulate. Ovulation increases your chances of being pregnant.
Don’t mix medications
Although some antibiotics have been anecdotally connected to unplanned pregnancies, research has largely debunked this connection. A possible connection with reduced birth control effectiveness is only recognized with one type of uncommon antibiotic called rifampin.
Don’t use St. John’s wort
Knowing what can make your birth control ineffective and how you can increase your chances for successfully avoiding pregnancy will help you make the best decisions for yourself.
Symptoms of pregnancy
The earliest symptoms of pregnancy can be easily overlooked, especially if you’re on birth control. If you experience any of these symptoms, take a pregnancy test to confirm your pregnancy status. If you want to double check the at-home pregnancy test, a simple blood test by your doctor can confirm your status.
The early signs of pregnancy include:
- tender or swollen breasts (hormonal changes can affect the way your breasts feel)
- a sudden aversion to certain foods or scents
- unusual food cravings
Many women begin suspecting they’re pregnant when they miss a period. Unfortunately, some women don’t have a period while on birth control, so a missed period may not necessarily be an easy indicator.
Implementation bleeding, which happens when a fertilized egg attaches to your uterus, can be mistaken for a period. This is especially true if your period is typically very light.
What to do if you’re pregnant
If you discover that you’re pregnant, you should speak with your doctor as soon as possible. If you plan to keep the pregnancy, you’ll need to start caring for your growing baby. This means going off of the birth control pill and beginning to take a daily prenatal vitamin with at least 400 micrograms of folic acid. You’ll also have to begin preparing for an upcoming delivery.
If you decide you’d like to terminate the pregnancy, you should begin this process as quickly as you can. Depending on where you live, legal restrictions could prevent you from having the procedure after you’ve reached a certain point in the pregnancy.
Can birth control harm your baby?
Other Reasons the Pill Can Fail
Other medications. Some medicines can make your birth control pill less effective. Most antibiotics are safe to take while you’re on birth controlpills, but one — rifampin (Rifadin IV) — can stop the pill from working. Tell your doctor you’re on birth control if he prescribes you rifampin.
Other medicines like mood stabilizers, epilepsy medicines, and HIV drugs can also make the pill less effective. Make sure to discuss these with your doctor.
Certain herbs. The supplement St. John’s Wort is popular for issues like depression or insomnia, but it can reduce the amount of hormones in the pill. Talk to your doctor if you’re taking this herb and consider using a backup method of birth control while you’re on it.
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