Yahoo News 8 surprising things that can stop your pill from working
The benefits and pitfalls of the pill are extensively debated, but for many, it’s the best available form of contraception. Not only does it give you more control over when you get your period, and for some, lighten the flow and help to reduce pain, but it’s 99% effective at preventing unwanted pregnancy (but not STIs, so let’s also give a shout out to condoms right about now).
The 99%, however, comes with a caveat. Even if you’re taking your pill correctly, getting sick, taking other medication, or even how you store your packets can have an impact on its effectiveness.
We spoke to Karin O’Sullivan, clinical advisor for the sexual health company FPA, to get the lowdown on taking the pill safely and reliably.
The time of day
"Taking a pill at the same time each day will help you to remember to take it regularly," says Karin. This is especially important if you’re taking the progestogen-only pill.
"If you’re taking the combined contraceptive pill, you’ve ‘missed a pill’ if you take it 48 hours or more after your last pill. But if you’re taking the progestogen-only pill, you’ve missed one if you’ve taken it three or more hours after your usual pill-taking time, or 12 hours if your progestogen-only pill has a type of progestogen called desogestrel." If you miss the window, you’re no longer protected against pregnancy.
The stage of your cycle
"For most pills, if you start taking them for the first time up to (and including) the fifth day of your period, you’ll be protected from pregnancy immediately," she continues. "For some new types of pill with a progestogen called drospirenone, you’ll only be protected from pregnancy if you start the pill on day 1 of your cycle. And if you have a short menstrual cycle, with your period coming every 23 days or less, starting the pill as late as the fifth day may not provide you with immediate contraceptive protection. This is because you may ovulate early in your menstrual cycle."
"If you start the pill at any other time in your cycle you’ll need to avoid sex or use additional contraception, such as condoms, for the first two days of pill-taking for progestogen-only pills, seven days for most combined contraceptive pills, or nine days for Qlaira [a daily combined contraceptive pill that varies your hormone levels during your cycle]." If you’re unsure, your doctor or nurse can provide advise about whether you need additional contraception.
Getting sick
Yep, because being stuck in the bathroom with a bug doesn’t suck enough by itself, it can also prevent your pill from doing its job. "If you vomit within three hours of taking your pill it won’t have been absorbed by your body, so just take another pill as soon as you feel well enough and take your next pill at your usual time," Karin advises. "As long as you’re not sick again your contraception won’t have been affected."
"If you have very severe diarrhoea, this may make your pill less effective. If that happens, keep taking your pill at the normal time, but treat each day you have severe diarrhoea as if you had missed a pill. For the same reason, any conditions which cause diarrhoea, such as Crohn’s disease or Irritable Bowel Syndrome, can also be a problem for your contraceptive cover if they’re not well controlled."
Consuming laxatives
Remember a few years back, when BooTea and other similar products came under fire for causing problems with the pill? This is because many of these drinks have laxative effects and can stop your contraception from working. In fact, many of the brands even state this on their websites.
Of course, it’s not just diet teas – anything with laxative properties can prevent the pill from getting properly absorbed into your system. So, if you’re taking them, you need to consider using additional contraception to ensure that you’re fully protected.
Undergoing gastric bypass surgery
The list of side effects of gastric bypass surgery is extensive, and anyone undergoing the op should be fully informed of the risks. However, lots of people don’t realise that in addition to the potential risks of the procedure, it can influence your body’s reaction to your contraception.
"If you’ve had gastric bypass surgery, this can permanently prevent the hormones from contraceptive pills being properly absorbed into your body," confirms Karin. "In this case, another contraceptive method might be better for you. The contraceptive patch and vaginal ring both work in the same way as the combined pill but are not absorbed through the stomach. Other progestogen-only methods include the implant, IUS and injection. Another option is the IUD which is not hormonal but has copper on the device."
Taking other medication
"The majority of medicines that can prevent the contraceptive pill from working properly are called enzyme-inducers," says Karin. "The hormones from the contraceptive pill enter your bloodstream through your liver, but because enzyme-inducers make everything go through your liver much more quickly, that can mean you absorb less of the hormones you need."
Enzyme-inducers include modafinil, some medications used to treat epilepsy, migraine and HIV, and the complementary medicine St John’s Wort, which is sometimes used to treat mental health conditions. It used to be thought that antibiotics would stop the contraceptive pill from working, but it’s now known that for most commonly prescribed tablets, this won’t be the case. There are only two very strong antibiotics which are generally only prescribed for TB or meningitis – rifabutin and rifampicin – that will have this effect.
Fasting
"If you fast for 24 hours at a time, and more than once in any month, there’s a risk this can prevent your contraception pill from working properly – so you should discuss it with your doctor or nurse," explains Karin.
You can usually adjust the time you take your pill, so you take it when you eat. While you’re fasting, you may prefer to use an additional form of contraception as well. "If you regularly fast more than once a month, a different method of contraception might be more suitable for you," says Karin.
Extreme temperatures
"Keeping contraceptive pills in very hot or cold temperatures can risk making them less effective," Karin explains. England may be the land of mediocre sunshine and disappointing snowfall, but it’s still worth bearing this in mind and keeping your pill packet out of the way of any possible extremes. And if you’re travelling somewhere with a very hot, or cold climate, you might want to discuss using another method with your doctor or nurse.
I’ve missed a pill – now what?
If you’re taking the progestogen-only pill, and you’re more than three hours late in taking your next pill, or 12 hours if you are taking a desogestrel POP, you’re no longer protected against pregnancy. You should take a pill as soon as you remember, and then take your next one at the usual time. This may mean taking two pills in one day, but this isn’t harmful. For the next two days, you should also use an additional method of contraception, such as condoms. "Once you've missed a progestogen-only pill, the contraceptive effect might be reduced. When you start taking the pill again you need two days to give it time to work and protect you from pregnancy again," says Karin. So, if you've missed a pill and had unprotected sex, seek advice immediately because you might need emergency contraception.
If you’re taking the progestogen-only pill, and you’re less than three hours late in taking your next pill, or 12 hours if you are taking a desogestrel POP, then you’re still protected from pregnancy. Just take a pill as soon as you remember, and take your next one at the usual time.
For those taking the combined contraceptive pill, the impact of missing a pill is greater depending on how many you’ve missed, and whether it’s at the beginning of a new pack or not.
For example, taking one pill anywhere in your pack up to 48 hours late, or starting a new pack (after a planned break) less than nine full days after you last took a pill shouldn’t be a problem. You’ll still be protected from pregnancy. But taking a pill 48 hours (or more) late, or starting a new pack (after a planned break) after nine or more full days, may affect your contraceptive cover.
It’s more risky to start a pack late and miss more than one pill. This is because during the seven-day break, or placebo week, your ovaries aren’t getting any effects from the pill. If you make the break or placebo week longer you may ovulate (release an egg).
"Although traditionally the combined pill has been taken for three weeks followed by a seven-day break, you don’t need to take it this way," says Karin. "It’s possible to take the pill in other ways, such as having a shorter four-day break, taking three packs in a row before having a break (called tricycling) or not take a break at all (continuous use)." It's best to talk to a nurse or doctor about the different ways of taking the pill.
If you’re not sure what to do, continue to take your pill and use additional contraception such as condoms for the next seven days, or nine days for Qlaira. If you’ve had unprotected sex during this time you should seek advice immediately, as you might need emergency contraception.
You Might Also Like
