The Pill Isn’t Bulletproof: 3 Factors That Affect Reliability

July 1, 2019   Sexual Health


How often does this happen to you?

You feel your phone vibrate and look at it, expecting the usual chatter from the group text with your closest friends planning the latest summer excursion, only to find another familiar notification—it’s time to take your birth control.

But there’s just one problem. You’ve been pulled into an impromptu meeting with the notorious long-talker in your office. With no end in sight and your schedule shifting, you have to take your pill hours later than you usually do.

According to the Centers for Disease Control and Prevention, IF used correctly, birth control pills are 99.7% effective at preventing pregnancy, but sometimes, life just gets in the way. On average, typical use cases report a 91% effectiveness. In other words, 9 out of 100 women who use the pill as their only form of contraceptive still become pregnant.

Although highly effective, there are many factors that affect the pill’s reliability. For the sake of brevity, let’s discuss three of the most common ones.

Your schedule

In a perfect world, you’d take your pill at the same exact time every day. However, we live in an imperfect world and things come up! You may get called into that meeting we mentioned earlier, or maybe you forget to take it altogether. While delaying the time you take your pill doesn’t necessarily mean it will stop “working,” the time shift does have an effect on the pill’s performance.

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Other pills

Yes, you read that right. Because the pill’s primary function is triggering a hormonal response that prevents ovulation, other medications like antidepressants and antibiotics can interfere with this reaction and dampen the effects. That’s why it’s important to review each medication with your provider before you take it to confirm that it will not interfere with your birth control pill.

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Tummy trouble

We don’t need to tell you that your immune system doesn’t abide by your schedule. There’s no predicting when the latest stomach bug will hit, or if the shrimp they were serving at your friend’s wedding were as “fresh” as you had hoped. If you experience vomiting and diarrhea within a few hours of taking your pill, it’s very likely that your body hasn’t had a chance to fully absorb it. To ensure you’re still protected, take another pill. If your illness persists for more than 24 hours, consider it a missed day and use additional contraceptives like condoms to ensure you’re fully protected.

Whether you choose to take birth control pills or use another form of contraceptive, we recommend that you speak with your provider to discuss which form of birth control best meets your lifestyle and health needs.

Elizabeth Chase, MD

Brush your teeth, wash your face, take your pill. Hooking the pill to your daily routine can really help you stay on track. 

— Elizabeth Chase, M.D., F.P.M.R.S.