Birth control not working

When you take the pill every single day, it’s great at preventing pregnancy. But missing pills, taking certain medications, and other things may make it not work as well.

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How effective is the birth control pill?

If you use it perfectly, the pill is 99% effective. But people aren’t perfect and it’s easy to forget or miss pills — so in reality the pill is about 91% effective. That means about 9 out of 100 pill users get pregnant each year.

The better you are about taking your pill every day and starting your pill packs on time, the better the pill will work. You can use our birth control app to remind you to take your pills when you need to. But there’s a very small chance that you could still get pregnant, even if you always take your pills correctly.

If you want a method that’s even better at preventing pregnancy, you might want to check out IUDs and the implant. They’re the best at preventing pregnancy. But if you decide the pill is right for you, make sure you always take your pills on time so they work as well as possible.

What lowers the birth control pill’s effectiveness?

The main thing that makes the pill not work is not taking it every day. But other things, like vomiting or having diarrhea for more than 48 hours (2 days) may lower how well the pill prevents pregnancy. The pill may not work quite as well for people who are overweight.

These medicines or supplements can also make the pill not work as well:

• The antibiotic Rifampin (other antibiotics don’t make the pill less effective)

• The antifungal Griseofulvin (other antifungals don’t make the pill less effective)

• Certain HIV medicines

• Certain anti-seizure medicines (these are sometimes also used to treat psychiatric disorders like bipolar disorder)

• The herb St. John’s Wort

If you take any of these while you’re on the pill, use condoms as a backup method. Switch to a different method of birth control if you’ll be on them for a long time.

Your nurse or doctor can help you decide if there’s any reason the birth control pill won’t work well for you.

How long do birth control pills take to work?

It depends on when you start taking them and what type of pills you’re using. You can start taking the birth control pill any day of the month. But depending on when you start and the kind of pill you’re using, you may need to use a backup birth control method — like condoms — for up to 7 days.

Combination Pills (COCs)

  • If you start combination pills within 5 days after the first day of your period, you’ll be protected from pregnancy right away. For example, if you get your period Monday morning, you can start the pill anytime until Saturday morning and be protected from pregnancy that same day.

  • If you start combination pills any other time, you need to take the pill for 7 days before you’ll be protected from pregnancy. So use another method of birth control — like a condom — if you have penis-in-vagina sex during your first week on the pill.

Progestin-Only Pills (Mini Pills)

  • You can start progestin-only pills any day of the month. You’ll be protected from pregnancy after 48 hours (2 days). So use another method of birth control (like condoms) if you have penis-in-vagina sex during the first 48 hours.

Your nurse or doctor can help you figure out the best time to start your birth control pills, and when they’ll start working.

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7 facts anyone taking birth control should know

1) Birth control pills prevent pregnancy through two different mechanisms

All birth control pills use hormones to prevent pregnancy. Some contain a hormone called progestin. Others contain two hormones, progestin and estrogen. All of them work by doing two things: They prevent women from ovulating, and they cause the cervical mucus to thicken, which makes it more difficult for a sperm to penetrate and make contact with an egg if the woman is ovulating.

In a way, birth control mimics the body’s response to pregnancy. “There is some truth to the idea that birth control pills trick your body into thinking you’re pregnant,” said Dr. Vanessa Cullins, Planned Parenthood’s vice president of external medical affairs. “When you’re pregnant, you don’t ovulate, and the cervical mucus is thickening to prevent anything from easily getting into your uterus.”

2) Lots of women take birth control incorrectly

If women follow the exact instructions for taking birth control pills — every day, at the same time — they prevent pregnancy in 99 percent of all cases. But lots of people don’t do that. In real life, birth control pills have a 9 percent failure rate. That means nine of every 100 women using birth control pills as their only means of contraception become pregnant in any given year.

“It’s hard to actually when you’re living a busy life,” Cullins says. “If you take these pills every single day, the chances of getting pregnant is 1 percent. But typically the chance is much higher than that, because people miss pills. This isn’t just true with birth control pills. It’s true with any prescription medication.”

Birth control pills have a higher failure rate than other contraceptives, like intra-uterine devices (IUDs) or birth control rings.

The main difference: Pills have to be taken every day, which leaves more room for human error.

3) There’s a three-hour window for taking your birth control pill “on time”

I asked Cullins whether there is wiggle room in terms of when birth control is effective. For instance, if a birth control user typically takes a pill at 9 am but one morning waits until 11 am, is she at greater risk for pregnancy?

The answer is no. Cullins said that for those taking progestin-only pills, “on time” means taking the pill within the same three-hour window daily. A three-hour difference is not enough to lower the pill’s efficacy. “That’s acceptable,” she said.

For combination progestin-estrogen pills, the space is even wider. Women who miss one day of their pill can take two pills the next day without reducing their birth control’s effectiveness. This chart with data from Planned Parenthood shows the organization’s recommendations for how to handle a missed combination pill.

“Two or three missed pills is when you need to begin to get concerned, and once you get to three missed pills, you need to consider emergency contraception and using backup birth control until she has finished the first week of the pills of the new package that is begun after her bleed from emergency contraception,” Cullins said.

4) Missing a period on the pill doesn’t mean something’s wrong

Missing a period while on the pill doesn’t indicate anything abnormal, Cullins said, as long as you have been taking the pill consistently and correctly each day.

“It’s not dangerous not to have your period while on the pill,” she says. “What happens is, over time, the uterine lining can become very thin if you take the pill regularly. All that means is if you stop bleeding on the pill, the lining has become so thin that you don’t have anything to bleed from.”

This is not permanent: When a woman stops taking birth control pills, the ovaries start making more estrogen, the uterine lining gets thicker, and women start to bleed again.

Missed periods after taking your pills incorrectly, however, could indicate a pregnancy. In that situation, it’s worth taking a pregnancy test.

5) We don’t know whether most antibiotics make birth control less effective

There are two antibiotics that researchers have found make birth control pills less effective: griseofulvin, an antifungal used to treat athlete’s foot and ringworm, and rifampicin, which is typically used to treat tuberculosis.

The reason that happens is that these drugs speed up the liver’s metabolism, which makes the liver metabolize the hormones in the birth control faster. As a result, hormones leave the blood stream faster and are unable to adequately affect the ovaries to prevent ovulation or the cervix to prevent thickening of the cervical mucus.

Lots of antibiotics, not just the two listed above, come with warnings that they’ll make birth control ineffective and suggest using a backup method of contraception. While a backup method is never a bad idea, there’s actually sparse evidence that these other drugs make birth control less effective. “Uncertainty persists with respect to the other broad-spectrum antibiotics,” researchers in the journal Contraception wrote in a review article about interactions between birth control and antibiotics. They argue that in light of that uncertainty, it is completely appropriate for women to use a backup method — but not to ditch their antibiotics out of concern over interactions.

6) Those “sugar pills” at the end of a birth control pack? They have active ingredients.

Lots of birth control packs have four weeks of pills: three weeks of pills that prevent pregnancy and one week of pills that are inactive.

Women can safely skip that last week of pills and still prevent pregnancy, Cullins said. But that doesn’t mean the last week’s pills are just sugar pills. As it turns out, some of them actually have active ingredients to make the pills work better or aid in women’s health.

“Some of the pills might have low-dose estrogen for three to four days, to help prevent breakthrough bleeding ,” she said. “Others sometimes contain iron or folic acid or other vitamins. And the hard part about skipping the pills is that you have to remember exactly when to start back up.”

7) Even under Obamacare, not everyone with insurance gets free birth control

The number of women getting free birth control pills has quadrupled under Obamacare, recent research shows. Two-thirds of women in a recent Guttmacher Institute survey reported paying zero dollars for their contraceptive.

But that still leaves one-third of women paying something for birth control, even after Obamacare has mandated it be free.

The one-third of women still paying for their birth control are most likely in grandfathered health insurance plans. These are the plans that existed before Obamacare that do not have to comply with the contraceptives mandate (or most other Obamacare requirements, for that matter).

Grandfathered plans are, however, disappearing. When a company significantly changes its insurance (drops a benefit, for example, or changes what enrollees have to pay), then it loses its grandfathered status. Just over a quarter of health insurance plans are currently grandfathered, a number that has steadily dropped since Obamacare passed.

As that figure declines, the number of women accessing no-cost contraceptives will likely continue growing.

How does birth control work and which methods are most effective

  • Birth control works primarily by blocking sperm, disabling sperm, or preventing ovulation.
  • Some types of birth control will start working right away, like condoms and copper IUDs. But others can take days to kick in, like some forms of hormonal birth control.
  • For most birth control methods, you can get pregnant as soon as you stop using them.
  • IUDs and implants are the most effective methods, followed by the pill, while condoms and spermicides are less reliable.
  • This article was reviewed by Olivia P. Myrick, MD, who is a clinical assistant professor with the Department of Obstetrics and Gynecology at NYU Langone.
  • Visit Insider’s homepage for more stories.

Everyone is different, so how do you decide which birth control method is right for you? Luckily, there are a lot of different options to choose from. Here’s what you should know when choosing the right birth control for you.

Three ways birth control prevents pregnancy

  1. By blocking sperm: Barrier methods like male and female condoms or diaphragms prevent sperm from entering the uterus. There are also hormonal birth controls, like the pill, that can thicken the mucus in your cervix, making it harder for sperm to swim through.
  2. By disabling sperm: Methods like spermicides kill sperm or make them unable to fertilize eggs. Copper IUDs, for example, have no hormones. Their only contraceptive method is the copper itself which has a disabling effect on sperm.
  3. By preventing ovulation and fertilization: Hormonal methods, like birth control pills, rings, implants, injections, and hormonal IUDs, prevent eggs from being released or from traveling into the fallopian tubes to be fertilized.

How long it takes for birth control to work

Barrier methods like condoms work immediately and keep working the entire time they are in place, so long as they are used correctly.

Spermicides begin working immediately but have a limit to how long they last. So, it’s important to read the instructions for any product you are using, as some may only be effective for one hour, while some may last up to six. It’s also important not to do anything to wash out the spermicide, such as douching, for six to eight hours after sex.

Copper IUDs start working right away, while hormonal IUDs may have some delay. This is because you may have ovulated just prior to the IUD placement and it could theoretically be fertilized if you have unprotected sex.

If you get a hormonal IUD within a week of your period starting, this is not a concern and it will work right away. Otherwise, for the first seven days after getting the IUD, you should err on the side of caution and use a second form of protection like condoms, to prevent pregnancy. The same is true for birth control injections.

A similar rule applies to birth control pills, rings, and implants. If you start these methods within 5 days after the start of your period, you’re protected immediately.

How long hormonal birth control stays in your system

After removing a hormonal IUD or implant, you can start trying to get pregnant right away.

If you stop taking birth control pills or remove a birth control ring, you’ll probably start ovulating again within two weeks, at which point you can get pregnant.

For people using the birth control shot, there may be a longer wait, taking 3 to 18 months before you can get pregnant.

In general, after stopping any form of contraception, it is a good idea to wait for your first normal period before you start trying to conceive.

How effective are condoms, spermicides, and hormonal birth control

In general, all forms of birth control are highly effective. It’s human error, like missing a dose or not using a condom correctly, that makes certain types of birth control less effective than others.

Here’s how effective each type of birth control is, according to the CDC:

  • Ovulation prevention: IUDs and implants are more than 99% effective and considered to be the most effective forms of birth control because human error is not a factor when using them. For the average person, the pill, the patch, and the birth control ring are 91% effective, while the shot fares slightly better, with 93% effectiveness. These methods can be more effective, but most people don’t take them as regularly as they should, which reduces their effectiveness.
  • Blocking sperm: Diaphragms lag a bit behind, working 88% of the time. Male condoms are 82% effective with typical use and female condoms are just behind at 79%.
  • Disabling sperm: Spermicide is the least reliable method, working only 72% of the time.

How to choose which birth control is best for you

“There are many factors that will enter into a woman’s decision of what method to use,” says Lew. This can include how long you want to prevent pregnancy and what side effects you are able to tolerate. Some people may also be unwilling to use hormones, or wish to prevent STIs, which are important factors, Lew says.

There are certain medical conditions that may limit your options as well. Speak with your doctor so that you can determine the right birth control method for you.

Related stories about birth control:

  • Plan B: Side effects, how long they last, and how to get relief
  • You can get pregnant with an IUD but it’s extremely rare
  • Birth control pills may be making part of your brain smaller
  • Planned Parenthood is expanding its birth control app to all 50 states in the wake of Trump’s massive funding cut

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No form of birth control is 100 percent effective. Now, a new study provides an explanation for why a small number of women who use hormonal contraceptive methods still become pregnant, even if they use them correctly.

A new study published in Obstetrics & Gynecology explains that some women have an uncommon genetic difference that makes hormonal contraception less effective for them. In the paper, researchers at the University of Colorado School of Medicine say that around 5 percent of women carry a gene that makes their bodies produce an enzyme that breaks down the hormones in birth control faster than usual.

The researchers think that the enzyme leaves women with hormone levels that may be too low to prevent pregnancy, particularly among users of low-dose contraceptives. Hormonal contraceptive methods like the pill, implant or injection work by releasing synthetic versions of female hormones, usually estrogen and progestin, that overrides a woman’s monthly cycle and prevents ovulation.

Receiving these hormones, ironically, tricks a woman’s body into thinking it’s pregnant, which stops the release of an egg each month. The hormones also work to prevent pregnancy by thickening the mucus near the cervix, which prevents sperm from reaching the egg.

Gene-Drug Interaction

To learn how a woman’s genetic makeup influences birth control hormones, the researchers examined 350 healthy women with a median age of 22.5 years old who had received a contraceptive implant. This long-lasting birth control device sits under the skin and delivers the hormones necessary to prevent ovulation.

The researchers found that around 5 percent of women tested positive for a genetic variant, called CYP3A7*1C. And among these women, the researchers observed lower levels of birth control hormones in their system. It’s thought that the enzyme somehow interferes with the ovulation-suppressing effects of hormonal birth control.

Lead study author Aaron Lazorwitz said that the CYP3A7*1C gene normally shuts off during gestation, before a woman is ever born. But in some women that never happens and evidently impacts how they process steroid hormone-based drugs, like birth control. Better understanding genetic differences in medication effectiveness could be a game-changer in women’s healthcare, Lazorwitz said.

“The field of pharmacogenomics, looking at how genetics affects drugs, has been a hot topic in multiple areas of medicine … women’s health research has unfortunately not focused much on this field to this point,” he said. “As we use the same types of hormonal medications for so many different treatments in women’s health, the impact of genetics on these medications has huge potential to change how we take care of women.”

According to the Centers for Disease Control and Prevention, 24 percent of women use a hormonal form of contraception like the pill or the implant. Lazorwitz said that many cases of birth control failure come down to user error — such as missing a few pills. But, as this study shows, there are factors outside of a woman’s control that can impact birth control effectiveness, and there are probably more to find, according to Lazorwitz.

“We think that genetics is part of the equation, but there likely are other things we haven’t even considered yet,” he said. “This is just the first step in our work to try and figure out this complicated issue. Thankfully, we have extremely efficacious birth control methods like intrauterine devices and the implant that we know work very well for the vast majority of women.”

Failure Risk

Lazorwitz said the findings likely apply to all forms of hormonal birth control — such as the pill, implant or injection — because the hormones used in these methods are similar and are processed similarly in the body. But future studies are needed to prove this.

The unintended pregnancy risk for women carrying this genetic variant cannot be quantified yet because it’s too early. Because the implant releases “more than enough” hormones needed to prevent pregnancy, Lazorwitz said the variant probably does not impact efficacy of the contraceptive implant.

The researchers are more concerned that the genetic variant could affect the effectiveness of lower-dose hormonal methods, like the pill. For now, Lazorwitz said women should continue to work with their doctors in finding the best birth control method for them.

“We want to reassure women taking hormonal birth control that they don’t need to go get genetic screening or anything like that at this time … We hope that this kind of research will one day lead to enough information that we can develop some tools or screenings to help guide women on their individualized decision-making process in choosing a birth control method,” he said.

Download Clue to send a daily reminder to take your pill.

Top things to know

  • Hormonal birth control (HBC) usually works when used correctly and consistently

  • Unintended pregnancies are declining because of increasing access to effective contraception

  • Human behavior can play a part in HBC being less effective. The effectiveness of any method depends on typical vs. perfect use.

  • Tracking your HBC in Clue can help you prevent failure

Most of the time, hormonal birth control doesn’t fail. When people use hormonal birth control consistently and correctly, pregnancy occurs in only 0.05 percent to 0.3 percent of people (depending on the method) over a year of use (1). (Compare that to the eighty-five percent of people who become pregnant within a year, when not using birth control.)

Almost half of pregnancies are unintended, but this number is declining, likely because of the increasing availability of highly effective methods of birth control (2).

If birth control is so effective, why do we hear so many stories about people becoming pregnant while using it? Generally, it’s because as humans, we are more flawed than the medical technology of birth control.

When we talk about birth control and why certain methods fail, it’s important to make a distinction between perfect use and typical use (1).

  • Typical use reflects how people actually use a type of birth control, even if they use it inconsistently or incorrectly.

  • Perfect use reflects how effective the form of birth control is if used exactly as prescribed (3).

While certain behaviors can put a person at risk for birth control failure, there are times when birth control fails without a real reason and without anyone to blame. Contraception is a modern technology, and no technology is perfect (1).

Why hormonal birth control fails

Hormonal birth control works to prevent pregnancy by stopping ovulation and/or, thickening cervical mucus (1, 4). Human behavior is commonly a factor in why these methods fail. Below, we address the different hormonal birth controls, and factors that may cause them to fail, in greater depth.

The pill

Failure rate: 9% typical use, 0.3% perfect use (1)

Human behavior is the most common reason that birth control pills fail (1). The majority of people using the pill forget to take one or more each month (5), while others have challenges filling the prescription monthly (6). Some people might stop taking it because they are concerned about side effects (1).

Taking medications like certain antibiotics, some anticonvulsants, and the herb St. John’s Wort can make the pill less effective (7, 8). Prolonged vomiting or diarrhea can prevent absorption of the pill and lead to pregnancy if a backup method isn’t used (9).

The patch

Failure rate: 9% typical use, 0.3% perfect use (1)

The patch contains hormones like the pill, but it sticks to the skin (1). The patch can fail if it detaches and isn’t replaced, or if the patch isn’t replaced weekly (1).

The ring

Failure rate: 9% typical use, 0.3% perfect use (1)

The ring is inserted into the vagina to deliver hormones (1). The ring can fail if it’s withdrawn accidentally during sex, when using a tampon, or having a bowel movement and not reinserted within three hours (1). It could also fail to prevent pregnancy if the same ring is used for more than four weeks (1).

The shot

Failure rate: 6% typical use, 0.2% perfect use (1)

The shot contains a progestin (a synthetic form of progesterone) that lasts three months (1). It can fail if a person doesn’t receive their next dose in time, or if it is given incorrectly (10).

The implant

Failure rate 0.05% typical use, 0.05% perfect use (1, 11)

Hormonal implants are thin rods that are inserted under the skin in the upper arm (1). Although the implant is one of the most effective forms of birth control (1), it can fail if it’s not correctly inserted or if a person is taking antiepileptic drugs (12).

Why IUDs fail

Hormonal IUD

Failure rate: 0.2% typical use, 0.2% perfect use (1)

Intrauterine devices, or IUDs, are small implants placed inside the uterus. While the hormonal IUD thickens cervical mucus and sometimes prevents ovulation like other hormonal birth control methods, the presence of the IUD inside the uterus also causes inflammation that is toxic to both sperm and eggs (1).

An IUD can fail if it is not placed correctly by the healthcare provider, or if it’s expelled from the uterus (1). All human anatomy varies slightly from person to person, and uteruses come in a variety of shapes, sizes, and positions. Someone with a uterus that is smaller than average, shaped or positioned atypically may be more at risk for IUD failure because if the device is not in the appropriate position, it may be less effective or be more likely to be expelled (13).

While the copper IUD does not contain hormones, we’ve included its failure rates here for comparison and clarity.

Copper IUD

Failure rate: 0.8% typical use, 0.6% perfect use (1, 11)

How to prevent your birth control from failing

1. Use two birth control methods simultaneously (1).

No, this doesn’t mean using two condoms at once. It means pairing a hormonal method with another method that doesn’t involve hormones but is still effective at preventing pregnancy. Some good options are condoms, spermicides, or withdrawal.

2. If you’re on the pill and need a reminder to take it, Clue can send you a birth control pill reminder notification. You can also track when you take your pills.

If you miss a pill and don’t know what to do, Clue can walk you through the difference between a taken, late and missed pill and let you know what your next step should be.

Choosing a birth control method is an important decision, but just because one method is the most effective doesn’t mean it’s the most effective for you.

While pills have prevented millions of pregnancies, they won’t work if you know you’re not good at remembering to take them every day.

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3. Explore options that don’t require daily effort.

The patch is a good option for many people because you only need to remember to change it once a week. Applying it is usually pretty easy, but if you use a lot of creams, lotions, or sunscreens, it might not adhere well. You’ll need to make sure your skin is clean and dry before attaching the patch and pressing it for ten seconds. Then, make sure all of the edges are stuck to the skin—peeling edges can cause the patch to be pulled off (1).

The ring also needs to be changed infrequently. If you don’t have trouble remembering to change it each month, you just need to remember to check that it’s still inserted after sex, tampon use and bowel movements.

IUDs and the implant have the lowest risk for human error, since you don’t have to worry about taking them or changing them frequently, but they can be inserted incorrectly by the healthcare provider, or expelled after the fact. After your IUD or implant is inserted, you can ask your healthcare provider to show you how to feel for it to know it’s there—then make sure you check it regularly.

If you’re having trouble using your birth control correctly and consistently, talk to your healthcare provider about trying a new option.

The Pill is the most commonly used form of birth control in the U.S. When taken exactly as directed, it’s 99.7 percent effective, making it a smart choice for many women.

But the Pill is not magic, so if it’s not taken as directed, it’s not going to do its job as well.

Some myths floating around out there about what might cause your birth control to fail are just that: myths. But there are a handful of things that could truly interfere with the Pill’s level of effectiveness—and could lead to an unplanned pregnancy.

1. Missing a pill or starting a pack late.

“The number one reason birth control pills fail is because women are not taking them daily,” Fahimeh Sasan, D.O., assistant professor of obstetrics, gynecology and reproductive science at the Icahn School of Medicine at Mount Sinai, tells SELF. Specifically, missing a pill is the biggest mistake you can make.

Does missing one pill mean you’re definitely going to get pregnant? No. But it does mean that you could get pregnant—especially if it’s the first active pill in the pack. “For most pills if you are in the middle or toward the end of your pack you should be fine, but if it is the first day of active pills and you forget to restart, this might be a problem,” says Nikki B. Zite, M.D., program director and professor of obstetrics and gynecology surgery at The University of Tennessee Graduate School of Medicine. “The first week of pills after the placebos are the most important to stop the egg from developing,” Zite says, so leaving a gap between the end of one pack and the start of the next one will put you at a higher risk of pregnancy than if you were to miss a pill mid-cycle.

If you miss a single pill other than the first one, take it as soon as you remember, and you should be fine. If you miss more than two pills, “it is likely best to consider yourself not protected.” You should not have unprotected sex until you are through that pack, including the placebos.

To help yourself remember, set a daily alarm, or try an app that reminds you. If you still tend to forget, ask your gynecologist about switching to a “set it and forget it” method, like an IUD, Zite suggests.

via whatshouldwecallbiddies2. If you have inflammatory bowel disease or other digestive disorders.

Bowel conditions like Crohn’s disease and IBD may prevent the body from absorbing any oral medication correctly, including the Pill. “Anything that interferes with the body’s ability to absorb the hormones or increases the rate at which they are metabolized (broken down) can decrease the effectiveness of birth control pills,” Zite says. Chronic diarrhea can also impede absorption. In fact, the Mayo Clinic says that if you’ve had serious diarrhea or vomiting for two or more days, you should act as though you’ve missed a pill. Zite recommends women with chronic bowel issues choose a non-oral method of contraception.

3. Taking certain seizure or migraine medications.

A certain category of epilepsy medications taken to prevent seizures are “liver enzyme-inducing,” meaning that they boost the rate at which the liver breaks down hormones. This means any hormonal birth control can be affected, including methods like the patch. Zite warns that some seizure medications—such as Topamax—can also be used for migraines, “so women should make sure that all their providers are aware of their birth control before starting any new medications.”

4. Not taking your progestin-only pill at the same time every day.

If you’re taking a combination pill (it’s the most standard, and includes a mix of estrogen and progestin), laboring over exact timing isn’t necessary. But progestin-only pills (aka mini-pills) are much more time-sensitive. These are commonly used while breastfeeding or when a woman cannot take estrogen for any other reason. “They work mostly by making cervical mucous unfavorable for sperm. Within three hours the mucous is able to be penetrated…so not much wiggle room there.” Planned Parenthood says to use backup for 48 hours after a late or missed mini-pill.

5. Taking certain antibiotics.

Most standard antibiotics, like the ones your doc prescribes for an upper respiratory infection, UTI, or post-wisdom teeth removal, are not going to affect your birth control, Sasan says. But a few less common types of antibiotics might interact poorly. “For example, rifampicin and rifabutin which can be used to treat or prevent diseases including tuberculosis and meningitis,” Sasan says. To be completely sure, you should always check with your doctor when adding a new prescription medication.

6. Or antiretroviral medications.

If you’re taking medication for HIV, the effectiveness of hormonal birth control pills may be compromised. Drugs known to interact are several protease inhibitors (PIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs), according to the National Institutes of Health. These drug interactions can impact the amount of hormones in the blood, potentially rendering the Pill less effective. They can also increase the risk of other, more dangerous hormone-related effects, like thromboembolism, a sometimes-fatal condition that happens when a blood clot breaks away and clogs a blood vessel elsewhere in the body.

7. Treating mood disorders with St. John’s wort.

The herb is most commonly taken for depression and related conditions like anxiety. But it might increase the breakdown of estrogen, according to the National Institutes of Health, making oral contraception less effective. “It’s best to avoid St. John’s wort and to discuss other herbal supplements with the prescriber or pharmacists,” Zite recommends.

Can a person get pregnant while taking the pill?

Although the birth control pill is generally very effective, some situations can reduce its effectiveness and may sometimes result in unintended pregnancies. These include:

Missing a day

Manufacturers intend for people to take the pill daily for it to be most effective. If a person misses a day, their hormone levels may not remain at consistent enough levels to prevent pregnancy.

If a person finds it difficult to take the pill on a daily basis, other birth control methods may better suit their needs. A doctor or gynecologist can advise on the range of alternative contraceptives.

Vomiting

Sometimes a person may be ill when they take the pill. When a person vomits, the pill can come back up, or they may not fully absorb it into their body.

Anyone who experiences vomiting shortly after taking the pill should take another pill as soon as possible and then take their next pill as usual.

Not taking the pills at the same time each day.

In addition to taking birth control pills daily, a person should also take the pills at around the same time each day. This can maintain their hormone levels more consistently.

A person should always take the minipill within the same 3-hour time window every day. Someone who misses their window should use a backup birth control method for the next 2 days or avoid having sex.

Many people set a daily alarm reminding them to take their pill at the correct time each day.

Not starting a new pack right away

Share on PinterestSome medications and supplements can interact with the pill and decrease its effectiveness.

It is essential to start a new pack of pills the day after finishing the previous one. However, sometimes a person may not have their new package yet. Missing a few days between packs can make the pill less effective at preventing pregnancy.

According to the CDC, anyone who misses two or more pills in a row should use a backup contraceptive method or avoid sexual intercourse until they have taken the birth control pill for 7 consecutive days.

Medications that interfere with the pill

Some medications can make the pill less effective. Medications include certain antibiotics, such as rifampicin, and anti-fungal drugs, such as griseofulvin.

A person should use backup contraception while taking these medications and for 48 hours after finishing the course.

Other more long-term medications and supplements may also affect how well birth control pills work. These can include:

  • epilepsy drugs, such as phenobarbital, phenytoin, and carbamazepine
  • anti-viral medications used to treat HIV
  • St. John’s Wort, which is a herbal remedy

How To Store Condoms And Other Birth Control, Because Temperature Matters More Than You’d Think

If your birth control isn’t surgical — as in, you don’t have an IUD or an implant that prevents pregnancy, and you haven’t had a birth control shot — then you’re going to have some equipment to store. Unfortunately, though, when people are handing out condoms or prescribing the Pill, they rarely specify that you need to store them correctly, which can be a massive problem. Keeping birth control in the wrong conditions can reduce its efficacy and increase the risk of bacterial nasties in your intimate parts. That is the opposite of a fun situation.

It’s not like most birth control methods are seriously delicate; they’re usually made to withstand as much as possible, because people have busy lives and can’t keep everything in laboratory conditions. However, there are some precautions you need to take to do things correctly, from keeping them at the right temperature to avoiding damaging their surfaces. And some are touchier than others: the NuvaRing and other birth control implants you do yourself require some attention to detail, (and I’m not just talking about in putting them in properly which is hilarious in and of itself).

Think you know how to store your birth control already? Some bits of “wisdom” about safe places to keep your birth control are actually completely wrong. Always read the instructions, but if you can’t be bothered, use this as your handy guide to storing every kind of birth control around.

Condoms

Joe Raedle/Getty Images News/Getty Images

Optimum place: Not your wallet. At least not long-term. Keeping a wallet in your purse “just in case” might seem useful, but sticking it in and forgetting about it is a massive risk: the friction of opening and closing your wallet, and of other things rubbing against it, might rip the condom or cause tiny holes, even if it’s safe inside the packet.

If you really want to keep them on you and don’t want to simply pull one out of your stash for the nights you think you’ll get lucky, keep them in a separate coin purse or bag, or an Altoids tin, and replace them regularly so they don’t expire.

At home, condoms shouldn’t be exposed to sun or kept in hot weather. Keep them somewhere cool, dry, and dark: condom manufacturers recommend somewhere between 32-100 degrees F.

The Pill (Combination & Progestin-Only)

Do not keep the Pill in your bathroom, even in a sealed cabinet. It has to be kept away from moisture and excess heat, and your showers are not helpful. Otherwise, storing it is pretty straightforward: keep it tightly sealed, don’t take the pills out of the packaging until you take them, and try to keep it at room temperature.

NuvaRing

Sandy Huffaker/Getty Images News/Getty Images

The NuvaRing and similar products are a little touchier than pills or condoms: they need to be kept under 85 degrees fahrenheit at all times, and for the first four months of their life span they need to be stored at under 77 degrees. The NuvaRing is also definitely not allowed to live in your purse. The pharmacist who gives you the NuvaRing needs to keep them in the fridge, but that’s not necessary for you — and it can’t be thrown down the toilet when you’re finished with it.

Contraceptive Patch

Getty Images/Getty Images News/Getty Images

Ortho Evra and patches like it, which you apply once a week for the first three weeks of your cycle, mostly get attention on the slapping-on stage, to avoid damaging them or putting them on skin that gets too much sun. But the patch has temperature requirements before you put it on: it needs to be kept at 77 degrees F, although you can get away with hotter or colder temperatures very briefly, and it needs to be kept in a dark, dry place. So the bathroom is, once again, out.

Diaphragm

If you clean and store a diaphragm properly, it can last for up to three years (longer if it’s silicone) but it needs care. Don’t store it with oil-based lubricants or powders, make sure it’s washed with soap and warm water before you put it away each time, and examine it regularly to see if the silicone or latex is damaged in any way. It’ll come with its own nice storage container, where it should live: don’t be tempted to get something that looks fancier.

Contraceptive Sponge

The cervical sponge is designed to soak up sperm, so obviously it needs to be discarded immediately after each use. But it’s not the sort of sponge you can chuck in with the kitchen wipes while you’re waiting to use it. Because it contains spermicide, it needs to be kept somewhere very clean, cool, and dark. And don’t get one wet: that activates the spermicide and it needs to be used immediately or thrown out.

Images: UCI UC Irvine, thetasha, Ryan Somma/Flickr; Today Sponges

Do you store your pills in the fridge? Why? Why not?

I’m looking for any wisdom about pill storage from any halfway decent source or just anecdotes, specifically, whether storing them in the fridge is a bad idea.

Backstory explaining my question and possibly answering any follow-ups to follow. Skip it if you want.

I am on Spiro and a birth control pill (Levlen ED) and everything has been going well for a few months. The boxes, though, say to store below 30C which is hard for me because I live in Australia, it has come into summer, and I do not have any climate control. It regularly gets over 40C here and that’s the temperature in my house. There is nothing I can do about it.

I did a bunch of reading in anticipation of this and the only thing I found suggesting not to store pills in the fridge is that it can be moist in there which is just as bad as heat for medication. I addressed this with an insulated lunch box that appears to be working as the cardboard pill box it still not wet after a few days.

However, in the last few days since the pills have been in the fridge, my nipples have suddenly stopped being sensitive. Now, I know this could be normal, but it could also be indicative. It just seems like a considerable coincidence and it has me worried. The fact that the pill box is dry, the pills themselves are in those foil packets, I have not had a return of erections, and I’m still peeing a lot suggests that Spiro is still working and that it’s not plausible the E is, destroyed, but still.

The only other variables are that this was a weight gain week (meaning more food than normal) during which I took the opportunity to add some weight to my barbell (I squat a few times a week anyway, but with maintenance weight, not usually added weight) and regain some muscle, so I may have raised my testosterone a little.

I am going to ask my pharmacist and endocrinologist, obviously, but I’m reaching out to you people for anything you might know.

Storing Your Medicine

Oxygen, light, and water are among the substances that humans need to survive. However, those same life-affirming elements can be destructive if they’re present where many people keep their medications, according to the U.S. Food and Drug Administration.

Take a look in your medicine chest. What’s there may trigger a nostalgic swing down memory lane: the cough syrup you used to give your toddler — now a teenager; the birth control pills you used to take before you hit menopause five years ago; and a trove of spotted or discolored pills, circa sometime in the last decade.

Unlike Social Security numbers, which we use our entire lives, we’re not meant to hold on to medication for an eternity. But if you’re like many people, you probably do. Cleaning out the medicine chest — and making sure your medications are kept in places where they won’t deteriorate — will help protect you. Here are some pointers to help keep you vigilant.

Is it all right to keep pills in the bathroom medicine cabinet?

No, although that’s where many people store them. It may be dark when you close the medicine cabinet, but chances are the humidity in the air after a shower will seep in. This begins a process that ultimately breaks down your drugs. Even turning on the hot water in the sink can allow moisture to filter into the cabinet. “Medication in general does not tolerate moisture,” says Calvin Chin, a San Francisco-based pharmacist. In fact, he says, “When you take medicine, it’s the moisture in your stomach that breaks it down.”

What’s a good place to store my drugs?

Instead of the bathroom medicine chest, try to store medications and vitamins in a cool, dry place away from bright windows or storage rooms affected by outdoor weather. This may be in your bedroom inside a locked cabinet drawer or in a kitchen cabinet. Make sure the cabinet isn’t above a stove or sink, where heat and steam could create moisture problems similar to bathroom storage. Don’t choose the refrigerator, unless the pharmacist, label, or package insert advises refrigeration after opening. Remember that the refrigerator is a cool place, but it’s also moist and easy access for curious children. Also, get in the habit of reading drug labels first because there are always exceptions. For example, most types of insulin — a medication used to treat diabetes — need to be refrigerated before opening. Once opened, insulin may be kept unrefrigerated as long as it’s stored away from heat and light. How long it can be kept unrefrigerated may vary depending on the type of insulin.

In order to protect children, keep medication and all vitamins out of reach and in a locked cabinet. Kids are able to scale cabinets often by sheer determination alone, and the bright colors of vitamins and nutritional supplements can attract them like candy. For this reason, vitamins containing iron (and most multivitamins do) should always be kept away from them. Thirty percent of children’s deaths from medication are caused by iron-containing supplements, according to the U.S. Consumer Product Safety Commission.

What’s the best container for pills?

If you’re a parent or even if you have frequent visits from kids, make sure your pharmacist dispenses prescriptions in childproof containers. Test them out yourself to see how easy it is — they work well if they also seem to be adult-proof.

For your own safety, store medications only in their original containers. As tempting as it may be to transfer a few pills from a large bottle into a smaller container, don’t — even if it’s another bottle that has the same prescription label. That way they don’t become mystery pills or have an inaccurate expiration date. Some drugs, such as the heart medications containing nitrate, should never be put in another container. If they are exposed to oxygen, nitrate evaporates.

Traveling with medications

If you’re driving, you may want to have certain medicines at hand, but don’t store them in the glove compartment, where they could be damaged from the heat, cold, or rain outside or from the car’s heater or air conditioner. If you’re traveling by air, it’s best to take medications in your carry-on luggage. Cargo compartments where checked luggage is stored during flight may be too hot or cold to properly protect your medication.

Bring medications with you in their original containers so that airport security personnel know that what you’re carrying are prescription pills from your doctor; keep them in a clear plastic bag so you can declare them. Although airport security may screen for sharp objects, people with diabetes are allowed to carry insulin, lancets, and needles used to check their blood sugar. If you are diabetic, ask your doctor for copies of your prescriptions and a letter explaining your condition (this isn’t required by the Transportation Security Administration, but it will make things eaiser). The letter should describe your medication regimen and list any devices you use, including syringes. Carry enough pills or insulin to last the whole trip, but have copies of your prescriptions on hand to save you hassles at the airport, as well as allow you to get more medication on the road if you run out.

It’s certainly useful to make use of a pill dispenser to ration out your doses, and you can still use one of these helpful aids while traveling. But if you don’t carry the original containers with you and you have an emergency on the road, that could spell trouble. “If you’re away from home and you have an emergency, there’s no medical history for you, it’s almost impossible to find out what the medications in the pill dispenser are,” warns Chin, the pharmacist from San Francisco. He also advises travelers to keep a list of medications that’s current in a purse or wallet.

How long should I keep my medicine?

One obvious answer is to check the expiration date. If the date has passed, throw the medication out. If your doctor has told you to stop taking a particular medicine, dispose of it immediately. Throw away medicines that have unreadable labels.

You can also use common sense to help ferret out the good from the bad. If you have a bottle of mystery fluid that was transferred to an unmarked bottle, don’t keep it. If pills are obviously discolored, spotted, crumbly, or smelly, get rid of them. Remember, if medicine you take for chronic conditions has gotten wet (or if it’s a drug that needs to be refrigerated but wasn’t), ask your doctor or pharmacist for an immediate replacement before you throw it out. Many pharmacies will expedite emergency orders.

How should I dispose of my medicine?

Studies show that pharmaceutical waste is present in the water we use and that certain drugs may harm our environment. Unfortunately, there are no waste treatment plants in the United States that are engineered to remove potentially harmful drugs from sewage. With this in mind, the White House Office of National Drug Control Policy came up with the first consumer guidelines for the proper disposal of prescription medications. The guidelines say that if you need to dispose of unused, unneeded, or expired medications you may:

  • take the drugs out of their original containers and throw them in the trash
  • as an extra precaution, mix the drugs with coffee grounds or kitty litter or some other undesirable substance, then put them in an empty can or sealed bag before throwing them out.
  • Scratch out the names of all medications on prescription bottles you’re getting rid of

Federal guidelines say do not flush drugs down the toilet. The only exception is if the drug’s instructions specifically tell you to flush them down the toilet if any are left over (this applies to some narcotics such as fentanyl patches). Pharmacies, water districts, or solid and hazardous waste agencies may sponsor take back programs to which you can bring unused medications. Check locally with these agencies or with your pharmacy for more information.

After getting rid of all the outdated pills you don’t need anymore, you’ll have plenty of space for those that you do.

Office of National Drug Control Policy. Proper Disposal of Prescription Drugs.

Environmental Protection Agency. Pharmaceuticals and Personal Care Products (PPCPs): Frequent Questions.

Safe Disposal of Medicine. Food and Drug Administration, 2016. https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm#Flush_List

Interview with Calvin Chin, Pharm.D., a pharmacist at Evergreen Pharmacyin San Francisco

Prevent Poisoning and Death from Iron Containing Medicine. CPSC Document #5051/ Consumer Product Safety Commission

FDA Tips for Taking Medicine: How to Get the Most Benefits with the Fewest Risks. U.S. Food and Drug Administration. FDA Consumer magazine.

Environmental Protection Agency. Wastes — Where You Live: State Programs.

American Diabetes Association. Storing Insulin.

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