The Pill: How Well it Works, Common Mistakes, and Other Helpful Info


The Pill: How Well it Works, Common Mistakes, and Other Helpful Info

The birth control pill, also called the pill, can be a great way of preventing pregnancy. Lots of people like to use the pill because it can be easy to get and use. The pill can be 99% effective when people take it at the same time every day. This means that if 100 people just use the pill for a year, chances are only 1 will get pregnant.

It’s common to forget to take a pill at the right time or to accidentally cause it to be less effective. This can happen by taking certain antibiotics or throwing up after taking a pill. When this happens, it’s usually closer to 92% effective. But there are lots of things you can do to keep it at as effective as possible!

What are some common mistakes with the pill?

Some mistakes that can lower the effectiveness of the pill are:

  • Taking it at a different time than usual
  • Skipping a pill (forgetting to take it for a day)
  • Throwing up soon after taking it
  • Taking certain antibiotics, like rifampicin or rifabutin

The pill works best when you take it at the same time every day and you don’t miss any. Many people find that setting alarms, using apps, or making the pill a part of their morning routine  helps them remember. It’s especially important to take the pill at the same time each day if you take a progestin-only “mini-pill.”

It can help to talk to your pharmacist before taking any new medication, like antibiotics. You may choose to use a back-up type of birth control, like condoms, while you’re taking antibiotics.

What should I do if I missed a pill or took it late?

Most often, you can find what to do if you forgot to take a pill in the leaflet that came with them, or on the manufacturer’s website. You can also use tools like sexandu.ca’s Stay on Schedule to find out what’s right for your situation or call your pharmacist.

For the more common combination birth control pills that have estrogen and progestin, missing a pill is less risky. Most often, if you miss one pill, you can:

  • Take it as soon as you remember, even if it’s at the same time as the next day’s pill. It’s ok to take two on the same day.
  • Think about using extra protection, like condoms, for the next 7 days. The pill will be less effective for this time. But, it’s still protecting you.
  • Take the rest of the pack normally.

If you miss more than one pill, it can help to get Plan B from a pharmacy if you have unprotected sex. It’s recommended to use backup birth control like condoms until you get your period or finish your pack.

Also know that you might have some light bleeding if you miss two or more pills. You also might not get your period until you finish your pack. Both of these are common!

What if I miss a Minipill?

Unlike the mixed pill, missing a Minipill for more than three hours means you’re no longer protected from pregnancy. If you’re taking Minipills and you miss a dose, you can use back-up methods of birth control like not having sex or using condoms for two days. It can also help to read the information leaflet that came with the pill, or speak to a healthcare provider if you have any concerns.

If you miss a Minipill, you can:

  • Take the pill as soon as you remember, but don’t take two at the same time. After, you can go keep taking your daily pill at your regular time.
  • Use condoms for the next 48 hours if you missed your pill by more than three hours. 
  • If within 3 hours of taking your Minipill, you vomited or had diarrhea, you can keep taking your pill everyday at the usual time. Use a back-up method of birth control like condoms or abstinence until 48 hours have passed since being sick.

How long does it take for the pill to start working?

Birth control pills aren’t as effective during the first week you start taking them. Using another kind of contraception, like condoms, can help lower your chances of pregnancy in that first week.

If you have sex without a condom before the pill reaches full effectiveness, you can take Plan B. Plan B, or emergency contraception, is a pill that prevents pregnancy after unprotected sex. You can take it up to 120 hours after sex, but it’s more effective the sooner you take it. You can get emergency contraception in Montreal at any pharmacy.

Is the pill less effective at the end of the pack (on the placebo pill or no pill)?

The pill is not less effective when you take your week of placebo pills or during the week when it says not to take pills. 3 weeks of hormonal pills have already stopped ovulation, so there’s no egg to fertilize. That means you have the same low chance of pregnancy as the rest of the month.

Most birth control pills come in either a 21 or 28-day pack. For the 21-day pack, you take one pill every day at the same time for 21 days. Then, you take no pills for 7 days, when you have your period. After that, you start on a new pack.

For the 28-day pack, you take one pill every day at the same time for 21 days. Then, for 7 days, you take placebo pills (also called sugar pills) that have no hormones. This is when you have your period. The placebo pills don’t do anything to your body, you only take them to help you stay in the habit of taking a pill every day. After that, you start on a new pack.

Does alcohol make the pill less effective?

Alcohol on its own doesn’t make the pill less effective, so your pills will still work if you drink. But, drinking does make it more likely that you’ll forget to take the pill on time. Since people can throw up after drinking too much, there’s also a risk for throwing up too soon after taking the pill.

It’s also good to keep in mind that you can get drunk more quickly if you’re using hormonal birth control. This means you may not know your limits as well when you start taking the pill.

Does smoking make the pill less effective?

If you’re on the pill and you smoke, there is some evidence that it could be less effective. Your doctor will often ask if you smoke before giving you the pill since smoking can increase your chances of side effects like blood clots, strokes, and heart attacks. If you do smoke, your doctor may suggest a different form of birth control instead of the pill.

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