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Birth Control (Contraception) Forum
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Birth Control Pill Specifics

Hello!

I'm an RN so I should probably know all the answers to my questions..but I specialize in pediatrics not women's health! Anyway, I had a few specific questions about the pill. I have been on it for 4 years, never had any problems. A few things I never learned though (and was never told) was about having sex right before the placebo-pill week. I know semen can live inside you for a while (and therefore get pregnant even when your on your period) so how does it work if you have sex the day before you start the placebo? Or have sex on the placebo pills? Since your abruptly withdrawing the medication for that week, how does it differ from missing a pill? (If your on the 21 day pack + 7 placebos.)

Also, what is the exact time frame that it starts getting iffy if you miss it? I know in hospitals of course we have a one-hour window of time to give meds, but how long is it that you can take a pill that it won't give you any grief? (I.e. if you take it everyday at 8, but forget and take it at 12 instead on occasion).

And, how likely is it that getting diarrhea could cause the pill to be effective?

Thank you so, so much for your time- I appreciate it!

1 Responses
603463 tn?1220630455
MEDICAL PROFESSIONAL
Hi!
Birth control pills work through several mechanisms, two of which are preventing ovulation  and also changes in the cervical mucus which make it hostile to sperm.  By putting the placebo week at the end of the pack, the pill companies are attempting to mimic a natural cycle, but it is  not necessary to dose the pills that way--in fact many of the new pills have a placebo week at the end of the third month.  Because of all of the changes the pills cause, and because there is sloughing of the endometrium, etc during the placebo week, women almost never become pregnant during that time.  Missing pills or not taking them on time is more risky in the early part of the cycle than later on.  Generally I tell my patients that they can miss up to two pills (and make them up the next day) before I become concerned and advise them to use a back up method.  Pills should not cause diarrhea, and diarrhea should not influence their effectiveness.
Hope this helps!
Dr B
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