Implant vs. The Pill?

[bgrace20]

Just a quick question about something I've been curious about. Everywhere I look says that the implant is more effective than the pill (even if only by a small percentage). Why is that? Is it due to human error when taking the pill that makes it less effective?

Thanks so much!

[Eddie C]

Hello there, bgrace.

You got it right. Because there's nothing the user of an implant has to do after insertion, there's no chance of use error so that makes it a little bit more effective than other methods such as the pill, where effectiveness relies heavily on how someone administers their method.

[Heather]

Just to be clear, in typical use, the implant is not just a little more effective than the pill, but considerably more: around 99% effective in typical use compared to the pill's 91% typical use rate.

[bgrace20]

Okay so in theory, if you are an absolutely perfect pill user, would the implant still be more effective?

[Sam W]

With perfect use, they're closer. However, from what we know about how people take the pill, the odds of someone being a perfect user (which generally only happens in laboratory conditions) are low, whereas it's pretty easy to be a perfect user of the implant.

[Heather]

Just to be clear, to get the "perfect" use effectiveness level for the pill, a person would have to take their pill every single day, for a full year without fail, and also never have anything going on which can impact the pill's effectiveness in any way, like gastrointesintal illness (throwing up, diarrhea). The reason typical use is 91% and perfect use is over 99% -- that's a pretty big split -- is because most people aren't going to be able to swing that.

I don't know about you, but I take one medication twice a day that is VITAL for me not to be in debilitating pain, that keeps my chronic pain at a level I can live with and that doesn't keep me from work and the rest of my life. I have reminders on my phone for it, I have it in places that make it hard for me to forget it. And goodness knows I have huge stakes at play when it comes to taking it properly and on time: if I screw up, I can wind up in a pain cycle that can take anywhere from days to months to turn around.

And yet.

I still DO space out every now and then, and also sometimes forget if I took my meds or not.

Long story short, it's really hard to remember to take a pill each day, every day, for a year or more at a time. This is why the typical use rate is so much lower for user-administered methods like the pill or patch than for method like the implant or IUD where the user doesn't have to do jack.

That all said, one easy way to use a method like the pill and still come very close to -- or even meet -- the typical use rate of something like the implant is just to back the pill up with another reliable method, like condoms. That way, if someone does forget to take a pill in that year -- as someone is very likely to do -- they still have the condom in play to basically make that pill error no big whoop, and not change how much protection they have, because they are using both methods. Make sense?