Scarleteen

Hi there,

I’m on the combination pill and I’ve been pretty good on taking it on time. I’ve only taken it late twice but it’s been within the 12 hour window. However I’m worried it’s not as effective since I’ve been having loose stools sporadically throughout the month. On my 3rd day of my placebo week I engaged in genital rubbing with my male partner about 5 minutes after he ejaculated away from me. The next day I got my with drawl bleed or “period” does this cancel out any chance of pregnancy?

Hey Jakelyn,

The withdrawal bleed doesn't itself say anything about a person's pregnancy status, however as it is something you're used to experiencing, it is an indication that the birth-control indeed is behaving as it usually does for you.

The consistency of your stool (apart from severe diarrhea lasting longer than 48 hours) doesn't indicate much specifically about what your reproductive system is up to. However I would say that it can be a good idea in general, and even more so when doubt and uncertainty are causing you stress, to use condoms or some other secondary method alongside oral birth control.

We go into the combined effectiveness of two methods here: The Buddy System: Effectiveness Rates for Backing Up Your Birth Control With a Second Method

Thank you Jacob,

I just read some articles online saying that if you have diarrhea it makes oral birth control less effective which is why I was concerned if the pill was protecting me from pregnancy

Got ya, it seems I misunderstood you there! I thought you were talking about it as an indicator of pregnancy, which on it's own it is not, but I'm going to edit my previous answer just so that I don't give the wrong impression to anyone else reading.

But totally, if somebody has severe diarrhea (defined as 6-8 watery stools per day), that gives very little opportunity for oral contraceptives to be absorbed in full. 48 hours straight of severe diarrhea is when CDC recommends taking additional action by using a second method for the rest of your cycle.

However using a second method also remains pretty good advice for anyone who is looking to avoid pregnancy.

It didn't sound from your question that your issues were as prolonged as 48 hours, as you said it was sporadic throughout the month, is that so?

Another thing to consider is long-acting contraceptives. We do have this resource which can be used for further info on finding the right one (among other methods): Birth Control Bingo. Maybe an option with more of a guaranteed dose over time would also be helpful?

Coming back to your original question, you do have the option of taking a pregnancy test to get some clarity, depending on how long ago this was. There's also no reason you can't seek emergency contraception if the level of risk, even if low-to-negligible and unclear within that, feels too much for you.

I'm sorry this isn't a definitive "yes" or "no". It's usually up to us to judge for ourselves how to react to information that is full of imprecise words like "could" and "might" and "risk of", which result from variability in biology and the real world in general. It's can feel like a lot of pressure, but it's also a reflection of the fact that it is your right to decide how to approach it.

What are you thinking you want to do next?