should I take plan B?

[chocolatechip8]

Hi scarleteen,

I was wondering if it is necessary to take plan B for this.

Earlier today I had a risk. Main points:
-had sex with boyfriend, condom broke.
- no ejaculation. Boyfriend urinated 2x between this session and last ejaculation.
- I have been on hormonal bc for 7 years, but in the past 2 of those years, my usage has been typical, not perfect, and I was not sexually active at all during those 2 years. However, I read an article saying that bcp effectiveness decreases the longer you have taken it, especially with typical use. Since I have been
sexually active, I have improved my pill usage, but it was not perfect this month (took second pill in pack 16 hours late).
- I was on the last day of my withdrawal bleed when this risk occurred and will start my new pack tonight (sunday start).

Would you recommend plan B in this case? I am mostly worried my bc pills are not enough to protect me from pregnancy anymore I used to think that as long as you were using them perfectly on that cycle, you were protected and that whatever happened before didn't matter. Now I am just confused!

Hope someone can shed some light. Thank you

[chocolatechip8]

Sorry, looks like I double posted!
If someone could kindly delete one of the posts

[Heather]

Got it, no worries. Welcome to the boards.

So, ultimately the question to ask yourself is if you feel comfortable having had your pill, with withdrawal, as protection, OR if you want a very minor increase in protection against pregnancy. Since your pill already does what Plan B does and then some, it would increase the level or protection, but only a very little bit. However, if an extra little bit makes you feel more comfortable, then there's your answer.

As extrenal input, if you have been taking your pill on time in this cycle, then I would say that no, Plan B isn't needed -- clinically again, emotionally, that's only something you can speak to -- because your pill already does what it can do more effectively. But if someone who did not want to become pregnant was NOT using their pill properly, and had a condom break, then yes, I would advise Plan B. I would also advise that if the pill has turned into something they have a problem using correctly and consistently, that they talk with their healthcare provider about their other options to see if a different method might be a better fit. Lastly, I'd advise having a chat about how to store and use condoms properly, as doing so makes breakage highly unlikely.

FYI, I don't know where you read that, but that is misinformation. There is not data that supports that assertion when pill users continue to use their pill correctly and as directed.

[chocolatechip8]

Hi Heather,

Thank you so much for replying so quickly, I really appreciate your input!

I have taken the EC as I found my peace of mind was worth the money in this case. Now that I am sexually active again after a couple of years, I am planning on setting alarms on my phone to achieve perfect pill usage again.

I will share the article where I read about the BC methods declining in effectiveness after a number of years (with typical usage):
http://www.nytimes.com/interactive/2014 ... .html?_r=0
It made me feel unsettled about the whole thing and for relying on BCP in the future.

For every 100 women, the number who will have an unplanned pregnancy over a given number of years.---> 48/100 for Birth Control Pill Typical Use '(scrolled over the graph). I am not sure if I am interpreting it right, but I am understanding that if a woman has been on BC pill with typical /imperfect usage for 7 years, and been sexually active all 7 years, she has a 48/100 chance of becoming pregnant in those 7 years.

However, I think my situation is different since I was only a typical user when I wasn't sexually active, and then reverted to a perfect user again. If I become a perfect user again, do I still get the same protection from the pill or did I mess things up for myself by being a 'typical' user for a couple of years? (I may be interpreting the thing completely wrong, I just want to make sure I am safe to rely on the birth control pill as my primary method after being on it so long and not always taking it perfectly, as long as I do from now on)

As for the condoms, that is another issue. It has broken around 1/3 of the times with my boyfriend (we just became sexually active with each other a couple of weeks ago) I have never had this problem with other people before. We have tried lube (made sure it was compatible with latex condoms) and larger condoms (thought they were maybe too tight), but the larger condom actually broke today . We are going to try putting lube on the outside of the condom instead of just on me...maybe keep trying different brands too? He also leaves a reservoir at the top. We store them out of the light and stuff inside his room. I am quite frustrated about the condom thing too...just trying to be more safe and they've been breaking and causing me more worry.

[Karyn]

So, it sounds to me like there might be some misunderstanding here about how the pill works. That article from the NY Times, while interesting, is also pretty misleading.

First of all, birth control isn't cumulative. Your typical use of the pill two years ago does not affect its effectiveness now: it's not something that accumulates in your system so that the last cycle's effectiveness impacts on this cycle's. For example, if you forgot a pill completely last June, but took the pill perfectly in August, your chances of getting pregnant in August are not higher as a result. There's a really good explanation of why it's not sound to calculate effectiveness rates the way the NYTimes did right here: http://andrewwhitby.com/2014/09/15/aver ... t-credits/

The only thing that would cause effectiveness rates to drop like the graphs in that article would be people getting worse at using their birth control over time.

It's a bit complicated, I know, but does that help clear anything up for you?

Per the condoms breaking, using lube on the outside of a condom is a must. Trying different brands could help too; some online suppliers offer sample packs so that you don't need to buy a whole box of each brand you try.

[chocolatechip8]

That helps a ton! I feel so silly now, haha, but that is exactly what I needed to hear That article made my heart drop when I read it last week...you definitely helped clear things up.

Thanks so much to the both of you!

[Karyn]

Glad to be able to help.