Should I be worried? Pregnancy question

[Hearth6]

Hi guys!
I am on the birth control pill Levora, and I missed one pill during my second week, on Thursday to be exact. The following day I took my missed pill from Thursday and then proceeded to take Friday's pill at normal time. So I took two pills in one day. I then took my next 8 pills perfectly before the placebo week. Ok, here's the question: I had unprotected intercourse the day I started my new pack, am I fully protected with my birth control pills even though I had that missed pill?

[Heather]

Here's the scoop on late and missed pills:

The typical use rate for combined oral contraceptives is 91% in one year of use, and that will be the level of protection from the pill alone most people have, because taking every single pill for one full year on time and without missing any is very uncommon for most people. Effectiveness rates aren't figured pack-to-pack, but per one full year.

So, you missed a pill, so that puts you in that group (and making it up like you did when you knew you missed it is the right thing to do to assure you don't wind up with less protection than that). But probably, you were in that group already.

If you want more than 91% protection against pregnancy, then what you want to do is to pick a backup method to use with your pill, like condoms. That also gives you some backup peace of mind when common mishaps like these happen, as they usually will from time to time.

[Hearth6]

But since I was on the pill perfectly for the next 8 days after I missed that pill, does that get me back to full protection?

[Heather]

You mean that 99%+? If so, that figure is for one FULL YEAR of perfect use. That's how effectiveness rates are figured, rather than day to day, or month to month.

So, if in a year, someone were to make NO mistakes whatsoever (again, that's really rare, which is why we have typical use rates that reflect real-life use, not lab studies), then they'd be at that 99%+. Otherwise, nope. So, no, because you missed a pill in this year, you need to figure that you don't have that 99%, but once more, since any person is so unlikely to make zero mistakes in a year, no one should really figure they have that level of effectiveness with the pill, and should instead figure it's most likely to give them the typical use rate of effectiveness, which is that 91%.

If you want more protection than that, your best bet is to use a second method with your pill. Dual contraception -- using two methods, not just one -- is what we know, from a lot of study, is the most effective way for sexually active people to prevent pregnancy.

[Hearth6]

Oh wow I never knew that..so I am at 91% protection even after being on the pill for 8 straight days? I thought the protection is higher than 91%

[Heather]

Again, effectiveness rates are for ONE YEAR of use. So, we can't talk about where someone is at with your method for eight days of use, because we don't (and can't) have that kind of data.

91%, just to try and make it clear one last time, is the effectiveness rate for one full year of typical use -- the way most people will use it, outside clinical study, in real life, for one year -- of the pill (and also for the patch or ring).

For more on the effectiveness rates of different methods, you can check out: Birth Control Bingo!

And if you want to start backing up your pill with a second method, you can see estimates of the effectiveness rates of your pill plus all other methods that can be used with it here: The Buddy System: Effectiveness Rates for Backing Up Your Birth Control With a Second Method

[Hearth6]

Thanks or all this: just one last thing, my pamphlet says I do not need a backup method if I miss only one pill, so does that keep me on track for 99% use in a year or am I under that 91% still?

[Heather]

That's because, as I explained, one missed pill every now and then -- when you make it up like you did -- still has you within the typical use rate for effectiveness. And as I already explained, missing that one pill doesn't leave you unprotected or reduce your effectiveness: a missed pill now and then is figured into typical use rates, because that's typical for people using the pill.

[Hearth6]

So I can only be 99% if I take it perfectly for a year..and since that's rare..isn't it pretty common then for people to get pregnant on the pill?

[Heather]

No more common that every 9 of 100 users (thus, 91%). So, no, I'd not say 91 out of every people NOT becoming pregnant using the pill makes becoming pregnant common: quite the opposite.

To put it in a different context if that doesn't make sense, if out of every 100 people, only 9 had purple platform shoes, you'd probably not say that it's common to have purple platform shoes, right?

It's really sounding to me like you feel uncomfortable with the effectiveness level your pill, by itself, provides. Would you like to talk about how to back up with a second method so you can increase your level of protection to something closer to that 99% you seem to want, even with typical use?

[Hearth6]

I see that male condoms + the combination pill make 98.8% with typical use? I can feel good about that..
One last thing so I can ease my worry until my next period: if I had unprotected sex twice on day 6 of my cycle, are the chances of getting pregnant lessened since it is only day 6 in my cycle? I took my pills at regular time for 8 days

[Heather]

Like I said, what you want to do is to add a second method that you use with your pill, so that even if and when you do make an oops with one, you've got the other in place.

Were you able to look at that second link I gave you? If so, any thoughts or feelings about second methods you can use with the pill that you want to talk about, or have questions with?

[Hearth6]

I see that male condoms + the combination pill make 98.8% with typical use? I can feel good about that..
One last thing so I can ease my worry until my next period: if I had unprotected sex twice on day 6 of my cycle, are the chances of getting pregnant lessened since it is only day 6 in my cycle? I took my pills at regular time for 8 days

[Heather]

Yep. And if you use male condoms perfectly in a year -- which often is easier to manage than a method like the pill -- it can provide even more protection than that. Plus, condoms give you the extra bonus of protection from STIs and other infections (like BV or UTIs), too!

What day of your cycle you have intercourse in on the pill makes no difference whatsoever in effectiveness. The pill's effectiveness is exactly the same on every day of a pack, including during the placebo week. I know you keep pushing me to give you an answer you want, but I have to stick to the facts here, and they remain that in one year of typical use, and that includes missed pills, the effectiveness level of your pill is going to be around 91%. When you had sex doesn't impact that.

It sounds like you could use a little help knowing what next steps are when you're freaking about possible pregnancy (even when, like in your case, it's highly unlikely). If so, you can check this out, and pick an answer that'll send you to a page hand-tailored for your situation: http://www.scarleteen.com/article/bodie ... _companion

[Hearth6]

So you're saying its highly unlikely due to the 91% protection? Ok that makes me feel better. Thank you SO much for your help I really appreciate it . I will check out all these links and do more research, and definitely double up on protection everytime for maximum protection.

[Heather]

I think you might absorb and really feel some of this better if you tried your hand at these answers: so, again, wouldn't YOU say that something only happening 9 out of every 100 times is highly unlikely? Or for every 9 of every 100 people?

[Hearth6]

Yeah you're right, it is highly unlikely. I really appreciate all your help. Oh one more thing: if I threw up the pill 6 hours after taking it, it's not considered a missed pill right?

[Heather]

No problem.

Since digestion happens WAY more quickly than six hours, someone is not going to BE throwing up a pill six hours after taking it, because it will have been absorbed long before then.

[Hearth6]

Oh ok . Thank you so much!!!

[Heather]

Happy to be of help!

[Hearth6]

I was reading the link you sent and it says it's 92% for typical use on the pill?

[Heather]

I need to update those pages (which involve doing the math all over, which takes a good deal of time): the most current stat is 91% (it used to be 92), which you'l see in the listing for the pill via that first link I gave you: http://www.scarleteen.com/birth_control ... ation_pill

Sorry for the inconsistencies!

[Hearth6]

No it's totally fine thank you for all your help