Vomit...Birth Control Help?!

[Tinasha]

I've been on the pill for 4 months, each had a period. A few weeks ago I started my 5th pack of pills right after I took the 7 placebos from the previous pack, no breaks in between packs. On the first week of this 5th pack, I had unprotected intercourse on the 3rd day, and on the 5th day I vomited 2 hours after taking my pill (I take them at 10 to 11pm, and vomited at 12am). Knowing that it could affect my birth control, I took another pill at 1am from my spare pack and continued the rest of the pills as regular. Am I still protected? Would that previous intercourse cause pregnancy?

[Heather]

Since absorption of the pill tends to happen more quickly than a couple of hours, you were probably fine anyway, but the fact that you made up with another pill means that you can feel certain you had the full level of protection your pill offers.

Are you usually backing up your pill with a second method, like condoms ( which is always smart anyway, since the pill offers no protection from infections, and condoms do)? If not, you might feel better doing that. Combining two methods is what gets you as close to 100% protection as you can get AND if and when things like this happen, as they do, that backup can also provide a lot of relief.

[Tinasha]

Can absorption of the pill be affected because of alcohol? That was the reason for my vomiting. I had too much to drink that night but I was aware enough that I had to take another pill.

No, I don't usually back up with a second method. My boyfriend does not like using condoms but will wear them when I think I'm at risk and scared of my protection from failing. However, we've abstained from sex for a full week after the day I vomited, but lately I've been getting PMS symptoms that I have not had before. Are sensitive nipples a part of PMS? Like I said, I've been on the pill for almost 5 months now and lately have been getting weird PMS symptoms, which seems odd to me since side effects of the pill should go away after 3 months.

[Heather]

What's normal with PMS is very individual. But breast tenderness is one of the most common side effects of the pill. It's not true that all side effects should - or will - go away after the first three months. Rather, they just tend to be the most intense in those first few months.

Alcohol is not indicated as something that decreases pill effectiveness. But suffice it to say, drinking so much you are vomiting certainly is dangerous and does not support general good health.

If you'd feel best using condoms with you pill, I'd be happy to talk with you or your boyfriend about ways to use them that best facilitate pleasure.

[Tinasha]

Are there any methods of contraception other than the condom that I can pair with the pill?

[Heather]

Sure: withdrawal or a cervical barrier, like a diaphragm.

But again, especially if those options don't appeal to you (as the person actually at risk of pregnancy, and the person already herself using a method, I feel your preferences matter most here) most people with pleasure issues with condoms just need a little troubleshooting and an adjustment to the way they have thought about condoms and they're good. And if you're with someone who has had other partners and hasn't used condoms with them, your STI risks will be higher with that person so condom use will be more important than usual.

[Tinasha]

Last couple of questions!
1- if I miss one pill is there a great chance of ovulating?
2- I also take my pills within 3 hours each night and I am on the combination pill. Am I considered a perfect or typical user?

[Heather]

Typical use of the pill includes people missing pills every now and then, and the typical use effectiveness rate (which is 91% in one year) is the level of effectiveness most people will have with the pill.

Really, a perfect user means someone using the pill perfectly for one full year, which really doesn't tend to happen outside clinical trials, so, chances are good you'll have the typical use rate, as most people do.

[Tinasha]

Thank you very much!