Taking control of birth control

October 13, 2006

Q: I missed my pill yesterday, what should I do?

A: Though they dont protect you from STDs, birth control pills are a great method of contraception. Unfortunately, they can be a little confusing at times. The most important part of making birth control pills work for you is remembering to take them at the same time every day. Some people find it helps to do it right when they wake up, others dont like this method because they do not always wake up at the same time every day. Some choose to take it before they go to bed, or even set an alarm on their cell phone to remind them. Choose whatever system works best for you, but be prepared for the fact that youll probably fuck it up every now and then. After all, you go to Brandeis. Youre a busy person.

Take a deep breath, no need to panic. If birth control pills had to be taken at EXACTLY the same millisecond every day in order to work, people wouldnt use them. They are designed to give you a little margin of error. Its fairly safe to say that you have a two to three hour window each day in which to take your pill, so if you are off by an hour theres no need to start shopping for strollers. If you take it three or four hours late, and your pill is a progestin-only pill (check the packaging) Planned Parenthood recommends that you use a backup method if you have sex in the next 48 hours. This could mean using a condom or spermicide.

If you miss a pill completely, most brands direct you to take two pills the next day (todays and yesterdays). Still, check the directions that came with your pack to be sure, or ask your gynecologist. Also, it is recommended that you use a backup method for the next day or two, though it is not required. By missing a pill you do not render your birth control useless, but you have decreased the effectiveness just a little. It is still protecting you, but you might want to add a little outside help to get it up to the level it normally works at. Still, when in doubt, use a backup method. A condom is a small price to pay for peace of mind.

Missing more than one pill is a little bit more serious. Different brands and different doctors have different recommendations. Some might have you take two pills a day for two days;

some might make you start over. This means that you would continue taking a pill a day until your period (or until the active pills have stopped) and then start a new pack the Sunday after (or during) your period. Until you start your new pack, use a backup method. Still, missing more than one pill is a confusing issue and the best thing to do is read the instructions that came with your pack, or call your physician or gynecologist.

No matter what happens, there is no reason to panic. First of all, backup methods arent so bad. In fact, we kind of like them! SSIS sells such a wide variety of condoms, we bet we will find something that works for you. We have condoms of all shapes and sizes: tapered heads, flared bases, roomier fitting, snugger fitting, pleasure pouches, latex and polyurethane.

Vaginal Contraceptive Film, or VCF, is another option. VCF is a small sheet of film, similar to a Listerine Pocket-Pack strip that is inserted into the vagina 15 minutes before intercourse. It is a spermicide, which is made of the chemical Nonoxonyl-9, which creates a hostile environment for sperm. Basically, it kills them. VCF works for 45 minutes, and after that you would have to insert another strip.

Spermicide is not for everyone, however. Nonoxonyl-9 is a strong chemical and many people have negative reactions to it. Get a spermicidally lubricated condom and test a little on the inside of your elbow where the skin is sensitive. You do NOT want to find out you have a bad reaction to it after its already in your vagina, or on your penis.

Alone, VCF is about 80-85% effective at preventing pregnancy. Condoms are 99% effective, and also protect you from contracting and transmitting STDs.

Nonoxonyl-9, however, can create micro-abrasions and micro-tears on the wall of the vagina, which can actually increase your chances of contracting and transmitting STDs. Because of this, we usually recommend VCF for people in monogamous relationships who have been tested for STDs.

If you messed up your pills, and forgot to use a backup method, there is still no need to panic! Emergency Contraception (or EC) is certainly an option. EC is a large dose of the same hormones in your birth control pills that will prevent a pregnancy if taken in the 72 hours after unprotected sex. Some people think that taking four of their regular birth control pills at once will accomplish the same thing, but this is NOT a good idea. Different pills contain different amounts of hormones, and the only way to take a large dose safely is to take EC. It is available at the Health Center for $20, and will not be marked on your insurance.

While EC is a great option in an emergency, and is often worth the peace of mind it provides, it should not be used as a regular form of birth control. If you are using it often, you might want to talk to your gynecologist about switching to a form of birth control that will work better for you.

Dont forget, you can always pick up pregnancy tests at SSIS. We sell two for $2, in case its too early to detect the first time you take it. The test will detect pregnancy 7 to 14 days after fertilization. You can also get free pregnancy testing at the Health Center.

If you are consistently forgetting to take your pill, you might want to look into other birth control options. The patch, a tan patch you stick on your body, you only change once a week. It should stay on while swimming and in the shower. There are directions on the Planned Parenthood website for what to do if you forget to change your patch at the end of the week.

For those who want even less to remember, the Nuva Ring is another great option. It is also an alternative for those who dont like the band-aid style gunk left behind by the patch. The Nuva Ring is a clear plastic ring about the size of a hair tie that you insert in your vagina for three weeks each month. You take it out the fourth week, when you have your period, and insert a new one to begin the next month. It is extremely unlikely it will fall out, and you even leave it in during sex. According to first hand reports, neither you nor your partner will be able to feel it, unless they are using their hands.

There is also Depo-Provera, a birth control shot that you take every three months. Many people like this method because it is so private, and you dont have to remember anything daily or even weekly. If you would like to try another method besides the pill, talk to your gynecologist. You might be limited by the types of hormones that work best for you, but there is most likely another option out there for you.

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