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The Pill
HTHGS:
Questions about the pill (written by Dr. Pluhar)
Ask Erika,
I have a few questions about having sex and I probably should know the answers
to but I'm just not sure. My boyfriend and I who are still virgins want to have
sex but the only way I we will do it is if I'm on birth control pills which I
have no problem taking because we don't want kids at this point in our
relationship. My question is how long does it take for the pill to work? I ask
this question because I will only be on the pill for a little over a month
before we do this. Also should my boyfriend wear a condom? If he does what are
my chances of still getting pregnant? If you could answer these question I would
greatly appreciate it. I know they sound stupid but I just need to know.
Dear Sincerely concerned,
Thank you for your questions. I'm glad you wrote in, and know that I don't think
ANY of the questions we get through this website are stupid. They are about
sexuality, which is an important and often not understood part of being human!
That said, there are several
ways to start the pills. The most common and preferred method is to start taking
pills on the first day of your next menstrual period. If you do this, you will
not need a back-up method and will be fully protected. If you are starting on
Sunday, which is also common, you will need to use a back-up method such as a
condom for 7 days after starting. (Note: the Sunday start method leads to no
periods on weekends). If you start at any other time (e.g., the same day you get
your pills), you will need to use a back-up method for 7 days.
As for your question about using condoms, because pills do not provide
protection against from sexually transmitted infections (STI’s), including
HIV/AIDS, you will want to you a condom if you are concerned about infections.
Condom use will also provide a second level of protection against pregnancy. I
would recommend getting tested for STI’s and HIV if you think you may wish to
have intercourse without a condom.
It sounds like you and your partner
are taking your time and planning in preparation for this next step in your
sexual relationship, which is great! I encourage you to continue to be open with
each other, and to communicate honestly before, during, and after you have
intercourse.
HTHGS: Effectiveness of biphasil 28 (written by Dr. Pluhar)
Ask Dr. Pluhar,
A month and a half ago my doctor prescribed the contraceptive pill (biphasil 28)
as requested. I was already, and still am, on Mynomycin for acne treatment. He
said that the antibiotic would not interfere with the contraceptive pill because
I had been on the antibiotic for more than a month. I am concerned about the
effectiveness of the contraceptive. Please inform me on the risks/likelihood.
Thanks for you time,
Dear Please inform me,
Thank you for your question. This is an issue that has
challenged experts in the fields of family planning and contraception,
particularly in terms of what message to send to women relying on birth control
pills for contraception. Here is the response from Dr. Robert Hatcher, a
veteran in the field, and senior author of what many people call "the Bible
of contraception," Contraceptive Technology. You can find this and
similar responses on his website (www.managingcontraception.com):
"For ONE antibiotic, rifampin, the message is
fairly clear: use a back-up contraceptive or a higher dose pill, reduce the
pill-free interval or use an entirely different contraceptive.
For other antibiotics the message I want patients to
receive is NOT clear and I think that I can assure you that as long as we are
using our current COCs the messages women receive from package inserts,
clinicians, women's magazines, the National Medical Advisory Committee of
Planned Parenthood and contraceptive texts will remain conflicting and
frustrating.
Given all the conflicting messages, here is an attempt
at summarizing but not cutting through the confusion regarding the antibiotics
most women and their health care providers are most concerned about: If you are
taking a broad spectrum antibiotic such as tetracycline, doxycycline, ampicillin
or erythromycin, some clinicians recommend that you use a back-up contraceptive,
others do not. Some women taking these broad spectrum antibiotics use a back-up
contraceptive, others do not. The decision is up to you" (Hatcher, June 12,
2000, www.managingcontraception.com).
I hope this is helpful to you. My suggestion
would be that if you are really concerned about getting pregnant and will feel
uncomfortable every time you have sex due to the fact that there is not one
consistent message from the experts, then use a back-up method such as a condom.
Sincerely,
Dr. Erika Pluhar
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