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When is birth control less effective?

March 5, 2018 by Adagio Health

Birth control. We like to think that the birth control we take is effective. And it is! But there are some things that can make your birth control less effective. Let’s talk about that!

Not taking your pill at the same time everyday
It matters less if you’re on a mixed pill (estrogen and progestin) than a progestin-only pill, but either way, you should really do your best to take your pill the same time everyday. If you’re on a mixed pill, around the same time every day is good enough.

Missing pills or starting your pack late
If you miss a single pill, it’s not the end of the world. However, the earlier in your pack you skip it, the more likely you are to have a problem. That’s why starting your pack late is also a big no-no.

(Few) Antibiotics
Majority of antibiotics WILL NOT mess with your birth control. There are a few that will mess with your birth control, like rifampin or rifabutin. Not sure? When you pick up your antibiotic from the pharmacist, just ask!

Mood stabilizer & epilepsy medicines are often a problem. Medications like Barbituates, Carbamazepine, and Oxycarbazepine (to list a few) can be really problematic because the medication makes the birth control less effective, and the birth control makes the medication less effective.

Some medicines for HIV

  • John’s Wort (which is an herbal remedy taken for depression, anxiety or insomnia)
  • Some seizure or migraine medications (like Topamax)
  • Laxatives
  • Medicines that are used to treat diarrhea
  • Some medications used to treat skin infections such as athlete’s foot (mainly griseofulvin)

Inflammatory bowel disease or other digestive disorders
When your body can’t absorb things properly, hormone birth control can be infective. However, non-oral forms of birth control can often bypass these issues.

Being overweight
Being overweight (so having a BMI of 25 or higher) has proven to make not only to make birth control less effective, but also to make emergency contraceptive (like Plan B) less effective. It sucks to say, but if that’s not a reason to slim down then I don’t know what is!

So this hasn’t been proven to make your birth control less effective, but grapefruit does decrease the body’s ability to breakdown estrogen. This could potentially increase your risk for side effects like blood clots.


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Which medications are problems?