Contraceptive Care: Six Things to Be Careful About When on Birth Control

Contraceptive Care: Six Things to Be Careful About When on Birth Control

For most people, using birth control involves very little effort and a whole lot of reward; however, there are some things you need to watch out for to ensure your chosen method is effective.
Your lifestyle choices, pre-existing health conditions, and medication you’re on can all influence the level of protection that you get. For example, if you’re using a birth control method that has hormones, certain medication can interfere with it. Contraceptives that contain hormones include the pill, the patch, certain intrauterine devices (IUDs), the shot, the implant, and the ring.

There are several factors that can influence the effectiveness of your birth control – here’s a list of the six most common ones:

Taking antibiotics

There’s a common misconception that all antibiotics interfere with the birth control pill and other hormone-based contraceptives; however, there are in fact only certain antibiotics you need to be careful about. Research indicates that antibiotics prescribed for regular conditions, such as for acne and urinary tract, throat, and vaginal infections, do not interfere with birth control at all.  

Serious senior African American female healthcare provider discusses drug side effects with a teenage female patient and the girl's father contraceptive safe sex

An exception is if you have stomach flu (gastroenteritis) and you have been vomiting or have had diarrhea, then you do need to be careful as the pill may have not been properly absorbed.

Antibiotics that do interfere with hormonal methods of birth control are those used to treat Tuberculosis (TB) and meningitis – Rifampicin and Rifabutin. This is because this class of antibiotics induces enzymes in the body, which in turn interferes with birth control. 

What are the alternatives?

If you’re having treatment for TB, then you’ll most likely be taking the medication for at least six to nine months. You will either have to use an internal or external condom as well or switch to another method, such as a non hormonal IUD or progestogen-only injection. Your birth control can still be affected up to 28 days after stopping the antibiotics. 

Taking supplements

Don’t make the mistake of thinking that all herbal remedies are harmless – the herb, St. John’s Wort, can have a powerful effect on many medications, including birth control pills and the implant, and actually reduces effectiveness by a whopping 15%. 

Closeup view of woman hands holding tea cup with common lady's mantle leaf ground infusion tea in it wearing floral summer dress. Relaxing herbal tea concept contraceptive safe sex

It’s prescribed for mild depression, insomnia, and anxiety and contains enzymes which increase the rate at which the pill is processed. The pill becomes less effective because there’s less concentration of it in your body.

What are the alternatives?

If you’re taking St. John’s Wort, make sure you use a back-up method, such as an internal or external condom, diaphragm, or sponge.

Prescribed meds

Certain anti-seizure and mood-stabilizing medication can reduce the effectiveness of the pill, ring, patch, and mini-pill. Most typically, medication for epilepsy and bipolar disorder such as Lamotrigine, Oxycarbazepine,  Carbamazepine, Phenytoin, Primidone, Topiramate, and Felbamate are the ones to watch out for. 

And it works the other way too – your birth control can reduce the effectiveness of your epilepsy and bipolar meds, lowering your seizure threshold and increasing depressive or manic behaviour. 

Woman holding white pill contraceptive safe sex

If you’re taking medication for HIV, then you also need to be careful as certain antiretrovirals mess with birth control, such as Nevirapine and Nelfinavir. 

What are the alternatives?

If you are on anti-seizure or bipolar meds, don’t worry, there are still many birth control options that are safe for you to use, for example, non hormonal IUDs, internal or external condoms, diaphragms, and injections.

If you need to take HIV medication, speak to your doctor about prescribing Tenofovir as it doesn’t interfere with birth control. 

Serious side effects

Birth control is generally safe but as with any medication, it’s always important to look out for serious side effects. And go straight to a doctor if you experience any. The following side effects can be cause for concern:

  • severe abdominal pain;
  • numbness, dizziness, or severe headaches;
  • blurred vision or slurred speech;
  • intense leg pain; and
  • chest pain or shortness of breath. 

Careful pregnant girl checking medication instructions for safe use

What are the alternatives?

If you experience these side effects, it may mean that hormonal birth control methods are not suitable for you. If that’s the case, talk to your doctor about a method that will suit your lifestyle – there is something for everyone.

Your age, health conditions, and lifestyle

Some hormonal contraceptives are not safe for women who have specific health conditions. If you have had a blood clot or stroke; have a genetic blood disorder, uterine or breast cancer; suffer from liver disease; or experience severe migraines, then you’ll usually need to find an alternative method of birth control

Shot of two sporty young people running out on a country road

Similarly, your age and whether you are a smoker also play a role.  Smokers over the age of 35 may not be able to use certain contraceptives, such as the patch, ring, and the combined pill as it can heighten the risk of heart disease.

What are the alternatives?

If this is you, consider alternative methods of birth control, such as an IUD, progestogen-only pill, implant, or injection.  

How you use it

Statistically, you have a 1% chance of getting pregnant while on the pill; but, did you know that 9% of women fall pregnant while on the pill? And that’s mostly due to forgetting to take it. When it comes to the pill – both the combination and minipill – it needs to be taken every day in order for it to work effectively. 

Man sitting in the bed tearing open condom packet for protection during sex contraceptive

It doesn’t matter whether you’ve had sex or not, you still need to take the pill consistently.  With the mini pill especially, if it’s not taken at the same time every day, you could still ovulate. This means you could still get pregnant. It makes sense to set an alarm on your phone or get an app. Apps such as Clue, Glow, and Ovia help you track your ovulation and period. They remind you when to take your pill.

What are the alternatives?

We all have those days where life doesn’t go to plan. If you’ve missed one pill, take two pills at your next dose. Having missed two pills, use a back-up method, such as an internal or external condom and diaphragm when you have sex for the next seven days. If you’ve missed a few days, it’s best to contact your doctor for advice.

No birth control is 100% effective, but using your contraceptive correctly, keeping up with your health-care visits, and staying informed about your own health conditions is the best way to ensure you are protected from falling pregnant. 

Do you have something to share? Leave your comments below, contact us on our social media platforms: Facebook, Instagram and Twitter or send us an email to [email protected] For more information on contraception, visit findmymethod.org

About the author: Julia Riccardi is a freelance writer and editor based in Johannesburg, South Africa. She has a BA in English and Comparative Religion and a passion for words, people, and holistic health.