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Dear Sexpert,

I’ve been on the pill since high school, but I am having trouble taking my pill at the same time everyday because my college schedule is so hectic. Is it okay if I don’t take my pill at the same time everyday? My boyfriend and I have pretty regular sex, and I don’t want to run the risk of getting pregnant. We don’t use a condom, because he doesn’t like how it feels.

-No Room For A Bun In The Oven

Dear No Room,

The birth control pill prevents pregnancy through the suppression of ovulation through the combined actions of the hormones estrogen and progestin. If not taken regularly, the pill is not as effective but can still provide protection. Not taking the hormone pills consistently every day, missing two or more pills in a row, not taking the pills in the correct order or even taking a low-dose pill only a half-day late can decrease the pill's effectiveness but does not necessarily mean you will get pregnant. Further, pills can and should be started anytime they are desired in the menstrual cycle as long as the woman is reasonably sure she is not pregnant. As long as a back-up method is used for 7 days after starting, it is actually better to “quick start.” The pill is 99.7% effective with perfect use and 92% effective with typical use.

There are other means of hormonal contraception besides the pill. These include the contraceptive patch, certain intrauterine devices (IUDs), the vaginal ring, birth control implants and Depo-Provera. These methods, including the pill, all prevent a woman from becoming pregnant, but do NOT protect her from contracting STIs. Hormonal IUDs like Mirena use synthetic imitations of naturally occurring hormones to achieve this. Copper IUDs are good for 12 years, Mirena is good for five and Skyla is only good for three. The patch is a transdermal system that is as effective as the pill, and it is the first weekly, non-invasive form of reversible contraception that is 99% effective when used correctly. It looks like a square band-aid and it is applied to a specific part of the body. It works by slowly releasing a combination of estrogen and progestin hormones through the skin, and like with the pill, these hormones prevent ovulation and thicken the cervical mucus, which creates a barrier to prevent sperm from entering the uterus. The vaginal ring is a flexible, transparent and thin polymer ring that provides the body with a continuous low dose of etonogestrel and ethinyl estradiol. It is inserted into a woman’s vagina for three consecutive weeks and removed for the duration of the fourth week, at which time a new ring is inserted. Depo-Provera is an injectable form of contraception that works for three months, and birth control implants that are placed in your arm can last up to three years.

You should talk to your health care provider or visit one of the professional health care providers at Sexual Health and Wellness at UHS in order to decide which form of hormonal birth control is best for you. You should remember that although these forms of birth control can all prevent pregnancy, they in no way protect you from contracting an STI. Only a physical barrier such as a condom can prevent contraction of STIs.

--The Sexpert

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