How To Prevent Birth Control Ineffectiveness
Always talk with your doctor about birth control interactions before taking new medications, including vitamins or over-the-counter medications. Ask if the medication or supplement will interfere with your birth control effectiveness. Even if more research is needed, its generally better to err on the side of caution. You can use backup forms of birth control in addition to oral contraceptives when taking medications that interfere with the effectiveness.
If you forget to use a backup method, you can take over-the-counter emergency contraception for up to five days after intercourse. For long term medications, such as retrovirals, diabetes medications, or anticonvulsants, it is best to talk with your provider about other contraception methods, such as long-acting reversible contraception or injectable progesterone.
Can Antibiotics Affect Your Birth Control
The whole point of birth control is to avoid pregnancy.
So you dont want to do anything that could make your contraception less effective.
Yet certain medications can change how the body metabolizes hormonal birth control, including the pill, patch, and vaginal ring.
In these instances, unless you use another contraceptive, your risk of pregnancy increases.
Many women wonder if antibiotics in particular interact with hormonal birth control.
After all, 125 million women were prescribed antibiotics in 2020 for bacterial infections like urinary tract infections , sinus infections, and skin infections, and 14% of women between ages 15 and 49 take birth control pills.
While you should always discuss your current medications with your healthcare provider, this article will help you understand if antibiotics affect your birth control.
Ill discuss what the research says about taking antibiotics with birth control, how birth control works, and other medications that may interfere with birth control.
How Birth Control Pills Work
Birth control pills are a form of hormonal contraception meant to prevent pregnancy. Most birth control pills contain the two hormones estrogen and progesterone. This helps block the release of eggs from the ovary, or ovulation. Some birth control pills, such as the minipill, help thicken cervical mucus to make it more difficult for sperm to reach an unfertilized egg.
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Can Birth Control Pills Help Clear Acne
A special type of birth control pill called combined contraceptives stabilizes these hormones and this stabilization can help clear acne, usually by about 35% after the first 3 months and 55% to 60% after 6 months. These pills come with risks, so its important to check with your doctor before taking them.
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Common Reasons Birth Control Fails
Even when used with perfect use, birth control is not 100% effective and can result in pregnancy. There are several reasons that birth control can fail and become ineffective. The most common reasons that birth control fails are:
- Interference with other drugs / medications
- Human error not following the instructions
- Storage temperatures causes medication to become inactive
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The Truth About Antibiotics And Birth Control
Have you ever been told to use a backup birth control method if you are taking antibiotics? It is always best to play it safe. After all, several antibiotic information sheets come with a warning that says antibiotics may make birth control pills less effective. But how much evidence is there to support this claim? Heres a closer look at what the latest research studies have found in terms of the link between antibiotics and birth control.
Understanding How Birth Control Pills Work
Birth control pills are a method of preventing pregnancy. While there are countless types of birth control pills, most of them contain both estrogen and progesterone to stop the release of eggs from the ovary . There are some pills that prevent pregnancy by thickening the cervical mucus and making it more difficult for the sperm to reach the egg. Regardless of exactly how they prevent pregnancy, birth control pills are a highly effective form of hormonal contraception.
Is Your Medicine Impacting Your Birth Control?
What about other antibiotics? A study published in the Journal of the American Academy of Dermatology concluded that hormone levels remain unchanged when the following commonly prescribed antibiotics are taken with birth control pills:
Stay Aware and Consult Your Physician for Guidance
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Antibiotics That Do Not Affect Birth Control
Most antibiotics have no proven effects on hormonal birth control and will not increase your chances of getting pregnant if you have sex during treatment. Commonly prescribed antibiotics that are safe to take while on birth control include:
- Ampicillin, for treating bladder infections, pneumonia, and more.
- Cephalexin, for treating upper respiratory, ear, skin, urinary tract, and bone infections.
- Ciprofloxacin, for treating skin, respiratory, joint, and urinary tract infections.
- Clarithromycin, for treating bacterial skin and respiratory infections.
- Clindamycin, for treating skin, lung, soft tissue, vaginal, and pelvic infections.
- Doxycycline, for treating urinary tract infections, gonorrhea, chlamydia, syphilis, respiratory infections, and more.
- Metronidazole, for treating vaginal, stomach, liver, skin, joint, and respiratory system infections.
- Minocycline, for treating urinary tract, respiratory, and skin infections, as well as chlamydia.
- Ofloxacin, for treating skin infections, urinary tract infections, pelvic inflammatory disease, chlamydia, and gonorrhea.
- Roxithromycin, for treating bacterial respiratory tract, urinary and soft tissue infections.
- Sulfamethoxazole, for treating urinary tract, ear, and respiratory infections, among others.
- Tetracycline, for treating skin, respiratory, urinary, and other infections, as well as syphilis, gonorrhea, and chlamydia.
- And many more.
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Using A Backup Method
Although there have been some cases reported of contraceptive failing when a woman takes antibiotics, it doesnt happen regularly. To ease your mind while taking antibiotics, your doctor will generally recommend that a backup method of birth control is used during this time. Typically, a condom, spermicide, or a female condom are all good options to use as a backup method.
If you are takingboth antibiotics and birth control at the same time and wondering doantibiotics affect birth control, you should speak with your doctor and findout how long you should use a backup method for.
When Can Antibiotics Affect Your Birth Control
Antibiotics can directly affect birth control if youre taking:
These antibiotics are usually used to treat specific conditions. So your antibiotics might affect your birth control if youre getting treatment for:
- methicillin-resistant staphylococcus aureus
If youre not being treated for these conditions, youre probably not taking either of these antibiotics. So, your birth control should work just as well as normal, unless you have other side effects or symptoms .
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Im On Hormonal Birth Control Can I Get Pregnant If I Take Antibiotics
In most cases, no, as long as you continue to use your hormonal contraception as prescribed you are safe from pregnancy even if you are on antibiotics.
It is a myth that all antibiotics will interfere with the efficacy of your birth control pill.
There is however, one class of antibiotics that is the exception: rifamycins .
Do Antibiotics Affect The Contraceptive Pill
For decades, if a woman was started on an antibiotic, it was standard practice for the doctor to ask if she was also taking the contraceptive pill. It was thought that antibiotics interfered with the levels of the pill in a womans body, and might stop it from working. Therefore, women on the pill were advised to use condoms or avoid intercourse if they were taking an antibiotic.
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How Do Antibiotics Work
Different antibiotics have different mechanisms of working. Some affect how bacteria operate, while others may break down bacterial cell walls. Its important to remember that antibiotics are only effective against bacterial infections. That means it is ineffective against viral and fungal infections.
You should never take antibiotics to treat the common cold and flu, stomach flu, and other infections caused by a virus. Overusing or incorrectly using antibiotics may create superbugs that are resistant to conventional bacteria.
Aside from viral and fungal infections, antibiotics can be used to treat a wide range of bacterial infections and diseases, including:
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The Connection Between Antibiotics And Birth Control Pills
To date, the only antibiotic proven to impact birth control pills is rifampin. This drug is used to treat tuberculosis and other bacterial infections. If you take this medication while using birth control pills, it decreases the hormone levels in your birth control pills. This decrease in hormone levels can affect whether ovulation is prevented. In other words, your birth control becomes less effective. Rifampin also decreases hormone levels in the birth control patch and vaginal ring.
Other drugs may make birth control less effective, such as:
- some anti-HIV protease inhibitors
- some anti-seizure medications
- the antifungal drug griseofulvin
Birth control pills may make other drugs less effective, such as analgesics and blood pressure medications. The effects of antidepressants, bronchodilators, and tranquilizers may be increased when you use them with birth control pills.
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Oral Contraceptive Steroid Pharmacokinetics
The estrogens most commonly found in oral contraceptive preparations are ethinylestradiol and mestranol, a prodrug which is metabolized to ethinylestradiol. After metabolism via the first pass effect, ethinylestradiol has an oral bioavailability of 40% to 50% . Hydroxylation is the main metabolic pathway for ethinylestradiol, whereas conjugation is considered to be a minor pathway in most women, resulting in sulphation or glucuronidation of the original estrogenic steroid. Glucuronide and sulphate conjugates reach the small intestine by way of the bile duct. Hydrolytic enzymes of intestinal bacteria break the conjugates down, resulting in the release of free, active estrogenic hormone. The active hormone is then available for reabsorption and undergoes enterohepatic cycling, which is responsible for plasma estrogen levels necessary for contraception.
The progestins present in oral contraceptive pills also undergo conjugation. Hydrolysis of conjugates leads to the formation of inactive metabolites because the parent molecule cannot be directly conjugated. Progestins are not thought to undergo extensive enterohepatic cycling and are, thus, less likely to be involved in drug interactions with antibiotics than ethinylestradiol .
How Antibiotics Might Affect Birth Control
Some types of antibiotics have the potential to affect birth control because they can alter the bodys hormone levels. Hormonal birth control methods that these antibiotics might impact include:
- The pill
- The ring
- The shot
All four of these birth control methods contain the hormones estrogen and/or progestin which thickens the mucus in the cervix, making it difficult for sperm to fertilize an egg, and thin the lining of the uterus to reduce the chance of getting pregnant. The methods that contain estrogen also prevent you from ovulating, while progestin-only methods stop ovulation but not consistently. Certain antibiotics can lower the levels of estrogen and progestin in your body, potentially to the point of affecting your birth control.
Theoretically, antibiotics might also reduce your birth controls efficacy by interrupting the recirculation of estrogens in the body a process called enterohepatic circulation. They do this by killing the bacteria in the small intestine that help break the hormone down and redistribute it within the body.
For these reasons, many manufacturers have historically placed warnings on antibiotic labels to inform women about this risk. Over the years, scientists have done many studies on various types of antibiotics effects on hormonal birth control to determine which ones you should and should not take at the same time.
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Why Is My Birth Control Not Helping With My Acne Scars
This anti-acne effect is limited to methods that use a combination of estrogen and progesterone, for example: B. some pills, patch and ring. The FDA has specifically approved three types of birth control for acne, although people using other estrogen/progesterone combinations may see similar results.
How Do Birth Control Pills Work
Birth control pills typically contain two hormones, estrogen and progestin. These hormones prevent pregnancy by stopping ovulation from occurring, thickening the cervical mucus making it less likely that sperm can enter the uterus, and thinning the uterine lining so that even if an egg is successfully fertilized, it’s less likely to successfully attach.
This form of birth control works by maintaining consistent hormone levels, preventing the monthly spike in estrogen that triggers the release of an egg.
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Understand How Your Contraceptive Works
Excessive vomiting and/or diarrhea can also lower the effectiveness of the pill. If you are experiencing these symptoms, contact your healthcare provider for advice about additional methods of birth control. If you have any questions about birth control methods or potential interactions with other medications, talk to your healthcare provider. You will lower your chances of birth control failure if you have a proper and thorough understanding of how to use your contraceptive.
The Claim: Antibiotics Cancel Out Birth Control
If you use birth control, a widely shared post on Facebook claims you should avoid antibiotics.
PSA: Antibiotics will cancel out your birth control and your doctor will f—ing forget to tell you that, reads a shared more than 83,000 times.
The post was published in October 2018, but it continues to gain traction on Facebook. And the post’s claim is misleading.
Experts say most antibiotics do not interfere with the effectiveness of contraceptives. The only exception is rifampin, an antibiotic used to treat tuberculosis.
USA TODAY reached out to the Facebook user who shared the post for comment.
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Hiv Medications Or Antiretrovirals
These medications are used to prevent the HIV virus from multiplying and keep it under control.
Antiretrovirals that interact with birth control: There is a risk of interaction with all ARVs.
Antiretrovirals that dont interact with birth control: The good news is that there are some safe contraception-ARV combinations. Your doctor can make recommendations on a case-by-case basis.
Safest contraception options: In most cases, the birth control shot , hormonal IUD , and copper IUD are all safe to use on HIV treatment. Non-hormonal methods are another safe alternative.
How Long Do Certain Antibiotics Affect Birth Control
Exactly how long an antibiotic can affect birth control depends on the amount of time youre taking it, says Dr. Ross. And since your doctor may recommend you take rifampin for several months , using a second method of protection, such as a condom, is super important. If I were on rifampin and I were taking any type of birth control, I would be using back-up contraception, and I would be very careful, says Dr. Sophocles.
To prevent unwanted pregnancy, Dr. Sophocles recommends using backup contraception the entire time youre on rifampin or rifabutin and the first few days youre off the antibiotic, while Dr. Ross suggests sticking to it for up to a month afterward. After all, missing a single pill can put you at risk of pregnancy, and it can take at least seven days after you first start taking birth control pills for them to effectively protect against pregnancy.
And while you dont normally need to use additional contraceptives if youre taking antibiotics other than those two, theres no harm in playing it safe, especially since condoms prevent STIs, too.
If you have an easy opportunity to use back-up contraception, use it, says Dr. Sophocles. Its never going to hurt to use it, and its a lot better than having an oops.
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Enzyme Inducers = Use A Backup Method
This being said t is still important to ask your pharmacist about whether or not your antibiotic is considered broad-spectrum, because there are some antibiotics that do significantly interact with combined hormonal contraceptives.
Antibiotics that are known to definitely affect the efficacy of combined hormonal contraceptives are called enzyme inducers because they essentially make your body chew up the hormones in the birth control faster than normal. These types of antibiotics include the following:
Rifampin, Rifabutin and griseofulvin are antibiotics known to reduce the levels of hormones in the pill, the patch or the ring. It is very important that women on these antibiotics who also use combined hormonal contraception use a backup method of birth control while they are taking these antibiotics. The CDC has classified these antibiotics as category 3 interactions with combined hormonal contraceptives because when used together, the effectiveness of the birth control is reduced and pregnancy risk is increased.
Things To Keep In Mind When Youre Sick
Even if you arenât on rifampin, being ill is hard on the body and mind. If you are sick, itâs easy to lose track of time and responsibilities, and you might forget to take your pill . Use Clue to set up pill reminders, or task a family member, partner, or friend, to help remind to make sure to take your contraceptive pill daily at the same time.
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I Need To Take These Medications What Are My Options
If you are already on hormonal birth control and are about to start taking one of these medications, your provider will discuss birth control options with you to make sure your medications dont interact. The birth control shot, IUD, or implant may be your best bet.
If you are interested in starting hormonal birth control, be sure to let your provider know about your existing prescriptions. If you are taking one of the medications above and decide to stop, be aware that it could take up to 28 days after stopping before any hormonal birth control will be fully effective. In the meantime, you will need backup contraception.
Either way, your prescriber will be able to advise you on the safest birth control for you depending on what other meds you take or are about to start.