Does diarrhea reduce the pill's efficacy?
March 9, 2012 7:18 PM   Subscribe

Birth control pills + diarrhea: does it reduce the pill's efficacy, and if so, when can we start having sex without a condom again?

You're not her doctor. My wife started up on Ortho Tri-Cyclen Lo with a Sunday start on Feb 12th. On Monday/Tuesday of Week 3, she had some sort of stomach bug and had a bout of diarrhea all day on that Tuesday, Feb 28th, though she did take the pill as normal each day. Today is Friday of Week 4 (placebo pills), she's had her period as normal this week, and will be starting up with Week 1 again on Sunday.

We've used condoms since the illness.

So, is there any risk having a day of diarrhea (and I mean a full day) while on Ortho Tri-Cyclen Lo, and if so, how long until full efficacy has been restored and we can resume having baby- and condom-free sexytimes?
posted by anonymous to Health & Fitness (11 answers total)

She was just sick the one day? You're probably good, but use condoms for an extra week if it would make you feel better.

The only way I'd be truly concerned would be if she was vomiting to the point that she couldn't keep anything down -- i.e. taking a pill with water and then puking it all up minutes later.
posted by Sara C. at 7:29 PM on March 9, 2012

Also, wait, if she only just started on hormonal BC on 2/12 shouldn't you guys still be using condoms anyway? Both times I started up with hormonal, both the pill and the ring, I was told to continue using condoms for a month.

If you guys were having sex without condoms before she got sick on the 28th, the time to worry about it is past.

Use condoms, don't, you've already left yourself open for pregnancy at this point. You were much more likely to get pregnant on 2/27 than you are now.
posted by Sara C. at 7:34 PM on March 9, 2012 [3 favorites]

Worst case scenario - the pill was completely ineffective the day she had the stomach flu, and she ovulated. But you were taking other precautions, so the egg was never fertilized and was gone within a few days. It's been 2 weeks, she's on a new pack, everything starts from scratch and you're out of danger.

The BC should've come with an insert, this situation is like having missed a pill. Follow what the insert says for when you miss a pill and you'll be fine.
posted by TungstenChef at 7:41 PM on March 9, 2012 [1 favorite]

2/12 shouldn't you guys still be using condoms anyway?

Probably not. Different pills have different lengths to take before they protect you, but mine have always been a week.

If she wasn't vomiting, she should be okay.

Also, check the pack because different pills have different windows -- I want to say she's most likely totally protected, but there's a possibility she's not if she's on a different type of pill than I've been on. All BCPs are different, so there is really not a good yes or no to this one.
posted by DoubleLune at 7:44 PM on March 9, 2012

Also, when in doubt ask your pharmacist. They have studied this kind of thing for years.
posted by TungstenChef at 8:05 PM on March 9, 2012 [4 favorites]

I'd give it a month - one whole cycle - to be safe. If she diarrhea her body may have flushed that pill right through.

Have a look at the packaging the pills came with. Surely they'd have some sort of info regarding when its effectiveness is compromised?
posted by Jilder at 10:18 PM on March 9, 2012

IANYD. She had her period as normal since the incident, so your chance of having gotten her pregnant is exceedingly low. You don't need to use condoms now, but if you are this worried about getting her pregnant, shouldn't you be using more than one method? The pill is >99% effective with perfect use but most people cannot do perfect use (same time every day, taking it consistently every single day) and with typical use it is more like 92% effective.

I strongly suggest you get your wife a copy of Taking Charge Of Your Fertility so she can understand how her cycle works and her fertility in general, as a bonus this will make you seem like the coolest, most comfortable with your sexuality husband ever.
posted by treehorn+bunny at 11:02 PM on March 9, 2012 [1 favorite]

p.s. so you don't get unnecessarily nervous, DoubleLune is correct that typically you only have to use backup for 1 week after starting the pill.
posted by treehorn+bunny at 11:02 PM on March 9, 2012

There is a lot of misinformation upthread. Googling Ortho Tri-Cyclen Lo it's a Combined OCP - these answers only apply to the combined pill:

- In terms of diarrhoea and vomiting, seven days of condom use from the point that the diarrhoea (or vomiting) resolves is standard advice. The only exception is where the upset coincides with the end of a pack (or the start of placebo bills) - you don't want to extend the pill-free (or placebo) time; in that case you'd start the next pack immediately, and miss out the pill-free/placebo period. NHS link.

- If you start taking the combined pill within the first five days of your period you have contraceptive cover from that point. NHS link

The prescribing doctor really should have provided you with this information, since stomach bugs are so common.
posted by Coobeastie at 1:39 AM on March 10, 2012 [1 favorite]

Hi everyone, OP here. Thanks for the answers.

Sara C., DoubleLune is correct: Ortho Tri-Cyclen Lo has a one-week use-extra-protection window, which we followed scrupulously.

TungstenChef, Jilter, Coobeastie: we read the insert closely, and it matches the NHS link that Coobeastie posted. But, this scenario isn't covered exactly. There's what to do if you miss two or more pills, and if you miss one pill. The latter is the applicable scenario, and the insert says there are no additional precautions required. But, the instruction is to take the missed pill as soon as you remember, which is impossible since it was taken already.

Given that, we asked here. My wife was on the pill (same type, and it worked without incident) for several years before taking a break over the last few, but we just can't for the life of us remember how we handled this before.

I think we're just going to keep using condoms for the next week as if she's starting anew on the pill this month, even though that's probably unnecessary. Any more advice is welcome, and thanks again everyone.
posted by S. Puppet Sockefeller IV at 5:05 AM on March 10, 2012

as a bonus this will make you seem like the coolest, most comfortable with your sexuality husband ever

She already knows this about me!
posted by S. Puppet Sockefeller IV at 5:06 AM on March 10, 2012 [1 favorite]

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