Data Collection And Analysis
Two independent reviewers abstracted data. We made telephone calls to investigators to obtain additional information. We assessed the validity of each study using methods suggested in the Cochrane Handbook. We generated 2×2 tables for the principal outcome measures. The Peto modified MantelHaenszel technique was used to calculate odds ratios. We assessed statistical heterogeneity between studies.
Will Emergency Contraception Like Plan B Work If I Am On These Medications
Emergency contraception like Plan B may not work if you:
-
Weigh over 165 pounds
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Take anti-seizure medications, antibiotics for TB, HIV medications, or St. Johns Wort
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Have recently used anti-seizure medications, antibiotics for TB, HIV medications, or St. Johns Wort
In these cases, the best method of emergency contraception is the copper IUD, for example, ParaGard. This will need to be inserted by a trained healthcare professional within 5 days of having unprotected sex. For more information about emergency contraception, see our blog post here.
The Truth About Antibiotics And Birth Control
Q: I heard that antibiotics interfere with birth control pills, but Im on the birth control that gets implanted under my skin will antibiotics interfere with that too?
A: Im so glad you asked this question! This is one of the biggest medical myths of all time one that gets propagated in doctors offices, health clinics, hospitals, blogs, magazines and OK fine, student health centers every day. So now, for the first time ever in print online on this blog the TRUTH!
The only antibiotic that has ever been shown to interfere with birth control levels and effectiveness is a medicine called rifampin which is used to treat tuberculosis. Rifampin may also interfere with the birth control patch and vaginal ring so if you are taking it, be sure to use a back-up, non-hormonal form of birth control.
There are some other medications that can interfere with your birth control, however, and if you are taking any of them you should always use back-up contraception.
- Griseofulvin
John A. Vaughn, MD
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The Birth Control Pill
Oral contraceptives contain hormones that stop ovulation. If you use them perfectly, theyâre a great way to prevent pregnancy, with a 99.7% effectiveness rate. But in reality, a lot of women forget to take them every day, so the typical use rate is only 91%. Other reasons why your pill might not work include:
- Youâre vomiting or have diarrhea for more than 48 hours.
- You take the antibiotic rifampin, the antifungal griseofulvin, certain anti-seizure meds, or the herbal supplement St. Johnâs wort.
- Youâre obese. Some research suggests that the birth control pill doesnât work as well in very overweight women.
If you have any of these issues, talk to your doctor about using condoms as a backup method, or switch to another form of birth control entirely.
If you skip a dose, take it as soon as you can. If youâve missed more than two pills, take them as soon as you remember, and continue to take pills daily while you use a backup method of birth control like condoms for the next week. If youâre on the mini-pill or the progestin-only pill, take it within the same 3 hours every day .
How Effective Is Birth Control
Most statistics regarding birth controls effectiveness describe their efficacy with perfect use. Perfect use means taking your hormonal dose at the same time every day, removing and reinserting your vaginal ring on schedule, or ensuring your IUD stays put.
Because alarms get snoozed, life happens, and human beings are imperfect, there are occasions when birth control can leave room for a pregnancy to occur. To that end, these are the use failure rates for non-barrier birth control options:
- LNg IUDs .1-.4%
Lets explore 5 different scenarios that can result in birth control failure.
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Natural Lubricants May Damage Condoms
Using a natural, oil-based lubricant during sex may make barrier birth control methods like condoms less reliable.
When using during sex, certain natural oils, like coconut oil or almond oil, can weaken latex condoms, making them less effective. These oils can sometimes even cause condoms to break.
To ensure that your latex condom stays in working order, you may want to try to use a water-based lubricant instead of an oil-based one.
If you want to use oil-based lubricants, you can try using non-latex condoms, such as condoms made from lambskin, as they can protect against pregnancy even if used with natural, fat-based lubricants.
Short Acting Hormonal Methods
Prevent pregnancy by interfering with ovulation and possibly fertilization of the egg. If you want to get pregnant, you can stop using them at any time.
Combination Oral ContraceptivesThe Pill
What is it?
- A pill that has two hormones to stop the ovaries from releasing eggs
- It also thickens the cervical mucus, which keeps sperm from getting to the egg.
How do I use it?
- You should swallow the pill at the same time every day, whether or not you have sex.
- If you miss one or more pills, or start a pill pack too late, you may need to use another method of birth control, like a condom and spermicide
How do I get it?
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You need a prescription from a healthcare provider.
Chance of getting pregnant with typical use
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Out of 100 women who use this method, about 9 may get pregnant.
Some Side Effects
- Spotting or bleeding between periods
- Nausea
Less Common Serious Side Effects
- It is not common, but some women who take the pill develop high blood pressure.
- It is rare, but some women will have blood clots, heart attacks, or strokes.
Does it protect me from sexually transmitted infections ? No.
- A pill that has only one hormone, a progestin.
- It thickens the cervical mucus, which keeps sperm from getting to the egg.
- Less often, it stops the ovaries from releasing eggs.
How do I use it?
How do I get it?
-
You need a prescription from a healthcare provider.
Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year
Some Side Effects
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Risk Of Bias In Included Studies
Several of the trials were of high quality. The Kenyan trial , Nigerian trial , and Los Angeles trial featured adequate allocation concealment, double blinding of treatment, and intenttotreat analysis. However, the Nigerian trial stopped prematurely, and the incidence of pelvic inflammatory disease is higher than that of unscheduled visits to the clinic, a doubtful occurrence. The Turkish trial did not describe its method of randomization. No placebo was provided, and blinding was not maintained. No sample size calculation is available.
Are There Any Side Effects From Using The Copper Iud
- When it is first inserted some users have period type cramping that usually settles after a few days.
- Your vaginal bleeding pattern will change. Spotting can occur in the first 3 months. This nearly always settles with time and your regular bleeding pattern will return. For most users, periods are about 50% heavier.
- Sometimes the IUD can fall out. This is more common in the first 3 months of it being inserted.
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Im Taking Antibiotics Will They Affect My Pill
To answer this we need to look a little more closely at the science. Rifampicin and rifabutin are two antibiotics known as enzyme-inducing antibiotics. This means they can increase the enzymes in your body. Subsequently, this increases the metabolism of oestrogens and progestogens, the hormones contained within the combined pill that work to prevent pregnancy. The result is a direct hit on its efficacy.
All other antibiotics are non-enzyme-inducing, and these will not have any effect on the pill. There is no compromise in efficacy and no other precautions regarding contraception are required. The good news is most antibiotics commonly prescribed are non-enzyme-inducing, and your pill will continue to work just fine. Phew!
It is worth noting, however, that while these antibiotics may not directly impact the efficacy of the pill, other side effects may create issues. Antibiotics of any type can cause vomiting or severe diarrhoea. You may also be experiencing these symptoms due to the illness itself.
Whether youre taking antibiotics or not, this information is important to remember. Vomiting with any cause, due to illness or as the result of an almighty hangover, can still impact the absorption of the pill!
Where Can I Get The Copper Iud
The Paragard IUD is the only copper IUD available in the United States. You can have it inserted at most family planning clinics, planned parenthood centers, clinics, and hospitals.
Not only will your health care provider advise you on the suitability of a copper IUD for contraception, but they will likely also be the ones to insert the device.
If you need more information on how to get birth control, take a look at our detailed article on the subject.
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How Does It Happen
There are a few reasons pregnancy could occur in people with an IUD. In some cases, a person could become pregnant before the IUD is effective since not all types are effective immediately.
Copper IUDs, like Paragard, protect against pregnancy immediately because the copper changes the environment in the uterus, making it toxic to both the sperm and the egg. This prevents the sperm from reaching the egg and the egg from attaching to the uterine wall.
Hormonal IUDs, like Mirena or Kyleena, take about seven days to start working. These types are generally considered effective immediately if inserted during your period because of where you are in your menstrual and ovulation cycles.
If you have a hormonal IUD inserted, its recommended to use a backup contraceptive method or abstain from intercourse for seven days.
In other cases, pregnancy could occur if the IUD shifts its position. In a small number of people, the IUD may slip partially or entirely out of the uterus . If the IUD shifts, even partly out of position, it will no longer be fully effective at preventing pregnancy.
Another potential way pregnancy can occur is if the IUD remains in your body longer than its recommended expiration date. The amount of time an IUD can stay in and remain effective depends on the type of IUD. The manufacturer recommendations for a few IUDs are:
- Skyla: Up to three years
- Kyleena: Up to five years
- Mirena: Up to seven years
- Paragard: Up to 10 years
Facts Proving Iud & Uti Link
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In a previous post, I explained why certain condoms can cause a UTI this time lets examine the connection between IUD & UTI.
IUDs were pretty popular in the USA starting 1960 through early 2000, however nowadays most of IUD users live in China, and only 6% of women using contraception choose IUD as their contraceptive method in the USA. Perhaps, general unpopularity of this contraception method is the main reason why your gynecologist never heard about IUD & UTI link.
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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.
If You Cant Take The Emergency Contraceptive Pill
Another form of emergency contraception is a copper intrauterine device . Intrauterine means it is put into your uterus. This must be done by a doctor or at a family planning clinic.
The IUD prevents implantation of a possible fertilised egg.
If youve had unprotected sex and cant take the emergency contraceptive pill, talk to your doctor or family planning clinic about the IUD as soon as possible.
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You Missed Your Period
If you have an IUD, then you know some of its less than thrilling side effects, the biggest one of which is bleeding. And if your IUD is copper, it can cause heavy bleeding, as was found in the study, âSide effects from the copper IUD: do they decrease over time?â But while your period might get heavier , a missed period is often a marker of pregnancy, the Cleveland Clinic reported, whether you have an IUD or not.
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You Feel Pregnancy Fatigue
Canât get out of bed lately? Even with an IUD, you might be pregnant, Dr. Langdon explains. âFatigue is a big sign that you might be expecting,â she says. If youâve been pregnant before, you might recognize that all-consuming tiredness you feel early on when youâre expecting. Fatigue affects up to 60% of all pregnant women, What To Expect reported. So if all you want to do is sink into your bed and sleep all day, you might want to take a pregnancy test⦠just in case.
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Mirena Insertion And Removal
Women can have Mirena birth control inserted during a regular doctors visit. Mirena insertion takes about five minutes.
Doctors use a few tools to help insert the device but the insertion is not considered surgery.
Women should wait at least seven days after the start of their period to insert Mirena. Women who have just given birth, had a miscarriage or an abortion should wait at least six weeks.
A doctor or other trained health provider can remove Mirena at any time.
Eight out of 10 women who have had their Mirena IUD removed can get pregnant within a year, according to Bayers Mirena Handbook.
Health care providers must remove Mirena if it moves out of place. If a patient is not pregnant, she can get a new IUD inserted.
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Does The Mirena Iud Lose Effectiveness When On Antibiotics L
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Drugs or herbal products that induce enzymes, including CYP3A4, that metabolize progestins may decrease the serum concentrations of progestins.
Some drugs or herbal products that may decrease the serum concentration of levonorgestrel include:
Significant changes in the serum concentrations of the progestin have been noted in some cases of co-administration with HIV protease inhibitors or with non-nucleoside reverse transcriptase inhibitors.
Consult the labeling of all concurrently used drugs to obtain further information about interactions with Mirena or the potential for enzyme alterations.
This is from the Mirana IUD Website. Thought it would be useful as some drugs CAN affect the IUD.
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Iud And Miscarriage Risk
If you have an intrauterine device and become pregnant, there may be complications. Research suggests that if a person chooses to leave their IUD in during pregnancy, their miscarriage risk will increase to around 40%. Moreover, it can raise the likelihood of preterm birth by some 500%.
With these risks in mind, you should call your healthcare provider immediately to have your IUD removed if you find yourself pregnant and decide to continue the pregnancy. Removing the IUD early in a timely fashion can largely reverse those risks.
Who Should Not Use Mirena
Women who are pregnant or suspect they may be pregnant, should not use Mirena.
Patients with the following health conditions should not use Mirena
- Uterine abnormalities
- History of pelvic inflammatory disease
- Postpartum endometriosis or recent infected abortion
- Abnormal Pap smear
- Vaginal, cervical or genital infections
- Liver disease or tumors
Michelle Llamas has been writing articles and producing podcasts about drugs, medical devices and the FDA for nearly a decade. She focuses on various medical conditions, health policy, COVID-19, LGBTQ health, mental health and womens health issues. Michelle collaborates with experts, including board-certified doctors, patients and advocates, to provide trusted health information to the public. Some of her qualifications include:
- Member of American Medical Writers Association and former Engage Committee and Membership Committee member
- Centers for Disease Control and Prevention Health Literacy certificates
- Original works published or cited in The Lancet, British Journal of Clinical Pharmacology and the Journal for Palliative Medicine
- Patient Advocacy Certificate from University of Miami
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Desire To Continue The Pregnancy
If the woman wishes to continue with the pregnancy, a doctor will perform a pelvic examination. If the IUD strings are visible, the doctor will remove the IUD gently.
If the IUD strings are not visible, a woman may need to undergo an ultrasound to determine its location. The next course of action depends on the location, as below:
- No IUD found: The woman will need an X-ray to locate the device.
- IUD within the cervix: The doctor will remove the IUD by pulling the strings.
- IUD above the cervix: The doctor will talk about the risks and complications of continuing the pregnancy.
