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Missed pill and oral sex risks

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Mortality asks:

I have two questions that I'd love to get answered. From the answers I've read here you give really good answers to most the questions.

I'm on hormonal birth control, and I was late with two pills this past week and had missed one a bit over a week ago. Yesterday me and my boyfriend had intercourse twice and he came in me both times. On the info-thingy that comes with my pills it says that a missed pill in the third week of active pills don't compromise my protection as long as all the others are taken correctly. But I'd been late with two.. I tend to get extremely worried for no good reasons (I was worried I might be pregnant before I'd even kissed a guy and before I got my first period...) so if there was no pregnancy risk I just need to have heard (uhm, read?) it from someone whom I consider an expert.

I also wonder how much of a risk for an STI a guy going down on me would present. I know I'm clean now, but when I was still single I was at the receiving end of unprotected oral sex and I really want to know how much of a risk that is for me and how big of a risk it was for the guys in question. Thanks for taking your time with this question.

Heather Corinna replies:

Starting with the birth control issue, not knowing which pill in particular you're on and not being able to see the insert for myself, I can't give you a 100% answer per promising you I'm being as accurate as I know how to be.

However, there are indeed some BCPs which operate in the way you're describing, and where what you're presenting here would not present a risk. Too, know that if you're on a combination pill, if for those two lates and one missed, none of those pills were more than 24 hours late, you're likely not looking at ANY viable risk at all. If the two late ones were not more than 24 hours late, there's no need to worry about them at all. And with all combination pills, if that one missed pill was the only one you took more than 24 hours late, that would have been unlikely to compromise the effectiveness of your pill as birth control.

Obviously, using condoms with your pills is always a helpful backup, as well as providing protection against infections and diseases which the pill cannot. Since it sounds like you're worried a lot -- and sex is sure a whole lot less fun when you're stressed out, and it IS supposed to be fun -- I'd suggest doubling up with condoms from here on out, if for no other reason than your peace of mind. Too, if you're having a really tough time remembering to take your pills, you can always talk to your sexual healthcare provider about alternatives which won't require you having to remember to take something every day. There are also some cool BCP pill cases with a reminder clock on them (like these) if you like being on the pill and something like that would help you be sure to take it properly.

In terms of the STI risk, your biggest risk would be a Herpes risk (his oral herpes transmitted to you genitally), and considering how many people have oral herpes, and how many people with it aren't aware they have it, that's not an insubstantial risk. In terms of the risk to your partner, again, a herpes risk would be the largest risk (genital herpes can be transmitted to someone's mouth), but there are also risks of a couple other infections. So, per usual, we'll always advise everyone to practice safer sex with barriers for at least six months -- that's latex barriers, testing for both partners, and monogamy -- before going without barriers to reduce risks as best you can.

Hope that helps you out!

written 05 Oct 2007 . updated 05 Oct 2007

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