Pill + Condoms = Effective Enough?

Teenie asks:

I'm 18 and i've JUST started having sex. I've done the deed 3 times and I've done all this research about fertility detection, rhythm method, and effectiveness of condoms and the pill. I've been on the pill for 2 years for acne reasons and I've used a condom every session without slippage or breakage. I try to refrain from the days I'm supposed to be most fertile, or having sex the week before ovulation for example. But all information is different. I hear sperm can last from 5 to 7 days but then I hear 2 - 3 days: which is it?!

My mum's a public health nurse and she's always said that condoms don't always work: does that mean if they slip or break? I've been really careful about my pill lately, making sure I take it every day but the times aren't always consistent: it's usually between 8am and 3pm. I also take zoloft for other reasons: does that ruin the effectiveness of the pill?? My significant other and I also use withdrawl every time: but using the condom and pill as well I still worry lol but is there still a chance I could become pregnant. I'm pretty confident for taking all these extra precautions, but I would still like to know if that's ok.

Heather Corinna replies:

Good on you for doing so much research, but if you're using the birth control pill, then you're not ovulating, nor most fertile at any given time.

The combined pill suppresses ovulation, so there's no sense in charting when you're on it, because there isn't anything TO chart: your fertility status -- so long as you're taking your pill properly -- is exactly the same every day of every cycle. Charting isn't in any way useful or meaningful when you're on the pill, so won't help with pregnancy prevention.

But that's okay, because if you change your pill habits a bit, you don't need any extra help with that: you're on the pill AND using condoms, and that gets you about as close to a zero chance of pregnancy as it gets without abstaining from sex, so long as, again, you're using both methods properly and consistently.

Condoms don't always work, but it's important to understand that that nearly always is due to user error. Generally, condoms fail when:

  • Good quality condoms are not used, or condoms are used which were not stored properly,
  • Condoms are not used with some EXTRA (more than is on the condom) latex-safe lubricant: that's particularly important when on the pill, too, since it thickens cervical mucus and also can cause some vaginal dryness,
  • Condoms are not put on properly (with room left in the tip, rolled all the way down the shaft of the penis), or taken off properly (partners forget to hold the base of the condom with their hand when withdrawing), or
  • Condoms are not used for ALL direct genital contact, from start to finish, or just aren't used at all.

You also need to start taking your pill on time: how you're taking it now isn't timely. That's a pretty big window you've got there for taking it: ideally, for the pill to be as effective as possible, you want to take it at the same time every day, with no more than two to three hours of difference. Try and find something you do at the same time (or really close) everyday. Like, when you have lunch, when you brush your teeth at night: any daily habit, and take your pill at that time.

You also don't need to be using withdrawal: again, with the pill and condoms, there's just no need, and in fact, in racing to withdraw, it can (understandably) be pretty easy for a guy to forget to hold the base of the condom. To boot, there's just no reason to do something that isn't going to provide extra protection in a given situation when it also can be such a buzzkill. Who wants to panic and rush at the start of their orgasm?

Really, if you don't feel totally okay about your risks while using the pill combined with condoms, what I'd suggest is considering if you really feel ready -- for real -- for the risks involved in the kinds of sex you're having. Because if you're really worried about all this the whole time, while still using a very effective combination of birth control, that can be an indicator that this is just too much, too soon. So, I'd suggest thinking about it for yourself, just to be sure, and if you come to the conclusion that this IS too much risk for your comfort, just adapt: you can either take a break from all sex, full-stop, or you can skip intercourse for a while and engage in other activities together you feel safer about. ANY sort of sex always keeps, and EVERY sort of sex is always better when we're not bringing a big pile of anxiety to the table.

(Sperm, for the record, is thought to survive in the vagina and remain viable for around 5 days: but again, since you're using condoms and there isn't any sperm IN your vagina, that's not really something to be too concerned about. Too, your antidepressant isn't a medication that interferes with the effectiveness of your pill. In the future, you can always ask your pharmacist, with any new medication, if it is a problem to take with the pill: it's their job to know and make sure you know.)

I've included a few links for you I think might be of use -- particularly, have a good look at both the sex readiness checklist and at the birthcontrol rundown: the latter will show you how effective both your methods are, so you can get a better idea of what an excellent and effective combination that is.

originally written 07.13.2007  •  updated 01.27.2014  • 

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