Hey iced tea, the rate is based on how many women per 100 per year have a pregnancy despite using that form of contraception (and no other contraception). It's specific to the pill and indicates how good it is as a method... so how the 99% would change based on an individuals experience really can't be predicted so precisely.
Missing one pill, depending on when it happens in somebody's cycle, and what type of pill they are taking may effect hormone levels, and so I'm guessing, could effect pregnancy risks, but not beyond that cycle.
In practise it's often best to back up with condoms during the time after the missed pill just to be sure, if they're not already being used as a precaution against STIs.
But as you say if used correctly for a month I'm pretty sure the hormones will be operating at their best.
So, if each pill is taken correctly during a monthly cycle, then one can assume that the 99% effectiveness rate would be there? Correct?
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That 99% figure, as I understand it, comes from laboratory studies. For real-life use, if someone takes their pill on time every day, we would say that the success rate of the pill probably lies somewhere between the typical and perfect use rates. Effectiveness can be boosted by using condoms for genital contact.
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