Between pill packs... is sex safe?

Dear Garfield,

First of all, congratulations for being responsible about your lovemaking and protecting yourselves against an unwanted pregnancy. As for your question, you are protected during the time of your concern as long as you have been taking your birth control pills correctly.

The synthetic estrogen and progesterone of your pills have done several things: 1) The pills have altered the normal rise and fall of estrogen and progesterone in your bloodstream, thereby preventing the maturation of an egg follicle in an ovary; 2) They've altered the lining of the uterus, which makes it more inhospitable in the unlikely event an egg is released and fertilized; and, 3) The pills have created a thicker cervical mucus which makes it more difficult for those feisty sperm to enter the uterus at all and make their way to fertilize an egg.

Birth control pills traditionally come in packs of 21 or 28 pills. Both types of packs contain 21 active pills. The 7 extra pills in the 28-pill pack are placebo pills which are there to remind you to continue taking one pill everyday and to remind you when to begin the next pack. Whether you take placebo pills or simply wait 7 days to start the next pack, the 7-day break from hormones triggers monthly bleeding that mimics a woman's menstrual period. Women are still protected from pregnancy during this time as long as they have taken all the active pills consistently and correctly. For more details, take a look at Why do I menstruate while on birth control? in Go Ask Alice! archive for Sexual and Reproductive Health.

However, all contraceptive methods have a failure rate and for the pill, the rate is about 3%, meaning 3 women out of 100 will get pregnant even though they are on the pill. The failure rate is higher if the pill is not used correctly and consistently. You may want to consider discussing with your partner what you might do in the event the pill fails you. This is very unlikely, but should be considered. For instance, you could add condoms to your sexy play as a precaution. Condoms would also lessen your chances of contracting some sexually transmitted infections, something the pill cannot do and especially important if you and your partner are not in a monogamous relationship.

Take care and rest easy!