Dear Alice,

I was wondering if it is possible to take the pills on the month I needed it. My boyfriend and I have a long distance relationship. We only meet once between three to four months' time. So I was thinking of taking birth control pills only on the months we meet. Is that effective method for preventing pregnancy? It's just that we both prefer not to use a condom as it feels uncomfortable.

Dear Reader,

Reuniting with a long distance partner after months apart can be such a magical time! Feeling confident in your birth control choice through advanced planning takes the pressure off trying to make a game time decision. Reader, the short answer to your question is that taking birth control pills only during months you anticipate spending time with your beau is not an effective method for preventing pregnancy. For more information about how birth control pills work to prevent pregnancy, read How do birth control pills work? There are many reasons why a person may skip birth control pills including infrequent intercourse, cost, change in health insurance status, and side effects. However, these interruptions severely reduce the pill’s ability to prevent unintended pregnancy. Luckily, there are other contraceptive options that may better suit your needs without compromising comfort and sensation.

Deciding which birth control method is best for you is a highly individual decision because of how differently people prioritize factors like price, convenience, comfort, and more. Below is a list of different options that you may want to consider (Keep in mind that none of these options protect against STIs):

There are several methods that require a prescription (you've got to see a health care provider for these):

  • Intrauterine device (IUD): An IUD is a small, t-shaped device that's inserted into the uterus. It's effective for 3 to 12 years and requires minimal user maintenance — it only needs to be checked once a month. This method is about 99 percent effective at preventing pregnancy.
  • Contraceptive implant: This device is implanted in the upper arm by a health care provider. It remains in place, prevents pregnancy for up to three years, and is up to 99 percent effective.
  • Contraceptive patch: This method is used each week for the first three weeks of the month (one patch per week), and the fourth week of the month does not require a patch at all. When this method is used correctly and consistently, it’s 99 percent effective in preventing pregnancy.
  • Contraceptive injection: This injectable birth control method is only needed once every three months. Because this method is administered by a health care professional (limiting the risk of user error), it can be upwards of 99 percent effective in preventing pregnancy.
  • Vaginal ring: The contraceptive ring is inserted into the vagina and remains there for three weeks out of the month and then must be removed for the fourth week. When used correctly and consistently, it’s 99 percent effective in preventing pregnancy.
  • Diaphragms or cervical caps with spermicide: The diaphragm and cervical cap are similar, but have a few important distinctions. It’s recommended that spermicide be used with each. As far as effectiveness goes, the diaphragm is 94 percent effective and the cervical cap is about 86 percent effective at preventing pregnancy when used correctly and consistently every time you have sex.

Interested in a little do-it-yourself? Check out these over-the-counter (OTC) options:

  • Contraceptive sponge: The sponge is inserted before sex and protects against pregnancy for up to twenty-four hours. If used correctly and consistently each time, the sponge is 91 percent effective in preventing pregnancy.
  • Vaginal spermicide: Vaginal spermicide comes in various forms (cream, gel, suppositories, films, and foams), and may also act as a lubricant. This method runs between 72 to 82 percent effective at preventing pregnancy.
  • Fertility awareness: The idea behind fertility awareness is that by observing changes in body temperature and vaginal discharge, you can track fertile days. To reduce the risk of pregnancy, sex is to be avoided on days when these factors indicate fertility. This method requires the use of a basal thermometer and a commitment to daily measurements and observations. If used correctly and consistently, this method can be upwards of about 76 percent effective.

Although pulling out or withdrawal is another method that is both convenient and free, it’s not as effective as most other methods — largely because it doesn’t prevent contact with pre-ejaculatory fluid (which may contain stray sperm) and relies on the male partner’s accuracy and self-control in order to pull out in time. All of the above methods have trade-offs, so reading up on each of them may be helpful in deciding which — if any — is for you.

Check out Planned Parenthood’s My Method , an interactive tool to help you evaluate your birth control options. Talking with a health care provider is the absolute best way to have all of your specific questions answered and to make sure that a given method is the right one for you. May you have many future steamy and safe visits with your boyfriend!


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