The Doctor Is In: Are You Sure I Won’t Get Pregnant!?

Talking sex with your doctor isn’t always easy. Whether you are afraid she or he will judge you,  you just don’t feel comfortable sharing the intimate details of your life between the sheets, or you can’t think straight with a speculum between your legs, many people get tight lipped in the doctor’s office. But that doesn’t mean you don’t have questions.

We thought we’d help and every Thursday our friend Dr. Lissa Rankin will be answering your questions. The ones you couldn’t ask your doctor in person and didn’t really trust the Yahoo community to answer for you. Just leave your questions in the comments, or send em over to us. (We’ll keep it all anonymous for you.) Dr. Lissa will answer anything – really, anything – about sex and other lady things. Don’t be shy; she’s waiting for ya!

Q: I’ve been on the pill (normal combination pill) for 3 years. I am very happy with it. I never miss a pill, but I take it at very different times during the morning. Does this decrease the effectiveness?

A: It’s always better if you can take your pill as close to the same time as possible, but if you normally take it at 8am and the next day, it’s not until 11am, that shouldn’t make much difference. The one exception is very low dose pills like Yaz and Mircette (pills with 20 micrograms of estrogen). In this case, it’s more important to try to remember to take your pill at the same time.

Q: I was also wondering, is it possible to use the pill with the Mirena IUD? Would you recommend it?

I hear you, sister. I’m assuming you DO NOT want to get pregnant! While I appreciate the sentiment, I would not recommend using a Mirena IUD with a birth control pill. Both contain hormones that act differently. And since both the Mirena IUD and oral contraceptives are highly effective, I don’t see the reason to assume the risks of both. If you’re particularly worried about pregnancy and want to use double protection, consider condoms plus the Pill or condoms plus an IUD. But adding two hormonal methods together can really mess up your system.  

Q: And finally, when I’m having sex with my boyfriend we sometimes start without condoms and then later he’ll pull out and put a condom on and continue. How effective is this in preventing pregnancy when used in combination with the pill? We’re in a monogamous relationship & have been tested, so I’m not worrying about STDs.

A: If you’re religious about taking the pill, and you’re using the withdrawal method and you’re sort of using condoms, chances are good that you will be protected from pregnancy. But mostly, that’s because of the Pill, which in and of itself is highly effective. In general, withdrawing before ejaculation is not an effective method of birth control because sperm are present in the pre-ejaculate released before orgasm.  So if you want to do everything possible to protect yourself, put the condom on before you start fooling around and leave it on until you’re done and can safely remove it.

It’s all about assessing your own personal risk tolerance. No birth control is 100%, which means that sex can always result in pregnancy. That said, it sounds like you’re being very conscientious to try to avoid an unwanted pregnancy, and I commend you for that.

Is your partner opposed to wearing a condom during sex? My gut tells me that maybe you would be feel a bit more comfortable if he did. If so, maybe it’s worth having a chat with him about this. Remember, it’s your body, and if anybody gets pregnant, it will be you. Listen to your heart, and honor your body.

Get to know more about Dr. Lissa on her website,

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