It’s All About the Pill

I’m a 21-year-old female. I’ve been with my boyfriend for over a year now. I was a virgin before we became sexually active and petrified about getting pregnant. I took birth control pills, used condoms and, if I was ever nervous, I would get the morning-after pill—pretty neurotic, I guess. However, once we hit 6 months, we tried without the condoms and honestly, it felt amazing—to the point that I only orgasm without the condom! Neither of us has any sexually transmitted infections, but how effective are the pills alone, really? My friends shame me for not using a condom anymore, but I’m very regular with pill dosage.
—Comfortable Condom-less

I’m not here to shame you, just to give you some facts. Safer sex practices are very personal decisions that only you can make for yourself. My goal is to provide you with accurate, non-judgmental information to help you make your own informed decision.

First off, I think it’s important to understand pregnancy and how the pill works. Here’s a simplified explanation.

Once a month, during ovulation, an egg is released from the ovaries and travels down the fallopian tubes. This takes several days, and this is when you’re most fertile because fertilization happens in the tubes.

Meanwhile, ovulation triggers the building of the uterine lining in preparation for an egg to be implanted in the uterus and causes changes in vaginal mucus to make it friendlier to sperm.

If an egg doesn’t get fertilized, the lining sheds itself, and you get your period. If the egg is fertilized, it reaches the uterus and implants itself in the lining, resulting in a missed period and pregnancy.

Hormonal contraceptives, such as the pill, provide a daily dosage of one or both of the hormones estrogen and progestin. These hormones trick your body into thinking it’s already released an egg so that you never release an actual one. No egg, no pregnancy.

Progestin also thickens the vaginal mucus and alters the uterine lining, making it hard for sperm to get past the uterus or for an egg to implant itself, if it does get fertilized. Depending on the pill’s hormonal content, the process involves one or all of these steps.

While a condom is the only effective protection against both sexually transmitted infections and pregnancy, the pill is considered up to 99.9 per cent effective against pregnancy when used properly. Proper use means taking the pill at the exact same time every day to maintain the hormonal dosage and prevent the release of a real egg.

Individual success and failure rates can also depend on how your body reacts to the pill’s synthetic hormones. Other medications can also lower the effectiveness of the pill, so it’s important to ask your doctor about medications they prescribe to you.

You mentioned that you’re STI-free. However, you should know that it’s extremely difficult to be certain about that unless you’re getting regularly tested. Some STIs can take up to six months to show on tests; some won’t result in any symptoms and can be present for years before someone shows a physical symptom.

It sucks, but people also sometimes cheat or lie about their sexual past. I would still recommend getting STI tests and pap smears regularly.

Generally, it can be hard to know the exact level of effectiveness, but taking the pill properly plays a major role. As with any safer sex practice, the decisions you make are personal and relate to how much risk you are comfortable taking on.

The risk for pregnancy while on the pill is actually considered low. Still, someone has to make up that 0.1 per cent of women who do get pregnant, even though they are consistent with their pill popping. It’s important to talk about it with your partner and discuss what you would do if you became pregnant.

I really hope this helped clear up some of your questions, and feel free to write in again if you have more!

Submit your questions anonymously at and check out “Sex & Pancakes” on Facebook. Need some extra help? You can always contact Concordia Counselling & Development at 514-848-2424 ext. 3545 for SGW and ext. 3555 for Loyola. Got a quick health question? Call info-santé at 8-1-1 from any Montreal number.

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