How safe is the pill by itself, without condoms?

How about the pill plus the ‘pulling out’ method? Would it be horribly unsafe if the man were to finish inside the woman everytime? (There has got to be a more technical way to say that…)

The reason I’m asking is because once my SO gets on the pill we were throwing around the idea that most of the times we use the pull out method, while during the times in her cycle when she’s not fertile (in theory all the time with the pil but you know what I mean) I get to finish inside her since the idea of that is very arousing for the both of us.
So how safe is the pill, by itself?
(feel free to add anecdotes that are relevant, like how you knocked up your girlfriend thinking the pill was completely reliable)

Under typical conditions, there’s a roughly 5% chance of conception. Perfect use of the pill requires taking it every day at roughly the same time, and not foregoing condoms until it has reached its peak effectiveness. (It takes a few weeks.) With perfect use the chances of conception drop down to around 2%. Other drugs can cause bad interactions and eliminate the effectiveness of the pill, make sure your SO’s doctor is fully aware of every medication and health problem.

I feel sufficiently confident in the Pill to use it in my long term relationship alone, with no condoms (or even withdrawal). Then again, I’m also super-reliable with it; take it every day at the same time, never miss one, etc. There’s still a risk, sure; you have to decide if it’s an acceptable one for you. There’s no such thing as perfect contraception if you’re having penetrative sex, and of course with any birth control pill you have to go in prepared to deal with the consequences if it does fail.

And actually I’ve read that with perfect use the failure rate is less than 1% (for example, here:

The “pulling out” method (if you need to sound clinical, it’s “coitus interruptus”) is almost as effective for contraception as throwing salt over your left shoulder after sex. The pre-orgasmic secretions from the penis are nearly as rich in sperm as the semen itself. Even on an un-aroused penis, some live sperm can be found hanging around like touts at a racetrack. If you are hoping to increase effectiveness over just the pill, you can use spermacidal foam or jelly. The spermacidal sponge is back on the market, too. Spermacides cause irritation in some women, though. Condoms are a good supplement to the pill as well.

(The obligatory warning) Out of all those methods, only condoms are effective against sexually transmitted diseases. Spermacides, in the lab, can kill HIVirus. However, the irritation factor makes the vaginal tissue more vulnerable to infection.

My girlfriend is on implanon, which is basically a slow release (3 years) pill. According to the material that came with it, it had a 100% success rate in clinical trials. I would imagine this is because unlike the pill there’s no element of human error in it.

So we trust it without using other forms of BC and it works very well, thank you very much!

Silentgoldfish: Implanon looks interesting. I think we’ll definitely consider it as an option.

AskNott: Thanks for the technical term. Although, I have to say it sounds a little too hoity-toity for a term basically that means ‘pulling your dick out of the vagina before you come’. =|
And although pulling out by itself is probably a ridiculous and stupid form of birth control, I imagine with amount of semen release during orgasm vs the amount of pre-cum, pulling out would significantly lessen the odds. So I’m tempted to believe pulling out > finishing inside. I mean whatever bit helps. Or is the difference so negligible that it’s not worth it?

I’d say it’s not worth it. Finishing off inside feels so good that it’s worth the micron of added risk.

Another vote for implanon. If your partner is okay on the pill, then most times implanon is pretty okay too.

I’m on my second course (just finished the first 3 year stretch) and I’ve not even had so much as a pregnancy scare. And hubby and I haven’t been using condoms at all during that time.

It’s much better than trying to remember to take a pill at the same time each day, and god forbid you’re ill or on antibiotics at all, because then all bets are off.

Taken correctly, the pill’s effectiveness approaches 0.2% chance of conception per women/year of use (not per occurance of sexual activity).

There are also other hormonal BC options, such are Ortho-Evra, “the patch” which you apply once weekly, and Nuva-Ring, a plastic ring that sits just on your uterus and releases hormones for a month. Supposedly it doesn’t get in the way, you can search the SDMB for discussions on Nuva-ring.

There’s also Seasonale, the BCP system that eliminates your period, except for 4 times per year (once a season, get it?).

I thought the implant (formerly known as Norplant) went off the market in the US?

As for the ol’ anecdotal stories, I’ve been on the traditional pill for 9 years now (sexually active 90% of the time) and never had a scare. Of course, I have a near-religious devotion to taking my pill on time.


When do you get a chance to pay your bills?



<little sister voice>
That’s not what I meant!

Let’s make sure we’re all straight on this - pulling out is NOT a form of birth control at all. There’s probably a whole lot of pregnant teens in the history of the world that could tell you that. Condoms and the pill would be a much better combination.

Just for the record, a woman can get pregnant at any time in her cycle. It isn’t likely, but it is possible. If you’re so concerned about pregnancy that a method with around 1% failure rate isn’t good enough, use condoms as well, every time. Sorry.

Well technically anything that reduced the chance of conception can be considered a form of birth control, just less effective then some other methods, like having her jump up and down a few times after to shake out the swimmers. Remember there is no form of birth control that is totally effective in preventing pregnancy, you are just playign the odds.

Quick question about the “success rates” — what is the regularity of sex when it comes to these rates? Based on sex daily? 4 times a week? During the ‘fertile period’ only?

I mean, lets say I have sex with my g/f every single night for a year (while she’s on the pill - taken religiously ). Is the 1% margin for error the same as someone who has sex 3 days a week and is religiously on the pill? I wouldn’t think so (the 1% would be higher?)… or maybe I’m way off.

The listing is for a “woman year” of use. I’m sure that includes a wide variation in the frequency of sex during that period. But understand that the Pill does not protect “per use” – it is “always on” controlling the fertility cycle and making the implantation of a sperm nigh impossible. So, unless I have my facts all mixed up, the number of times you have sex would be basically irrelevant.

:dubious: Uh… yeah, about that…

Do antibiotics decrease the effectiveness of the pill?

Some do.
Verbatim from my “detailed patient labeling” (comes with every pill pack. I do not consider anyone who has not read the DPL at least once through to have a truly religious devotion to correct pill use)

…4. Drug Interactions
Certain drugs may interact with BCP to make them less effective in preventing pregnancy or cause an increase in breakthrough bleeding. Such drugs include rifampin, drugs used for epilepsy such as barbituates (for example, phenobarbitol) and phenylintoin (Dilantin is one brand of this drug), penylbutazone (Butazolidin is one brand) and possibly certain antibiotics. You may need to use an additional method of contraception during any cycle in which you take drugs that can make oral contraceptives less efftive

The DPL also has interesting information on effectiveness stats, explains what to do if you miss a pill, and discusses risks and side effects.

Norplant and implanon are two different implants, IIRC.