Alcohol can directly affect many medications, but birth control is not one of them. A person can drink alcohol without worrying that it may reduce the effectiveness of their birth control pill.

However, drinking too much alcohol can indirectly lower the effectiveness of birth control. Alcohol affects judgment, which in turn can lead to risky sexual behavior. It can also affect a person’s ability to use birth control correctly.

In this article, we discuss the risks of drinking alcohol while taking birth control pills.

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Birth control should work in the same way if a person drinks alcohol.

Alcohol does not affect the functioning of the birth control pill.

According to Planned Parenthood, the following forms of contraception will continue to work in the same way if a person drinks alcohol:

  • birth control pills
  • intrauterine devices (IUDs)
  • implants
  • patches
  • vaginal rings
  • the Depo-Provera shot
  • condoms

With correct use, these methods are 91–99 percent effective. The birth control pill would be 99 percent effective if everyone used it correctly all the time. As they do not, it is about 91 percent effective in reality.

If a person drinks so much alcohol that they vomit within 2 hours of taking their pill, it will be less effective. If this happens, they should take another pill as soon as possible and see a doctor for further advice.

Alcohol can also affect a person’s judgment and memory. A person consuming an excessive amount of alcohol may forget to take the pill that day.

Or, if they use the progestin-only pill (POP), they may forget to take it within the proper timeframe. The POP is only effective if an individual takes it within the same 3-hour period every day.

Missing a dose can cause ovulation, which is when an ovary releases an egg.

The 3 days on which a female is most fertile are the 2 days leading up to ovulation and the day it occurs. If they have sexual intercourse with a male during the most fertile days and do not use contraception, they have a 27–33 percent chance of becoming pregnant.

If a person misses a birth control pill and wishes to avoid unintended pregnancy, they should use condoms or another form of contraception in addition to the pill for 4 weeks.

People who take birth control pills metabolize, or process, alcohol more slowly than those not on the pill. This is because the liver has to metabolize both the alcohol and the hormones in the medication.

As a result, alcohol stays in the body for an extended period, and its effects last longer. People also remain intoxicated for longer during their menstrual periods, when the body releases more hormones.

Females typically tend to get intoxicated more quickly than males. This is because their bodies contain less of the enzyme that breaks down alcohol, which is called alcohol dehydrogenase.

Drinking excessive amounts of alcohol carries other risks, especially concerning sexual behavior.

Risky sexual behavior

People who are intoxicated may not use condoms or other contraception to protect themselves against sexually transmitted infections (STIs) or unintended pregnancy. Others may regret their choice of sexual partner.

The authors of a study from 2015 examined the relationship between alcohol and sexual behavior in adults aged 26, 32, and 38. They found that 13.5 percent of men and 11.9 percent of women aged 38 experienced unwanted outcomes following their behavior while intoxicated.

These outcomes included regretting sex, regretting the choice of sexual partner, and not using contraception.

Sexual assault

There is a link between alcohol and sexual assault. A publication released by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) states that approximately 50 percent of people who report sexual assault say that they were drinking at the time of the assault.

The same report states that men who have been drinking alcohol are responsible for 50 percent of sexual assaults.

It is important to note that even if a person has been drinking before someone sexually assaults them, they are in no way to blame. The fault always lies with the perpetrator.

People who are taking the birth control pill and know that they will be drinking should plan accordingly. They could consider:

  • setting an alarm to remind them to take their pill on time
  • taking their pill in the middle of each day, when they are less likely to be drinking
  • carrying a barrier form of birth control, such as condoms, to prevent STIs
  • explaining to their partner that they wish to use condoms as a backup method of contraception while drinking
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A doctor can advise which birth control methods are best.

Many forms of birth control are available. A doctor can provide advice on which is best for an individual.

The Centers for Disease Control and Prevention (CDC) estimate that 62 percent of women aged 15–44 in the U.S. were using contraception between 2011 and 2013. The most common forms between 2011 and 2015 were:

  • the pill (15.9 percent)
  • female sterilization (14.3 percent)
  • male condoms (9.2 percent)
  • IUDs (6.8 percent)

When choosing a form of contraception, a person should decide which factors are the most important to them.

Factors to consider for each method of birth control include:

  • how effectively it prevents pregnancy
  • how effectively it protects from STIs
  • how easy it is to use
  • the effects on menstruation
  • the impact on sexual pleasure
  • how long it lasts
  • whether or not it is reversible
  • the cost
  • the potential side effects
  • whether or not it contains hormones

In the U.S., the pill is the most common form of birth control. It is easy to use and generally regulates periods and reduces menstrual cramping. It is possible to get pregnant soon after stopping the pill.

However, a person must take the pill every day, and it can cause side effects, such as reduced sexual desire. Certain antibiotics and other medications can reduce the pill’s effectiveness.

For those who find it difficult to remember to take the pill every day, a long-term contraceptive device may be more suitable. These devices include IUDs, implants, and injections. A doctor can provide more information and advice.

Alcohol does not reduce the effectiveness of birth control pills. However, the pills amplify the effects of alcohol. This can impair judgment and lead to more risky behavior.

If a person forgets to take the pill or vomits within 2 hours of taking it, they may have an increased likelihood of pregnancy.

When drinking, it is best to take extra precautions to avoid unintended pregnancy. These include drinking alcohol in moderation to avoid vomiting and carrying a backup form of birth control. Condoms are the only method that also protects against STIs.

It may help to set a daily reminder to take the pill or to switch to a more convenient form of contraception, such a vaginal ring or an IUD.