6 common birth control mistakes you might be making and how to fix them, according to OB-GYNs

birth control pill — A common birth control mistake is not taking the pill at the same time every day.
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Common birth control mistakes include missing doses or taking it at different times in the day.
Birth control should also not be used with certain medications or while smoking.
To avoid birth control mistakes, talk to your gynecologist about how to use it properly.
Visit Insider’s Health Reference library for more advice.

There are many different contraception methods available to help you avoid unintended pregnancy, but how well they work depends on how you use them. Here are some of the most common birth control mistakes and how to avoid them.

1. You’re not taking the pill every day

There are two types of birth control pills – combination pills and mini pills. Combination pills contain both progestin (a synthetic form of progesterone) and estrogen, while mini pills only contain progestin. Both need to be taken consistently to prevent pregnancy, says Sophie Yen, MD, CEO and co-founder of Pandia Health, a birth control delivery service.

When used properly, the pill is 99% effective, but that percentage falls when you miss doses, Yen says. If you miss one pill, your risk of pregnancy is still low as long as you take it as soon as you remember. But if you miss two or more pills, Yen recommends using emergency contraception if you’ve had sex in the past five day and either abstaining or using a backup form of contraception, like a condom, for the next seven days.

The dosage of your pill also matters. A 2013 review of 26 studies found individuals who missed one to four consecutive pills had a low risk of ovulation overall. However, those on a lower dosage of about 20 mcg of estrogen were more likely to ovulate after missed doses than those on a 30 mcg dosage.

If you have trouble remembering to take your pill every day, Yen recommends these strategies:

Set a daily alarm on your phone.
Keep pills next to your toothbrush or face wash as a reminder to take them first thing in the morning or before bed.
Put pills on your bedside table next to a glass of water so you can take one when you wake up.

2. You're not taking the pill at the same time every day

When you take your pill also matters. Combination pills don't have to be taken at the same time every day, Yen says, as long as you take them within the same five to six-hour window. For example, if you take your pill at 7 a.m. most days of the week, but not until 10 a.m. on one or two days, you will generally still be protected from pregnancy.

The progesterone-only mini-pill, however, has a shorter window and must be taken within the same three hours every day for maximum effectiveness. The mini pill contains lower doses of hormones than the combination pill, so taking it at the same time is key to maintaining the hormone levels necessary to prevent pregnancy, Yen says.

Setting your pills out in a place where you will see them every day can help you remember to take them. You can also set up automatic reminders with birth control apps or phone alarms.

3. You're taking medication that interferes with birth control

Some medications can interfere with birth control pills and reduce their effectiveness, says Mary Minkin, MD, a clinical professor of obstetrics at the Yale University School of Medicine. These include:

Griseofulvin, an antifungal medication used to treat skin infections
Rifampicin, an antibiotic used to treat tuberculosis
St. John's wort, an herbal supplement sometimes used for depression and anxiety

Before starting any birth control, talk with your doctor about what medications you are on and update them whenever you start a new medication. If you are on rifampicin temporarily, Minkin recommends using a barrier method like a condom until you are off the antibiotic. It is important to discuss with your doctor if you are starting any new antibiotic or medication, to verify that it will not impact your body's ability to metabolize your birth control method.

4. You don't use a condom

Abstaining from sexual activity is the only 100% effective way to avoid unintended pregnancy, and while other contraceptive methods can lower your risk of unintended pregnancy, no method is foolproof.

Using a condom in combination with birth control can further protect you from unintended pregnancy, Yen says. Condoms also protect against sexually transmitted infections while birth control does not.

Yen recommends these tips to remember to use a condom:

Carry them with you in your bag.
Talk openly with your partner about your intention to use one before engaging in sexual activity.
Store them in your nightstand drawer.

5. You're smoking and using contraceptive

Smoking tobacco doesn't make birth control less effective, but it can increase your risk of blood clots, heart attacks, and stroke, especially if you're older than 35. Research is still emerging on how smoking cannabis may interact with birth control.

This is only the case for estrogen-containing birth control options, like combination birth control pills, the patch, or a ring, like the NuvaRing, Minkin says. If you smoke and are using an estrogen-containing form of birth control, you should quit smoking, Minkin says, or switch to a progesterone-only form of birth control, like the mini pill or an IUD.

6. You're misapplying the patch

The birth control patch contains estrogen and progestin to prevent ovulation but is placed on the skin so your body absorbs these hormones.

The patch should be applied on dry, clean skin and not in a place where it might be rubbed, like under bra straps, Yen says. Places where the patch works best include:

Belly
Upper outer arm
Buttocks
Back

Your skin must absorb the hormones for it to be effective, and misapplying the patch could mean less absorption, Yen says. If the edges of your patch peel, it is probably applied incorrectly and may fall off.

Other common patch mistakes include:

Putting it on moisturized skin, which eats away at the adhesive, causing it to fall off, Yen says.
Not refilling your prescription or changing the patch at the right time. A new patch needs to be applied every seven days.

Yen recommends these tips to help you remember when to change your patch:

Mark patch days on your calendar and change your patch on the same day every week.
Keep all your replacement patches in the same place so you don't lose them.

Insider's takeaway

There are many contraception methods available that lower your risk of unintended pregnancy, but they are only effective when used correctly. If you struggle with remembering to use methods like the pill, patch, or condoms, talk with your doctor about long-acting reversible forms of contraception, like an intrauterine device (IUD) or an implant.