Alcohol and Birth Control

Birth control pills are the leading form of contraception for American women. Some people are wondering whether or not alcohol and birth control pills are compatible. Actually, you can drink alcohol when you're on the pill. But there're rules to bear in mind: when you stop taking the pills in order to get pregnant, you should stop drinking alcohol at the same time. Most often, you won't know that you're pregnant until you're four to six weeks along, and could be exposing the embryo to alcohol, leading to serious birth and life-long defects in the child.

Can You Drink Alcohol While on Birth Control Pill?

Combining alcohol and birth control pills does not reduce the effectiveness of the pills in preventing unwanted pregnancy. However, it may increase your risk of pregnancy in the following ways.

First, if you're drunk, chances are you'll forget to take your pills at the right time. Birth control hormones reduce the liver's ability to metabolize alcohol, therefore increasing your blood alcohol levels and making you drunk quicker than you expect. You can easily ignore your pills when you're bothered by the sickness and dizziness after heavy drinking. If you take them in the morning, you may oversleep your designated time. Therefore, devise a plan so that you don't forget to take your birth control pills. Should you forget, use other protection for at least a month.

Secondly, if you have taken your pill, then get drunk and throw up within two hours of taking the pill, it will not have had time to be absorbed into your body and be effective.

If you're prone to drinking a lot and are still worrying about the effectiveness of birth control pills, here are some long-term birth control methods that you can try.

What Can Reduce the Effectiveness of Birth Control?

1. Missing a Pill or Wrong Timing

Missing a pill is the most common reason for the pill to fail, especially during the first week of pills after the placebos. If you leave a gap between the end of one pack and the beginning of the next one, you may have a higher risk of pregnancy. Also, some birth control pills (progestin-only pills or mini-pills) can be very time-sensitive and you need to take them at the same time everyday. Use backup for 48 hours after a late or missed mini-pill.

2. Digestive Disorders

Conditions like IBD and Crohn’s disease may prevent the body from properly absorbing oral birth control pills. If you've had serious diarrhea or vomiting for two or more days, use backup methods as though you've just missed a pill. For women with chronic bowel conditions, a non-oral contraception may be more preferable. 

3. Interaction with Other Medications or Herbs

Some epilepsy medications to prevent seizures can increase the rate at which the liver breaks down hormones. Therefore, hormonal birth control options can all be affected. Moreover, some antibiotics, such as rifampicin and rifabutin, can interact with birth control. If you take medicines for HIV, such as protease inhibitors (PIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs), your hormonal birth control pills may fail to work. Herbal supplement like St. John's wort which can be taken for anxiety and depression may also increase the breakdown of estrogen.

What Medications Can Interact With Alcohol?

Although alcohol and birth control pills don't interact with each other, some medications can't be taken together with alcohol.

1. Antidepressants

The combination of alcohol and antidepressants actually increases depression. Of the two classes of antidepressants, the ones called monoamine oxidase inhibitors have the worst interaction with alcohol, causing a dangerous rise in blood pressure. The other class, known as selective serotonin reuptake inhibitors, is less likely to cause an adverse interaction with alcohol.

2. Blood Pressure and Heart Medications

The effectiveness of beta-blockers which are used by those who've had heart attacks, chest pain, or abnormal heart rhythm, can be largely decreased by alcohol consumption. Angiotensin-converting enzymes or ACE inhibitors which are used for hypertension, strokes and heart attack can't be taken with alcohol either. Alcohol consumption can cause the blood pressure to drop too much, causing dizziness, lightheadedness, or even fainting.

3. Cholesterol Lowering Medications

Cholesterol-lowering medications such as Crestor and Lipitor, known as statins, are top-sellers in the US. It's best to limit alcohol consumption to one drink per day for women and two for men if you are on a statin drug. One drink equals twelve ounces of beer, one and a half ounces of liquor, and five ounces of wine. Statin drugs potentially cause liver damage. Combine that with heavy drinking, and your liver will take a beating that it won't recover from.

4. Diabetes Medications

Metformin, a common diabetic medication, has been connected to a rare, but potentially serious side effect in heavy drinkers. It raises the buildup of lactic acid in the blood, and may cause weakness and nausea. Other diabetic medications such as glimepiride and sulfonylureas can interact with alcohol too, causing seriously low blood sugar, dizziness, flushing, and nausea. If you must drink, eat something before or while drinking to moderate your blood sugar levels.

5. Gastro-Esophageal Reflux and Ulcer Drugs

Similar to alcohol and birth control pills, there seems to be no adverse interaction between alcohol and proton pump inhibitors which are commonly used to treat acid reflux and heartburn. However, alcohol causes the muscle between the esophagus and stomach to relax, increasing acid reflux and causing heartburn. Alcohol also slows down the healing of ulcers. 

6. Pain Killers

Mixing alcohol and pain medications, prescription or OTC, should be done with great care and knowledge. Taking acetaminophen while drinking in moderation is generally safe, however, excessive use will cause liver damage. Aspirin and ibuprofen can safely be taken in small amounts with alcohol, but remember that both the pain meds and alcohol cause stomach irritation. Combining the two can lead to stomach ulcers or bleeding.

7. Sleeping Pills

Mixing alcohol with sleeping pills can be dangerous, as the alcohol increases the effects of the sleep meds. The combination depresses parts of the brain, causing extreme sleepiness and dizziness. These symptoms raise the ante on the risk of car accidents or falls. Taking sleeping pills and drinking can also cause a severe drop in blood pressure and lead to impaired breathing. If you must drink, take your last drink at least six hours before bedtime and the time you take your sleeping pills.

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