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Birth Control and Alcohol: Risks, Effects, and Safety

3 min read · 6 sections

A recent national survey found that, from 2017 to 2019, 65.3% of American women aged 15–49 were currently using birth control.1 In 2020, an estimated 66.9% of women aged 18 and older reported past-month alcohol use.2

Since the majority of adult women use birth control and also drink alcohol, some may be concerned about whether drinking alcohol impacts the effectiveness of their contraception efforts.

This article discusses how alcohol may affect birth control, explores whether it is safe to drink alcohol on birth control, and reviews things that woman may want to consider when using both alcohol and contraceptives.

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How Does Alcohol Affect Birth Control?

Birth control (contraception) refers to any medication, device, or method used to prevent pregnancy, including intrauterine devices (IUDs), contraceptive injections, pills, patches, condoms, and other short-term or long-term methods.3,4

Overall, alcohol has not been found to reduce or change the efficacy of birth control; however, it’s important to remember that alcohol can impair a person’s judgement and may alter behavior as a result. This may interfere with any form of birth control that requires consistent compliance and consumption. For example, being under the influence of drugs or alcohol may make a person forget to take a pill or change a ring.  Alcohol use may also lead to the ineffective or inconsistent use of condoms, which not only increases the risk of unplanned pregnancy but also of sexually transmitted infections. Binge drinking problems and risky drinking, according to one study, increased the odds of ineffective contraception (whether it was a condom or a scheduled pill) by 1.7 times.

Another way intoxication may affect birth control is if you vomit after drinking too much within two hours of taking your pill, it may not have the chance to be absorbed by your body, and this may reduce its effectiveness.5 On the other hand, birth control can affect a person’s tolerance to alcohol. In fact, hormonal birth control can slow down the rate at which alcohol leaves the body and cause a person to feel the effects of alcohol longer.6 As they continue to drink, alcohol accumulates in the body and increases their blood alcohol level.6

In addition, heavy alcohol intake, including binge drinking is associated with greater risk of developing medical complications affecting the blood, such as blood clots in the lungs or legs.7 Some women may also be at higher risk for developing a blood clot while using hormonal birth control, so heavy or binge alcohol might increase that risk.8 Overall, drinking heavily while also taking birth control or other medications should always be discussed with a physician.

Is It Safe to Drink Alcohol on Birth Control?

In general, it is safe to drink alcohol while on birth control, however, there are some important considerations to be aware of. Alcohol has been found to leave the body slower in women on birth control.9 For instance, alcohol may interfere with a person’s ability to think clearly and move with coordination, and this may cause a person to misuse or even neglect to use contraceptives such as condoms.10,11 This may not only increase their risk of pregnancy but can also increase their chance of acquiring sexually transmitted diseases and infections (STDs/STIs).

If you take birth control pills, drinking too much may cause you to forget or miss taking one of your pills. Though missing one dose may not cause too much of an issue, as long as you take the missed pill as soon as possible, missing multiple doses can cause your birth control to be ineffective and lead to pregnancy.12 If you become pregnant and continue to drink, you could be placing your unborn child at risk for developing serious medical complications.13

Types of Birth Control & Alcohol’s Influence on their Effectiveness

There are many forms of birth control available to help prevent pregnancy, and several are at least 99% effective. Abstinence from sex is the only 100% effective way to ensure that you do not become pregnant.3,14 Some of the common types of birth control, along with their rates of effectiveness, include:5,14

  • IUDs: More than 99% effective and can stay in place for 3–10 years; alcohol use typically does not reduce effectiveness.
  • Implants: More than 99% effective when used correctly and work for up to 3 years; alcohol use typically does not reduce effectiveness.
  • Injection: Around 99% effective when used correctly (around 94% typically) and can last up to 3 months; alcohol use typically does not reduce effectiveness.
  • Patch: More than 99% effective when used perfectly (around 91% typical use) and three patches can last up to 3 weeks; alcohol use typically does not reduce effectiveness but may interfere with weekly compliance.
  • Vaginal ring: More than 99% effective when used perfectly (around 91% typical use); alcohol use typically does not reduce effectiveness but may interfere with compliance as the ring must be removed after three weeks and then a new one inserted the following week.
  • Combined/Progestin-only pill: More than 99% effective when used perfectly (91% typical use); alcohol use typically does not reduce effectiveness but may interfere with daily compliance.
  • Male Condom: Is 98% effective when used correctly (82% typical use); alcohol use may reduce effectiveness as there is increased likelihood of incorrect use or neglecting to use.

What to Consider when Drinking on Birth Control

Whether you are already using contraception or trying to find one that works for you, it is important to talk to your doctor or pharmacist to ensure proper use. Your doctor or pharmacist will be able to answer other questions you may have about other potential risks of drinking alcohol while on birth control, for example if you have any underlying health issues such as liver disease or blood clots.4 It is also important when choosing to drink alcohol that you consider the safety, availability, and accessibility of your birth control since alcohol use may lead to noncompliance with contraception requiring daily or weekly attention or ineffective contraception device use.11 Although alcohol does not typically reduce the effectiveness of contraception, drinking too much, whether in one sitting or over time, can have a serious impact on someone’s health.

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Sources

  1. Daniels K, Abma JC. (2020, October). Current contraceptive status among women aged 15–49: United States, 2017–2019. NCHS Data Brief, no 388. Hyattsville, MD: National Center for Health Statistics.
  2. National Institute on Alcohol Abuse and Alcoholism. (2021, June). Alcohol use in the United States.
  3. Office of Women’s Health. (2019, February 14). Birth control methods.
  4. U.S. Food and Drug Administration. (2021, June 18). Birth control.
  5. Planned Parenthood. (2015, June 22). Does drinking alcohol affect how well my birth control works?
  6. University of California, Davis. (2019, June 14).
  7. Ballard, H. S. (1997). The hematological complications of alcoholism. Alcohol health and research world, 21(1), 42-52.
  8. Shen, C. J., Kao, C. H., Hsu, T. Y., Chen, C. Y., Lin, C. L., & Shih, H. M. (2017). Effect of alcohol intoxication on the risk of venous thromboembolism: A nationwide retrospective cohort study. Medicine96(42), e8041.
  9. Jones, M. K., & Jones, B. M. (1984). Ethanol metabolism in women taking oral contraceptives. Alcoholism, clinical and experimental research8(1), 24–28.
  10. National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol’s effects on the body.
  11. Ochieng, E. O. & Arude, J. (2021, April 13). Influence of substance abuse on contraceptive use among undergraduate students. International Journal of Advanced Research, 9, 965-970. (ISSN 2320-5407).
  12. Cornell Health. (2019, October 18). Missed a birth control pill? Here’s what to do.
  13. Centers for Disease Control and Prevention. (2016, February 2). More than 3 million US women at risk for alcohol-exposed pregnancy.
  14. North Carolina Department of Health and Human Services. (n.d.). Food and Drug Administration (FDA) approved methods of birth control.

 

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