Birth control and pregnancy risks

Let’s get one thing straight right out of the gate so we can skip the inevitable assumptions—no, I am not pregnant. I have zero doubts about my ability to conceive, but I was chatting with a friend the other day, and since we both take Yasmin, our conversation drifted toward this specific question:
Do you think there’s any actual chance of getting pregnant while taking the pill perfectly? We were brainstorming possibilities, like—say, if someone has some sort of digestive issue they don't even notice, and for some reason, the hormones aren't being absorbed into the bloodstream properly?
That was really the only theory we could come up with.
Look, I know, everything is laid out perfectly in that little pamphlet you get with the prescription, but honestly, when you spend any time scrolling through forums, you always run into someone mentioning a friend—or even their own experience—of getting pregnant while on birth control. And let me be clear: I’m not talking about the obvious stuff, like forgetting a pill or finishing half a pack and then acting shocked when it fails. I’m asking what you all think about the specific scenario I just described.

quietangler89 said:Let’s just get one thing straight right off the bat so nobody starts jumping down my throat—no, I am not pregnant. And honestly, I have zero doubts about whether I *could* be if I wanted to. It all started when I was grabbing coffee with a friend the other day, and since we both happen to be on Yasmin, the conversation just drifted into this weird territory:
Do you guys think there's actually a chance of getting pregnant while taking the pill perfectly? Like, we were brainstorming ways it could fail, and we wondered if something like an upset stomach or some digestive issue could mess with absorption without you even noticing, so the hormones don't hit your bloodstream quite right?
That was pretty much the only theory we could come up with.
Look, I know, I know—everything is laid out perfectly in that little pamphlet they give you with the prescription. But let's be real; when you're scrolling through forums like this, you always run into someone mentioning a friend, or even a girl they know personally, who ended up pregnant despite being on birth control. And I'm not talking about those obvious cases where someone forgets a pill or finishes half a pack and then acts shocked when they get pregnant. No, I mean that specific scenario I mentioned above. What do you all think about that possibility?

Well... even the pill isn't 100% foolproof, so there's always a theoretical chance. 😁

When it comes to pills, just like any other method, no expert or scientist is going to claim they are 100% safe.
At most, you’re looking at 99.9%. That leaves that 0.1% margin—and damn it, someone is always going to end up in that percentage.

Vasectomy isn't even 100% foolproof.🙂

quietangler89 said:If you dig through any forum, there's always some lady bringing up her "friend" or talking about someone she knows who got pregnant while on birth control.

I know I did my part. I took every single pill right on time, didn't throw up, didn't have diarrhea, and wasn't taking anything else that would mess with the effectiveness. Everyone else's stories seem pretty much like lies to me.😬

Sure, it can happen, but I think it happens way less often than all these women make it sound.

Look, according to this, theoretically, one in a thousand women on the pill might get pregnant within a year, but in the real world, it's closer to one in a hundred.

Man, how many people actually manage to avoid pregnancy for years just by using withdrawal?
I’m concluding there’s clearly an underlying factor beyond just the numbers. I know couples where that method worked flawlessly for years without a single accidental pregnancy, yet others get pregnant after only six months.
My take is that some men release sperm in their pre-ejaculate while others don't.
So, in my opinion, the statistics here are questionable.

With birth control pills, pregnancies usually happen when someone misses a dose or deals with something like vomiting or diarrhea.
There is almost always a rational explanation.

From what I understand, birth control pills work by preventing ovulation and stopping a fertilized egg from implanting in the uterus.
Essentially, you’d need ovulation, fertilization, and then implantation to all fail simultaneously—so many things have to go wrong for a pregnancy to occur if they are taken correctly.
Logic tells me the chances are astronomically low.

Carol Brooks41 said:Man, I honestly can't wrap my head around how many people spend years successfully dodging a pregnancy just by relying on pulling out!

And how many others were left pregnant after an interrupted act? 😕 I can give you endless examples just from my own neighborhood. (And honestly, here we go again—how long was the sexual encounter actually interrupted, and so on and so forth...)

Carol Brooks41 said:From what I’ve gathered, birth control pills work by essentially shutting down ovulation and making sure a fertilized egg can't even think about nesting in the uterus.
Look, you have to realize there are so many moving parts here. First, you need ovulation, then fertilization, and then the embryo actually has to implant. There are just so many things that can go wrong—so many points where the whole process could just fail—for a pregnancy to actually take hold. And that’s assuming everything is being taken exactly as prescribed, too.
Common sense tells me the odds are astronomical.

Exactly. What you said is spot on—that’s precisely how those pills work. But look, what happens if you're dealing with some kind of digestive issue? I'm not talking about the obvious stuff like vomiting or diarrhea, but something more subtle that doesn't even show clear symptoms. Like I mentioned before, if the gut isn't functioning right, those tablets just aren't going to absorb into your bloodstream the way they're supposed to. It's a massive flaw in the process.
Look, my question comes in a few different flavors because, let’s be honest, it’s nearly impossible for any digestive issue to pass without throwing out some symptoms. But hey, you never truly know until you do.

On the other hand, a friend of mine dropped some info on me that she supposedly picked up back in nursing school. Honestly? It sounds a bit far-fetched to me. She’s claiming that you can actually become "addicted" to contraceptive pills, to the point where they eventually stop working properly. I don't know about that.🤷 It’s like how your body eventually just gets used to whatever pills you're popping. You take them long enough, and suddenly they don't even touch the problem anymore. Your system builds up a tolerance, and then what? You're left with a medication that's basically useless against the very illness you're trying to fight.
Look, I think that whole theory is just plain stupid. These pills aren't even antibiotics; there aren't any microorganisms in them that they need to kill off. What we’re actually doing is pumping a specific dose of synthetic hormones into our systems every single day just to trick the body into a fake state of pregnancy.

quietangler89 said:How many women end up pregnant just from pulling out? 😕 I can give you endless examples from my own circle. (And again—how much of a "pull out" was it really, and when exactly did it happen?)

Yes, what you said is spot on regarding how the pills work. But what if there’s an underlying digestive issue (not counting diarrhea or vomiting) that doesn't show obvious symptoms, causing the pills to not absorb properly into the bloodstream as they should?
My question has several angles; it's hard to have a digestive issue without symptoms, but you never know.

On another note, a friend told me something she supposedly learned in nursing school, though it sounds unrealistic to me: that you can actually get "used to" birth control pills, and they eventually stop protecting you effectively.🤷 It's like how the body adapts to certain medications over time until they no longer help with a specific condition.
Personally, I think that theory is nonsense. These aren't antibiotics; there are no microorganisms involved. You're just taking a daily dose of synthetic hormones to mimic pregnancy.

True, but most of them end up pregnant because things just didn't go perfectly.
Whether we're talking about pulling out or the pill, I'm referring to cases where everything is done correctly—meaning the pill was taken on time without health issues, and the withdrawal was timed perfectly.
Obviously, once you factor in human error, all those theories fall apart.

That idea about getting used to the pills might be true, though I don't know if it's actual "habituation" or something else—but it seems to apply after age 35 or even later.
In those older age groups, doctors recommend different contraceptive methods precisely because the pills might lose their effectiveness.
I just don't know the exact reason why.

A friend of mine actually managed to get pregnant while she was on Cilest because of her hyperthyroidism. Basically, if you’re dealing with a major hormonal imbalance—like those thyroid issues—and you aren't strictly sticking to the pill every single day, there's definitely a chance it won't work.

Carol Brooks41 said:Sure, but when you actually talk to most of them, they end up pregnant anyway because there's always a little bit of failure in the system.
As for withdrawal or the pill, I already laid out my thoughts regarding cases where everything goes perfectly—meaning the pills are taken right on schedule without any health complications, and the withdrawal is timed correctly.
It’s obvious that once you start making mistakes, all the theoretical effectiveness just goes out the window.

That point about getting used to the pill is true, though I can't say for sure if it's actual physiological adaptation or something else—but it seems to apply once you hit 35 or even later.
In those older age brackets, doctors suggest switching to different contraceptive methods specifically because the pill might lose its efficacy.
But honestly, I have no clue why that happens.

The issue isn't really about whether they work, it's about the increased risk of breast cancer. There used to be a lot of hypotheses about them being harmful, but according to every gynecologist I've spoken to (four of them, to be exact), those theories have been debunked. Some have even told me you can stay on them right up until menopause without an issue. Still, after I have my baby, I plan on getting an IUD. I have several reasons for that, the biggest being my endometriosis, and the fact that the hormones released over three years will eventually make my periods disappear. Then there's the financial side of things; you can get an IUD covered by Medicare, so you don't have to stress about the cost for the next three years.

Angela Wright said:It isn't actually about effectiveness; it's about the supposed breast cancer risk. There used to be hypotheses suggesting they were harmful, but according to all the gynecologists I've consulted—four of them, to be exact—those claims have been debunked. I've even been told you can use them without issue right up until menopause. Regardless, I plan on getting an IUD after I give birth for several reasons. My endometriosis is a major factor, and since the hormones are released gradually over three years, it eventually stops my period entirely. Then there's the cost; you can get the IUD covered by Medicare, so you don't have to stress about the expense for the next three years.

No, that's not it. I've heard those same "hypotheses" regarding breast cancer too.

I remember reading something about oral contraceptives losing their efficacy, but honestly, I can't recall where or what the specific details were.

I have an enlarged thyroid. There haven't been any signs of hyperthyroidism yet and my hormone levels have stayed normal, but I'm definitely going to start monitoring them more regularly from now on.

Angela Wright said:A friend of mine actually got pregnant while on Cilest because of hyperthyroidism. Basically, if there’s a major hormonal imbalance—like thyroid issues—and she isn't strictly following the schedule, there's a chance.

I know this is off-topic, but did she happen to have any hyperthyroid symptoms?

Carol Brooks41 said:I know we're off-topic here, but do you happen to know if she showed any signs of hyperthyroidism?

Yeah. It was textbook: hand tremors, racing heart, a visible swelling in her neck... She knew something was up, but she was taking birth control for entirely different reasons. After surviving lymphoma, doctors told her she’d likely never be able to have children because her natural cycle was completely shot—she was basically relying on those pills just to stay functional rather than for protection. And then, against all odds, a miracle happened.
Bottom line: when you're getting bloodwork done for hormones before starting a pill regimen, it wouldn't hurt to have them check your thyroid levels too.

Angela Wright said:A close friend of mine actually got pregnant while on Cilest because she was dealing with hyperthyroidism. Basically, if there’s a major hormonal imbalance—like thyroid issues—and she isn't being consistent with her medication, there's still a chance.

So, did she actually give birth despite being on the pill?
And was the baby healthy? No complications at all?

quietangler89 said:So she just had the baby despite being on the pill?
A healthy baby, no issues at all?

I don't believe birth control causes fetal disorders.
It's just standard hormones already present in the body; I fail to see how they would cause defects.

quietangler89 said:So she actually went through with the pregnancy despite being on birth control when she conceived?
Was the baby healthy, without any issues?

The baby is perfectly healthy and absolutely adorable😍. Honestly, the bigger concern was the chemo and radiation doses she had to endure during her illness about 12 years ago. From the very moment she found out she was pregnant, she was under constant medical supervision to make sure everything was developing exactly as it should.

Carol Brooks41 said:I don't think birth control pills cause fetal abnormalities.
They're just standard hormones that already exist in the body; I have no idea why they would trigger any kind of issues.

It is entirely possible for developmental degeneration to occur during the early stages of pregnancy, particularly if you're dealing with an extremely high hormonal dose.

Angela Wright said:Fruit development can degenerate during early stages if hormone doses are excessively high.

Sure, but most pills on the market today use very low dosages.
Besides, if someone is taking high concentrations for specific medical reasons, doctors already know exactly when to watch for potential malformations.

Basically, I'm saying there's no reason to assume the child won't be healthy.
The instructions on my birth control pills explicitly state that if you get pregnant while taking them, there's no reason for an abortion.

Angela Wright said:The kid is perfectly healthy and absolutely adorable😍. The real issue was the sheer amount of chemo and radiation they had to endure during their illness twelve years ago. From the very first day she found out she was pregnant, she was diligent about monitoring everything and making sure the baby developed properly.

Oh, fantastic. Just great! 😉
I mean, I was already thinking along those lines when I brought up that critical early stage of development...
You just can't play games when it comes to potential malformations.

So, I have hypothyroidism and I've been dealing with mild nausea for a few days... then last night I actually threw up. Now I'm starting to panic. 😱 🙂

Great. 😱

I’ll pin this on Yasmin (which I take regularly, though I know I’m about an hour off schedule sometimes)... anyway, this is my first box, well, near the end of it... (I used Diane before and never had any side effects).

I did ask my uncle—who I see all the time for thyroid checkups—if Euthyrox affects birth control, and he said no. My GP gave me the exact same answer...

And here's my biggest mistake... I didn't bother asking my OB-GYN what she thinks. 😵

Yeah... now I'm just sitting here overthinking everything. 🤔

Are you taking anything for hyperthyroidism?
I tend toward hyperthyroidism myself—my hormone levels are technically within the normal range, but they’re hovering right at the upper limit.

If you've only been on the medication for a month, what you're feeling is likely just side effects.