Antidepressants & Birth Control: Risks & Safe Use

Question
I recently went to my obgyn to get on the pill-I have been off for several years. She gave me Loestrin24fe as due to my age (39) I need less estrogen. After reading the pamphlet at home regarding conditions which your doctor should be advised of I called and told her that I was on antidepressants and one antibiotic, and she said they were strong drugs and that I should always have my partner wear a condom as back up. Do you know statistically what the odds are when women on the pill and antidepressants have sex without a condom? My partner finds them very uncomfortable. And could you describe the rhythm method so that I could use that in place of the condom-or if you have any recommendations of condoms that are less uncomfortable that would be great too. Thanks!

Answer
Hi Karen,

It is usually antibiotics that counteract the effects of the pill, so if you are on a regular antibiotic you should probably use a back up method. Antidepressants usuall have no effect so I dont think that was what your doctor was referring to. However, it is not all antibiotics, only a certian kind, so you will need to check with your doctor which one it is. Yes, it is very complicated when other drugs are involved, but if you do not want to become pregnant you should figure out exactly how the drugs interact. Perhaps call your local planned parenthood or family planning clinic and get their advice as they are experts on this kind of medicine.

As for needing a birth control without estrogen, have you considered Depo-provera? This a a hormone shot injected once every 3 months (so only 4 times per year and much less hassle than taking a pill every day. Have a look at this info sheet and then talk to your doctor about it.

http://www.optionsforsexualhealth.org/node/43/

I would recommend this more than using the rhythm method because if you are on the pill the rhythm method will not be very accurate as your ovulation will not be cyclical. If the pills are working you should have no ovulation at all, but if they are interfered with with the other drugs you are on then ovulation could occur at any time.

The other option is to stay on the pill but experiment with using different condoms until you find one you like. There are also other barrier methods such as the female condom and the diaphragm or cervical cap.

Good luck with this,
Allison