How to tell if BCP aren't as effective..

Ok I hate to ask a stupid question, but here goes.. The dietitian of all people told us we need to use a back-method because BCP aren't as effective after WLS.. without actually getting PG .. is there any other ways to tell. For example.. whenever I have to talk anti-biotics I have break through bleeding because the ant-biotic makes the BCP less effective.. so can I rationalize that since everything is right on track with the Pill that things are OK? We are BOTH infertile and that's why we are trying to lose weight and the whole 89 types of protection isn't exactly helping the sex life..any opinions here?

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