Do You Need Emergency Contraception After Missed Birth Control Pills?

Emergency contraceptive pills

After taking the combined oral contraceptive pill (21-day regimen) for three packs (three months), I stopped taking it on March 15, with my period starting on March 17.
This Tuesday (March 22), I was supposed to take a new pack at 10 AM but forgot and took it at 1 AM on Thursday (about 39 hours late).
I took two pills that morning and resumed taking one pill at 10 AM on Thursday (March 24).
That Thursday evening at 7 PM, I had unprotected intercourse, and I'm concerned about the effectiveness of the pill.
Should I take emergency contraception? I have been regular with my periods, almost every 28 days, and it seems like I was in the safe period, but I still have doubts.

Niming, 20~29 year old female. Ask Date: 2016/03/26

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it may not be necessary if your period is late by more than a week.
It is recommended to see a gynecologist.
Wishing you good health.

Reply Date: 2016/03/26

More Info

When it comes to missed birth control pills and the need for emergency contraception, it's essential to understand how hormonal contraceptives work and the implications of missed doses. In your case, you were on a 21-day birth control pill regimen and missed taking your pill for approximately 39 hours. This lapse in taking your contraceptive can potentially reduce its effectiveness, especially if it occurs during the first week of a new pack.

The general guideline for combination birth control pills (which contain both estrogen and progestin) is that if you miss one pill, you should take it as soon as you remember. If you miss two or more pills, especially in the first week of a new pack, you may need to use backup contraception (like condoms) for at least seven days. Since you had unprotected intercourse after missing a pill, there is a possibility of pregnancy, depending on where you were in your cycle and the timing of ovulation.

Given that you had unprotected intercourse on the evening of March 24, and considering that you missed a pill earlier that week, it would be prudent to consider taking emergency contraception (EC). Emergency contraception is most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours, but some forms can be effective up to 5 days after.

It's also important to note that while you mentioned your menstrual cycle has been regular and you believe you were in a "safe" period, ovulation can vary, and sperm can survive in the female reproductive tract for up to five days. Therefore, if ovulation occurred shortly after your missed pill, there is a risk of pregnancy.

In summary, given the circumstances of missing a pill and having unprotected intercourse, it is advisable to take emergency contraception to reduce the risk of unintended pregnancy. Additionally, you should continue taking your birth control pills as scheduled after this incident, and consider using a backup method (like condoms) until you have taken your pills consistently for seven days.

Lastly, if you have any concerns about your contraceptive method or experience any side effects, it would be beneficial to consult with a healthcare provider who can offer personalized advice and support. They can help you navigate your options and ensure that you are using the most effective method for your needs.

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