Essential Guidelines for Taking Emergency Contraceptive Pills

Q: Essential Guidelines for Taking Emergency Contraceptive Pills

Hello, the inquirer：<br>1. <br>Oral contraceptives must be taken consistently at the same time every day to be effective, especially during the first 12 days of use, as missing doses can reduce contraceptive efficacy. <br>Typically, they are started on the fifth day of the menstr

How to take emergency contraceptive pills?

Hello Doctor: I would like to ask about the precautions for taking birth control pills for the first time.
1.
Do I have to start taking the birth control pills on the first day of my period? 2.
If I have sexual intercourse (with a condom) before my period starts, should I take the birth control pills immediately or can I wait until the first day of my next period to start? 3.
If I do not plan to get pregnant but have sexual intercourse (with a condom), do I need to continue taking the birth control pills consistently? Thank you for taking the time to respond!

Michelle, 20~29 year old female. Ask Date: 2016/04/07

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the inquirer:
1.
Oral contraceptives must be taken consistently at the same time every day to be effective, especially during the first 12 days of use, as missing doses can reduce contraceptive efficacy.
Typically, they are started on the fifth day of the menstrual cycle (some products recommend starting on the first day, depending on the product).
For a 21-pill pack, take one pill daily in the order of the pill dates for 21 consecutive days.
The withdrawal bleed will occur during the 2nd to 4th day of the 7-day break.
For a 28-pill pack (where the last 7 pills are placebo), menstruation will occur during those last 7 days, so you should start the next pack immediately after finishing the 28-pill pack.
If you forget to take a pill one day, it is best to take it as soon as possible within 12 hours, and continue taking the regular pill for that day (taking two pills that day).
If you forget for two consecutive days, you should take two pills each day for the next two days, then resume taking one pill daily until the pack is finished.
If you miss three or more days, the contraceptive effect for that month is compromised, and you should stop taking the remaining pills, wait a few days for your period to start, and then begin a new pack on the first day (or the fifth day) of your next menstrual cycle.
2.
For the second question, I recommend using emergency contraception, as the failure rate of condoms is relatively high at 5-10%.
3.
It is not advisable to rely solely on condoms for contraception; it is better to use methods with lower failure rates, such as oral contraceptives or intrauterine devices.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2016/04/07

More Info

When it comes to emergency contraceptive pills (ECPs), it's essential to understand their purpose, usage guidelines, and the timing of administration. Here are some essential guidelines for taking emergency contraceptive pills, along with answers to your specific questions:
1. Timing of Administration: Emergency contraceptive pills are designed to prevent pregnancy after unprotected intercourse or contraceptive failure (e.g., a broken condom). They are most effective when taken as soon as possible after the incident, ideally within 72 hours (for most types) or up to 120 hours for some formulations like ulipristal acetate (ella). It is crucial to note that ECPs are not the same as regular contraceptive pills and are not intended for routine use.

2. Starting ECPs: You do not need to wait for your menstrual cycle to start taking emergency contraceptive pills. If you have had unprotected sex or contraceptive failure, you should take the ECP as soon as possible, regardless of where you are in your menstrual cycle. If you are already on regular birth control and experience a failure (like a missed pill), you should follow the guidelines provided by your healthcare provider regarding the use of ECPs.

3. Using ECPs with Regular Contraceptives: If you are using condoms and have not had any contraceptive failures, you do not need to take emergency contraceptive pills regularly. ECPs are intended for occasional use in emergencies, not as a substitute for regular contraceptive methods. If you find yourself frequently needing emergency contraception, it may be worth discussing with your healthcare provider to explore more reliable long-term contraceptive options.

4. Regular Contraceptive Pills: If you are considering starting a regular contraceptive pill regimen, it is generally recommended to begin taking them at least seven days before engaging in unprotected intercourse for them to be effective. Some formulations allow for immediate effectiveness if started during the first day of your menstrual period.

5. Consulting Healthcare Providers: If you have any concerns about your contraceptive methods or if you find yourself needing emergency contraception frequently, it is advisable to consult with a healthcare provider. They can help you assess your contraceptive needs and suggest the most appropriate method for your lifestyle.

6. Side Effects and Considerations: While ECPs are generally safe, they can cause side effects such as nausea, fatigue, headache, and changes in your menstrual cycle. If you experience severe side effects or if your period is more than a week late after taking ECPs, you should take a pregnancy test and consult a healthcare provider.

In summary, emergency contraceptive pills are a safe and effective way to prevent pregnancy after unprotected intercourse. They should be taken as soon as possible after the incident, regardless of your menstrual cycle. If you are using regular contraceptives and have had no failures, there is no need to take ECPs regularly. Always consult with a healthcare provider for personalized advice and to explore the best contraceptive options for your needs.

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