Do You Need Extra Contraception After Missing a Pill?

Q: Do You Need Extra Contraception After Missing a Pill?

Hello： (1) The mechanism of action of emergency contraceptive pills is not fully understood. <br>The negative feedback effect of hormones suppresses the secretion of ovulation-stimulating hormones, preventing follicular development. <br>Additionally, contraceptive pills cause the

If you have a break of 7 days from taking the oral contraceptive pill and engage in unprotected intercourse, there is a risk of pregnancy?

Hello, doctor.
I have been taking the Alesse contraceptive pill regularly for about six months, usually at 11 PM.
However, I forgot to take it on the night of August 18 and took it at 1 PM on August 19 instead.
I also took my regular dose that night.
Do I need to use additional contraception for the next seven days after August 19?

Mei, 20~29 year old female. Ask Date: 2016/08/20

Dr. Yang Wangjun reply Obstetrics and Gynecology

Hello: (1) The mechanism of action of emergency contraceptive pills is not fully understood.
The negative feedback effect of hormones suppresses the secretion of ovulation-stimulating hormones, preventing follicular development.
Additionally, contraceptive pills cause the endometrium to become unsuitable for implantation and thicken cervical mucus, making it difficult for sperm to enter.
When the pills are stopped on day 21, the endometrium sheds and bleeding occurs, thus making implantation unlikely during the 7 days off the medication, which also provides contraceptive effects.
Generally, it is not recommended to use additional contraception during these 7 days.
(2) As for forgetting to take a pill for one day, if the missed pill has already been taken, the hormone levels in the blood should be sufficient, and you can continue taking the pills as usual.
Thank you for your message!

Reply Date: 2016/08/20

More Info

When it comes to missing a birth control pill, it's important to understand how it can affect your contraceptive effectiveness and what steps you should take afterward. In your case, you mentioned that you usually take your birth control pill (Alesse) at 11 PM but forgot to take it on the evening of August 18. You remembered to take it the next day at 1 PM and also took your regular dose that night.
According to the guidelines for combination oral contraceptives like Alesse, if you miss a pill and take it within 24 hours of your usual time, you are generally still protected against pregnancy. Since you took the missed pill the next day and continued with your regular schedule, you should not need to use additional contraception for the next seven days.
However, if you had missed the pill for more than 24 hours, the recommendation would be different. In such cases, it is advised to use backup contraception, such as condoms, for at least seven days after the missed pill. This is because the hormone levels may not be sufficient to prevent ovulation if the pill is missed for an extended period.

In your specific situation, since you took the missed pill within the 24-hour window and resumed your regular schedule, your contraceptive effectiveness should remain intact. However, it’s always good practice to monitor for any signs of breakthrough bleeding or other irregularities in your cycle, as these can sometimes occur after a missed pill.

It's also worth noting that certain factors can affect the efficacy of birth control pills, such as gastrointestinal issues (vomiting or diarrhea), certain medications (like antibiotics), or even significant weight changes. If you experience any of these situations, you may want to consult your healthcare provider for personalized advice.

In summary, since you took your missed pill within the appropriate timeframe and continued with your regular dosing schedule, you do not need additional contraception for the next seven days. However, if you have any concerns or experience any unusual symptoms, it’s always best to consult with your healthcare provider for further guidance.

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