the Impact of Delayed Birth Control Pill Usage on Effectiveness

Emergency contraceptive pill usage?

Hello Doctor: I previously visited a gynecologist due to dysmenorrhea and irregular menstrual cycles.
The doctor prescribed me Esmya, instructing me to take it on the fifth day of my period.
I have been taking it continuously for several months, always on the fifth day.
I noticed that most women tend to get their period 2-3 days after stopping the medication, but I only get mine on the fifth day, which means my off-medication period exceeds 7 days (it has been as long as ten days).
I would like to know if this affects the contraceptive effectiveness.
For the past few months, I have been taking it this way and have had frequent unprotected intercourse with my boyfriend.
However, during the first seven days of the next cycle, we still use condoms, and I only stop using them after taking the medication for seven days.
Is this method of contraception safe? I have been doing this without issues, but this month I took my first pill late.
I was supposed to take it on the fifth day of my period (August 17) in the evening, but I forgot and took it the next morning around 8 AM (August 18, the sixth day), and then I took another pill that evening, which means I took one pill in the morning and one in the evening on August 18.
After that, I resumed taking it normally in the evening.
Is the contraceptive effect still effective? On August 23, I had unprotected intercourse without ejaculation, and on August 24, I had unprotected intercourse with ejaculation.
Is this safe? Thank you, Doctor, for taking the time to answer my questions.
Wishing you good health!

Halo31, 20~29 year old female. Ask Date: 2017/08/25

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I previously consulted a gynecologist due to dysmenorrhea and irregular menstrual cycles.
The doctor prescribed Esmya for me to take, instructing me to start on the fifth day of my period.
I have been consistently taking it on the fifth day for several months.
I noticed that most women get their period 2-3 days after stopping the medication, but I only get mine on the fifth day, which means my off-medication period exceeds 7 days (it has been 10 days already).

1.
Will this affect the contraceptive effectiveness?
Answer: The contraceptive effectiveness will not be affected.
I have been taking it this way for several months, and I have had frequent unprotected intercourse with my boyfriend.
However, during the first seven days of the next cycle, we will use condoms, and I will only stop using them after I have taken the medication for seven days.
2.
Is this method of contraception safe?
Answer: This method of contraception is very safe.
I have been taking it this way without any issues.
However, this month, I took the medication late on the first day.
I was supposed to take it on the fifth day of my period (August 17) in the evening, but I forgot and took it the next morning around 8 AM (August 18, the sixth day), and then I took another dose that evening, which means I took one dose in the morning and one in the evening on August 18.
After that, I resumed taking it normally in the evening.
3.
Is the contraceptive effectiveness still valid?
Answer: The contraceptive effectiveness is still valid.
4.
On August 23, I had unprotected intercourse without ejaculation, and on August 24, I had unprotected intercourse with ejaculation.
Is this safe?
Answer: It is safe.

Reply Date: 2017/08/25

More Info

When it comes to understanding the effectiveness of birth control pills, particularly in the context of delayed usage and irregularities in the menstrual cycle, there are several important factors to consider. Based on your description, you have been taking the birth control pill (in this case, "艾斯麗安") consistently but have experienced some delays in starting the pill after your menstrual cycle. You also mentioned having unprotected sexual intercourse with your partner during this time.

Firstly, it's essential to understand how birth control pills work. Most oral contraceptives function primarily by preventing ovulation, which means that they stop the ovaries from releasing eggs. They also thicken cervical mucus to block sperm from reaching any eggs that may have been released and thin the lining of the uterus to prevent implantation. For these pills to be effective, they need to be taken consistently and as directed.

In your case, you mentioned that you typically start taking the pill on the fifth day of your menstrual cycle. If you have been doing this consistently, your body should have adjusted to the hormonal changes induced by the pill. However, you also noted that you sometimes experience a delay in starting the pill, which can affect its effectiveness. The general recommendation is to take the pill at the same time every day to maintain stable hormone levels in your body.

Regarding the specific situation where you forgot to take the pill on the first day of your intended schedule and took it the following day instead, this could potentially impact the effectiveness of the pill. If you miss a dose, it is usually advised to take it as soon as you remember. If you miss a pill and it is more than 24 hours late, you may need to use backup contraception, such as condoms, for the next seven days to ensure protection against pregnancy.

You also mentioned having unprotected sexual intercourse on 8/23 and 8/24. If you had taken the pill correctly after your missed dose and continued to take it as prescribed afterward, the risk of pregnancy is significantly reduced. However, since you had a lapse in your routine, it is prudent to consider the possibility of reduced effectiveness during that time.

In terms of your question about whether your method of using condoms during the first week of the new cycle is safe, it is indeed a good practice. Using condoms during the first seven days of starting a new pack of birth control pills is recommended, especially if there has been any inconsistency in taking the pills. This ensures that you are adequately protected against unintended pregnancy.

In conclusion, while your previous experience with the pill has been without issues, any missed doses or delays in starting the pill can affect its effectiveness. It is crucial to maintain a consistent routine and to use backup methods of contraception when there are any lapses. If you have concerns about your contraceptive method or if you suspect you may be pregnant, it is advisable to consult with your healthcare provider for personalized guidance and support. They can provide you with the most accurate information based on your health history and current situation.

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