First Time Taking Birth Control Pills: Concerns and Effectiveness

First time taking oral contraceptives?

Hello Doctor, I would like to ask about my menstrual cycle.
My last period started on August 1 and ended on August 6, with a cycle length of about 30 to 31 days.
I decided to start taking oral contraceptive pills for birth control, but this was my first time taking them.
I heard that the pills should be started on the first day of menstruation, but I began taking them on the first day after my period ended.
I later asked a pharmacist, and they said it was fine.
I finished the first pack of pills on August 27, then took a seven-day break.
I missed one pill during that time but took it the next day.
My period started again on August 29, but on September 2, I had sexual intercourse without a condom.
My boyfriend did not ejaculate inside me, and I still had some menstrual bleeding at that time.
What is the likelihood of pregnancy in this situation? Does starting the contraceptive pills not on the first day of menstruation affect their effectiveness?

Mǎquè, 10~19 year old female. Ask Date: 2018/09/04

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The last menstrual period started on August 1 and ended on August 6, with a cycle length of approximately 30 to 31 days.
I had already decided to start taking oral contraceptive pills for birth control, so this was my first time taking them.
I heard that the first pill should be taken on the first day of menstruation, but I started taking them on the first day after my period ended.
I later asked a pharmacist, who said it was fine.
I finished the first pack of pills on August 27, then took a seven-day break.
During that time, I missed one pill but took it the next day.
My period started again on August 29, but on September 2, I had sexual intercourse without my boyfriend wearing a condom, although he did not ejaculate inside me.
At that time, I still had some menstrual bleeding.

1.
What is the likelihood of pregnancy in this situation?
Answer: The likelihood of pregnancy is low.
2.
Will starting the pill not on the first day of menstruation affect its contraceptive effectiveness?
Answer: It will not affect the contraceptive effectiveness.

Reply Date: 2018/09/04

More Info

When it comes to starting birth control pills for the first time, there are several important factors to consider regarding their effectiveness and the timing of initiation. Based on your description, it seems you have some concerns about the timing of when you started taking the pills and the potential risk of pregnancy after having unprotected intercourse.

Firstly, it's important to clarify that the effectiveness of birth control pills can be influenced by when you start taking them. The general recommendation is to begin taking the pill either on the first day of your menstrual period or on the first Sunday after your period begins. Starting the pill on the first day of your period provides immediate contraceptive protection. If you start taking the pill at any other time during your cycle, it may take up to seven days for the pill to become fully effective, depending on the type of pill you are using.

In your case, since you started taking the pill on the first day after your period ended, you may not have had immediate contraceptive protection. Since you mentioned that you had unprotected intercourse on September 2, which was shortly after your menstrual cycle and after you had started the pill, there is a possibility of pregnancy, especially if the pill had not yet reached its full effectiveness.

Regarding the missed pill, it's good that you took the missed dose the following day, as this helps maintain the effectiveness of the contraceptive method. However, missing a pill can still reduce its effectiveness, particularly if it occurs during the first week of starting the pill. If you miss a pill, the general advice is to take it as soon as you remember, and if you miss more than one pill, you should follow the specific instructions provided with your medication or consult your healthcare provider.

As for the risk of pregnancy, if you had unprotected intercourse before the pill had been taken consistently for seven days, there is a chance of pregnancy. The fact that your boyfriend did not ejaculate inside you reduces the risk, but it does not eliminate it entirely, as pre-ejaculate fluid can contain sperm.

If you are concerned about the possibility of pregnancy, you may want to consider taking a home pregnancy test if your next period is late. Additionally, if you are still uncertain or anxious about your situation, it would be beneficial to consult with a healthcare provider. They can provide personalized advice based on your specific circumstances and help you understand your options moving forward.

In summary, starting birth control pills at the right time is crucial for their effectiveness. Since you began taking them after your period, it may take some time for them to provide full contraceptive protection. If you have had unprotected intercourse during this time, there is a risk of pregnancy, and monitoring your menstrual cycle or consulting with a healthcare professional can help you navigate this situation effectively.

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