Birth Control Pills: Timing and Safety Concerns Explained

Can I take the emergency contraceptive pill after stopping regular birth control for 7 days? Should I take it on the 5th day of my period?

I consulted a gynecologist on August 27th (the 5th day of my menstrual cycle) due to contraceptive needs and started taking my first pack of Wenbunin 30 coated tablets.
However, after 7 days, I developed a rash on my chest and was concerned it was caused by Wenbunin, so I returned to the gynecologist for advice.
The doctor switched me to Aisilian and told me I could continue taking it from the 7 days I had already taken, and that I should just skip the extra 7 tablets.
Although the doctor said this, I still have doubts since these are different medications.
Will this have any impact?
(Later, I saw a dermatologist who indicated that the rash was likely not related to the medication.) Now, I am currently on the 4th day of the drug-free interval after finishing 21 tablets, and my period has not yet arrived.
My question is: I have read online that after finishing 21 tablets, one should take a 7-day break regardless of whether menstruation has occurred or not, and then continue with the next pack.
However, my doctor advised me to wait until the 5th day of my next period to start the next pack (her instruction was to start on the 5th day of menstruation for any pack).
If I follow my doctor's advice, the timing for starting the next pack will exceed the 7-day drug-free interval.
Is this acceptable, or should I follow the common advice of taking the next pack after a 7-day break?
Furthermore, if the same situation occurs with the 3rd and 4th packs, and I have unprotected intercourse during the extended drug-free period, is it safe? I am concerned that a prolonged break might mean I need to take 7 tablets again before achieving contraceptive effectiveness.
Additionally, if my period does not arrive after 7 days, should I return for a follow-up? There seems to be a discrepancy between my doctor's advice, online articles, and the Aisilian information leaflet, which is quite confusing for me as this is my first time taking these medications.
I apologize for the many questions.

Bing, 20~29 year old female. Ask Date: 2018/09/20

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On August 27th (the 5th day of my menstrual cycle), I consulted a gynecologist for contraception and started taking my first pack of Wenbunin 30 coated tablets.
However, after 7 days, I developed a rash on my chest and was concerned it was caused by Wenbunin, so I returned to the gynecologist for advice.
The doctor switched me to Aisilian and told me I could continue taking it directly from the 7 days of the previous medication, and that I should not take the extra 7 tablets.
Although the doctor said this, I still have doubts since they are different medications.
Will this have any effects? (Later, after seeing a dermatologist, it seemed the rash was not related to the medication.)
Answer: The impact is minimal.
Currently, I am on the 4th day of the drug-free interval after finishing 21 tablets, and my menstrual period has not yet arrived.
My question is: I have seen online that many people say to take 21 tablets, then have a 7-day break, regardless of whether menstruation has started or not, and then continue with the next pack.
However, my doctor told me to wait until the 5th day of my period after finishing the 21 tablets before starting the next pack (her implication is to start on the 5th day of menstruation for every pack).
If I follow my doctor's advice, the time to start the next pack will exceed the 7-day drug-free interval.
Is this acceptable, or should I follow the general advice and take the next pack after a 7-day break?
Answer: Both the doctor's advice and the general advice are correct.
Choose the method that suits you best.
If the same situation occurs with the 3rd and 4th packs, and if there is sexual intercourse with ejaculation during the 7-day break plus waiting for the 5th day of menstruation, is it safe? I am unsure if a prolonged drug-free period would mean I need to take 7 tablets again before achieving contraceptive effectiveness.
Answer: Having sexual intercourse with ejaculation during the waiting period is safe.
Additionally, if my period does not arrive after the 7-day break, do I need to return for a check-up?
Answer: No, you do not need to return for a check-up, but the doctor's advice is important in this context.

Reply Date: 2018/09/20

More Info

When it comes to understanding birth control pills, especially in the context of your specific situation, it’s important to clarify a few key points regarding their use, timing, and safety concerns.

First, let's address the transition between different types of birth control pills. You mentioned that you started taking 温不妊 (Wenbunin) and then switched to 爱斯丽安 (Aisilian) after experiencing a rash. Your doctor advised you to continue taking the new pill from the seventh day of your initial pill regimen, skipping the extra seven pills. This is generally acceptable, as both medications are likely to have similar hormonal compositions, but it’s always best to follow your healthcare provider's advice. The concern with switching pills is that different formulations can have varying levels of hormones, which may affect your body differently. However, since your doctor assessed your situation and made the recommendation, it should be safe to proceed as instructed.

Now, regarding the timing of your next pill pack after completing the 21 pills and entering the 7-day break: your doctor’s advice to wait until the fifth day of your period to start the next pack is a common practice. This method ensures that you are starting the new pack at the right time in your cycle, which can help maintain consistent hormone levels and improve the effectiveness of the birth control. However, if you wait longer than seven days to start the next pack, you may lose the contraceptive effect, and it could take another seven days of consistent use for the pill to become effective again.

If you have unprotected intercourse during this time, especially if it exceeds the seven-day break, there is a risk of pregnancy. It is crucial to adhere to the guidelines provided by your healthcare provider, as they are tailored to your specific health needs. If you find yourself in a situation where you have exceeded the recommended break and have had unprotected sex, consider using emergency contraception if appropriate and consult your doctor for further advice.

As for your concern about not having your period after the 21 pills, it’s not uncommon for some women to experience changes in their menstrual cycle when starting or switching birth control pills. If your period does not arrive within the expected timeframe after the seven-day break, it is advisable to take a pregnancy test to rule out pregnancy. If the test is negative and your period still does not come, or if you have any other concerning symptoms, you should definitely return to your healthcare provider for further evaluation.

In summary, while your doctor’s instructions are important, it’s also essential to understand the general guidelines surrounding birth control pills. Always communicate openly with your healthcare provider about any concerns or side effects you experience, and don’t hesitate to seek clarification on any instructions that seem unclear. Birth control can be a complex topic, but with proper guidance and understanding, you can effectively manage your reproductive health.

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