When to Resume Birth Control Pills After Irregular Periods?

If you have stopped taking the contraceptive pill and your period has not arrived, when can you start taking it again?

Hello, doctor.
I was previously diagnosed with polycystic ovary syndrome (PCOS), which has caused my menstrual cycles to be very irregular, sometimes occurring only once every two to three months.
Therefore, my doctor recommended that I start taking oral contraceptive pills to regulate my menstrual cycle.
I have been taking them for over a year, and I finished my last pack in November, with my period occurring from November 9 to November 14.
After that, I stopped taking the pills and have not resumed since then.
Now, at the end of December, my period still has not come.

I would like to know if I must wait for my period to return before I can continue taking the oral contraceptive pills.
Previously, I started taking them on the fifth day of my menstrual cycle, but now I am unsure when my next period will arrive.
If I do not need to wait for my next period to start taking them again, when can I begin? Thank you, doctor!

Niming, 20~29 year old female. Ask Date: 2018/12/31

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I was previously diagnosed with polycystic ovary syndrome (PCOS), which has caused my menstrual cycles to be very irregular, sometimes only occurring every 2 to 3 months.
Therefore, my doctor recommended that I start taking oral contraceptive pills to regulate my cycles.
I took them for over a year, and my last dose was in November, with my period occurring from November 9 to November 14.
After that, I stopped taking the pills and have not resumed since, and now, at the end of December, my period has not returned.

My question is whether I need to wait for my period to come before I can continue taking oral contraceptive pills.
Previously, I started taking them on the fifth day of my period, but now I am unsure when my next period will arrive.
If I do not need to wait for my next period to start taking them again, when can I resume?
Answer: You do not need to wait for your period to resume taking oral contraceptive pills.
You can start taking them again on a fixed date each month.

Reply Date: 2018/12/31

More Info

When it comes to resuming birth control pills after experiencing irregular periods, especially in the context of polycystic ovary syndrome (PCOS), there are several important considerations to keep in mind.
First, it’s essential to understand that birth control pills can help regulate menstrual cycles in women with PCOS. They work by providing a steady dose of hormones that can help to normalize the menstrual cycle and reduce symptoms associated with PCOS, such as excessive hair growth and acne. If you have been on birth control pills for over a year and have recently stopped taking them, it’s not uncommon for your menstrual cycle to take some time to regulate, especially if you have a history of irregular periods.

In your case, since you stopped taking the birth control pills after your last period in November and have not had a period since then, you might be wondering when you can safely resume taking the pills. Generally, it is recommended to wait until you have your next menstrual period before starting a new pack of birth control pills. This is because starting the pills during your period helps to ensure that you are not pregnant and allows the hormones to work effectively in regulating your cycle.

However, if you are experiencing significant delays in your menstrual cycle and are unsure when your next period will arrive, you do not necessarily have to wait for it to start taking the pills again. You can begin taking the birth control pills at any time, but it is important to note that if you start taking them outside of your menstrual cycle, you should use a backup method of contraception (such as condoms) for the first seven days of taking the pills to ensure you are protected against pregnancy.

If you decide to start taking the pills again without waiting for your period, it may take a few cycles for your body to adjust, and you might experience some irregular bleeding or spotting initially. This is quite common and should stabilize as your body gets used to the hormones again.

Additionally, it’s crucial to consult with your healthcare provider before making any changes to your birth control regimen, especially considering your history of PCOS and irregular periods. Your doctor may want to monitor your situation more closely and can provide personalized advice based on your health history and current symptoms.

In summary, while it is generally advisable to wait for your period to resume birth control pills, you can start taking them at any time if you are concerned about the irregularity of your cycles. Just remember to use backup contraception for the first week. Always keep in touch with your healthcare provider to ensure that you are making the best decisions for your reproductive health, especially with conditions like PCOS that can complicate menstrual regularity.

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