Missed Period After Taking Birth Control Pills: What to Do Next?

Emergency contraceptive pills, missed period?

Regarding the issue I raised in #142786, I have been taking the preconception medication (Wen Bu Ren 30) for three months.
However, during the last cycle, I experienced bleeding when I had three pills left (this was also my first time bleeding).
My period was due today, January 4, but it hasn't arrived, and the bleeding seems to be decreasing (it was already very light).
There is only a slight brownish discharge when I wipe with tissue.
I am supposed to start a new pack of medication (the fourth pack) on January 7.
Should I wait for my period to start before taking it? If my period does not come, should I just wait for the next cycle? Should this bleeding be considered a menstrual period (I have researched online, and some say it counts as a period)? Given that I have had sexual intercourse, should I take a pregnancy test?

Niming, 20~29 year old female. Ask Date: 2019/01/04

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I have been taking the pre-medication (Wen Bu Ren 30) for three months, but during the last cycle, I experienced bleeding when I had three pills left (this was also my first time bleeding).
My period was supposed to arrive today, January 4, but it hasn't come, and the amount of bleeding seems to be decreasing (it was already very light, just a slight amount).
I only noticed a faint brown color when wiping with tissue.
I am supposed to start a new pack of medication (the fourth pack) on January 7; should I wait for my period to start before taking it?
Answer: There is no need to wait for your period to start before taking it.

If my period does not come, should I just wait for the next one?
Answer: Yes, this bleeding can be considered a menstrual period (I have checked online, and some sources say it counts as a period).

Answer: It can be counted as a menstrual period since there has been sexual intercourse; should I take a pregnancy test?
Answer: There is no need to take a pregnancy test.

Reply Date: 2019/01/04

More Info

When dealing with missed periods after taking birth control pills, it's important to understand the various factors that could be at play. Birth control pills, particularly those that are hormonal, can influence your menstrual cycle in several ways. Here’s a comprehensive guide on what to do next if you find yourself in this situation.

Understanding Your Situation
1. Missed Period: If you have been consistently taking your birth control pills and you miss your period, it could be due to several reasons. Hormonal contraceptives can sometimes cause lighter periods or even missed periods altogether, especially if you have been on them for a while. This is often referred to as "amenorrhea" and can be a common side effect of hormonal birth control.

2. Light Spotting: The light brown discharge you described could be spotting, which is not uncommon when taking birth control pills. Spotting can occur due to hormonal fluctuations and may not necessarily indicate the start of a menstrual period.

3. Timing of New Pack: If you are nearing the end of your current pack of pills, you should generally continue taking the pills as scheduled, even if your period does not arrive. The standard recommendation is to start the new pack on time, regardless of whether you experience a withdrawal bleed (the period-like bleeding that occurs during the placebo week).

Next Steps
1. Continue Taking Pills: Since you are scheduled to start a new pack on January 7, you should proceed with taking the new pack as planned. Do not wait for a period to start the new pack. This helps maintain the effectiveness of the birth control and keeps your hormone levels stable.

2. Consider Pregnancy Testing: Given that you have had sexual intercourse, it is advisable to take a pregnancy test if your period does not arrive by the time you start the new pack. Home pregnancy tests are generally accurate if taken after a missed period. If you test positive, you should contact your healthcare provider for further guidance.

3. Evaluate the Spotting: The light brown spotting you experienced could be a sign of breakthrough bleeding, which is common with hormonal contraceptives. If this continues or if you have any concerns, it’s a good idea to consult your healthcare provider.

4. Consult Your Doctor: If you have any doubts or if your menstrual irregularities persist, it’s essential to consult with your healthcare provider. They can help determine if the birth control method you are using is suitable for you or if adjustments are necessary.

Additional Considerations
- Understanding Your Cycle: It’s important to track your menstrual cycle and any changes that occur while on birth control. This can help you and your healthcare provider make informed decisions about your reproductive health.

- Potential Side Effects: Be aware of other side effects of hormonal birth control, such as mood changes, weight fluctuations, or changes in libido. If you experience significant side effects, discuss them with your doctor.

- Alternative Birth Control Methods: If you find that hormonal birth control is causing too many irregularities in your cycle, you might want to discuss alternative methods with your healthcare provider. There are non-hormonal options available as well.

In conclusion, if you miss your period while on birth control pills, continue taking your pills as scheduled, consider taking a pregnancy test if your period does not arrive, and consult your healthcare provider for personalized advice. Understanding how your body responds to hormonal contraceptives is crucial for maintaining your reproductive health.

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