Emergency Contraceptive Pills: Usage and Effectiveness

Emergency contraceptive pill

Hello, Doctor! I am a user of the oral contraceptive pill, specifically the brand Wenbunin 28, which consists of 28 pills taken over a month.
I have been taking it for over a year.
The first day of this pack was December 17, but on December 18, I mistakenly thought I hadn't taken the pill on the 17th, so I took an extra pill on the 18th, resulting in me taking three pills over two days.
After researching online, I found that doctors recommend continuing to take the pills as scheduled, so I followed that advice.
Is this the correct approach?
Additionally, on January 3, I accidentally lost one of the pills I was supposed to take, which means I currently have 27 pills left.
Including the extra pill I took, I have only taken the pills for 26 days.
However, as of today, January 5, I have continued to take the pills in order.
Is this correct? Originally, I was supposed to finish on January 13, but now it seems I will run out on January 11 (I have not missed any doses in between).

I would like to ask, does the contraceptive effect still remain? Is there a risk of contraceptive failure? Also, if I have unprotected intercourse with my boyfriend but he does not ejaculate inside, is there a chance of pregnancy? Thank you for your response, Doctor!

kitty, 10~19 year old female. Ask Date: 2019/01/06

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Users of pre-exposure contraceptive pills, specifically the brand Wenbunin 28, take 28 pills over the course of a month.
I have been taking it for over a year.
The first day of this pack was December 17th, but on December 18th, I mistakenly thought I hadn't taken the pill on the 17th, so I took an extra pill on the 18th, meaning I took three pills over two days.
Later, I researched online and a doctor advised that I could continue taking the pills as usual, so I followed the sequence and continued taking them.
Is this correct? Answer: Yes.
Then, on January 3rd, when I was supposed to take my contraceptive pill, I accidentally lost the pill I had in hand.
This means I currently have 27 pills left, and considering the extra pill I took, I have only taken them for 26 days.
However, as of today, January 5th, I have continued to take them in order.
Is this correct? Answer: Yes.
I was originally supposed to finish on January 13th, but now I will run out on January 11th (I have not missed any doses in between).
I would like to ask the doctor, does the contraceptive effect still remain? Is there a risk of contraceptive failure? Answer: The contraceptive effect is still present; there will not be a contraceptive failure.
If I have unprotected intercourse with my boyfriend without ejaculation, is there a risk of pregnancy? Answer: There is no risk of pregnancy.

Reply Date: 2019/01/06

More Info

Understanding Emergency Contraceptive Pills (ECPs) and their effectiveness is crucial for anyone using hormonal contraceptives, especially in situations where there may be concerns about missed doses or accidental overconsumption.
In your case, you are using a combined oral contraceptive pill (COCP), specifically the "温不妊28," which is designed to be taken daily for 28 days. It is important to adhere to the prescribed regimen to maintain contraceptive effectiveness.
1. Accidental Overdose: You mentioned that you took an extra pill on December 18, thinking you missed the dose on December 17. Generally, taking an extra pill in a single day is not harmful, but it is advisable to continue taking the remaining pills as scheduled. The hormonal levels may be slightly elevated for that cycle, but it should not significantly impact the overall effectiveness of the contraceptive method.

2. Missing a Pill: On January 3, you lost a pill. If you have been taking the remaining pills consistently and correctly, the contraceptive effect should still be maintained. If you miss a pill, the general recommendation is to take it as soon as you remember. If it is close to the time of your next scheduled pill, you should skip the missed pill and continue with your regular schedule.
3. Remaining Pills: You mentioned that you have 27 pills left and have taken 26 pills in total. As long as you continue to take the remaining pills in the correct order and do not miss any further doses, you should still be protected against pregnancy.
4. Effectiveness: The effectiveness of COCPs is very high when taken correctly, with typical use showing about a 91% effectiveness rate. However, if pills are missed or taken incorrectly, this effectiveness can decrease. Since you have not missed any pills after the initial confusion and have continued taking them as directed, your contraceptive protection should remain intact.

5. Unprotected Intercourse: You expressed concern about having unprotected intercourse without ejaculation. While the risk of pregnancy is lower without ejaculation, it is important to note that pre-ejaculate fluid can contain sperm. Therefore, if you are concerned about potential pregnancy, it is advisable to consider using emergency contraception if you believe there is a significant risk.

6. Emergency Contraceptive Pills (ECPs): If you are worried about the possibility of pregnancy due to the missed pill or unprotected intercourse, you may consider taking an emergency contraceptive pill (ECP) as a precaution. ECPs are most effective when taken within 72 hours after unprotected intercourse, but some types can be effective up to 5 days after.
In conclusion, your current approach of continuing to take the remaining pills in order is correct. You should remain vigilant about taking your pills consistently and correctly. If you have any further concerns about missed doses or potential pregnancy, consulting with a healthcare provider would be beneficial. They can provide personalized advice and may recommend additional contraceptive measures if necessary. Always remember that maintaining open communication with your healthcare provider about your contraceptive methods and any concerns is key to effective family planning.

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