Missed Period After Birth Control: Could It Be Pregnancy?

After taking the 28-day oral contraceptive pill and reaching the last 4 placebo pills, menstruation has not occurred?

Hello doctor, my girlfriend has already taken the second pack of the 24+4 days contraceptive pill.
When she was on the first pack, her period arrived right on time after taking the last placebo pill.
However, yesterday she took the 24th pill of the second pack, and her period has not come yet; she only has a small amount of brown discharge.
Throughout this time, she has not missed any pills, except for one instance last week when she forgot to take a pill at 11:30 PM and took it the next day at 9 AM.
We have had sexual intercourse during this period, including ejaculation inside.
Could the absence of her period and the brown discharge indicate a possibility of pregnancy?

Xiao Bu, 20~29 year old female. Ask Date: 2019/05/29

Dr. Huang Jianzhong reply Obstetrics and Gynecology

My girlfriend has already taken the second pack of the 24+4 contraceptive pills.
During the first pack, her period came right on time after finishing the placebo pills.
However, yesterday she took the 24th pill of the second pack, and her period has not arrived yet; she only has a small amount of brown discharge.
Throughout this time, she has not missed any pills, except for one instance last week when she forgot to take it at 11:30 PM but took it the next day at 9 AM.
We have had sexual intercourse during this period, including ejaculation inside.
Is it possible that the absence of her period and the brown discharge indicate pregnancy? Ans: It is not possible that she is pregnant.

Reply Date: 2019/05/29

More Info

When it comes to missed periods while on birth control, particularly with the use of combination oral contraceptives like the one your girlfriend is taking, there are several factors to consider. First and foremost, it is important to understand how these contraceptives work. Birth control pills are designed to prevent ovulation, thicken cervical mucus, and thin the uterine lining, making it less likely for a pregnancy to occur.

In your girlfriend's case, she has been consistently taking her birth control pills, with only one missed dose that was taken the next day. While missing a pill can slightly increase the risk of ovulation, the timing of her missed pill (if it was taken within the 12-hour window) should not significantly affect her contraceptive effectiveness. However, it is worth noting that any missed pill can lead to breakthrough bleeding or spotting, which may explain the light brown discharge she is experiencing.

The presence of brown discharge can often be attributed to several factors, including hormonal fluctuations, the onset of menstruation, or even implantation bleeding if pregnancy were to occur. However, since she has been taking her birth control pills as directed, the likelihood of pregnancy is relatively low, but not impossible.

If your girlfriend's period does not arrive as expected, it would be prudent for her to take a home pregnancy test. These tests are designed to detect the hormone hCG (human chorionic gonadotropin), which is produced during pregnancy. It is best to wait until at least the first day of her missed period for the most accurate result, although some tests can detect pregnancy a few days before a missed period.

If the test is positive, it would be advisable for her to schedule an appointment with a healthcare provider to confirm the pregnancy and discuss her options moving forward. If the test is negative and her period still does not arrive, she should consult with her healthcare provider to rule out any other underlying issues, such as hormonal imbalances or other medical conditions.

In summary, while it is possible for your girlfriend to be pregnant despite taking birth control, the chances are relatively low given her adherence to the regimen. The brown discharge could be a sign of hormonal changes or the onset of her period. Taking a pregnancy test will provide clarity on her situation. If there are any concerns or if her symptoms persist, seeking medical advice is always the best course of action.

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