Missed Birth Control Pills: Your Menstrual Cycle and Next Steps

Missed birth control pill?

Hello, Doctor: I have polycystic ovary syndrome, so I sometimes take birth control pills.
However, I stopped taking them for a few months, and then my menstrual cycle became irregular, so I bought Dailian to take again.
In the first few days of taking it, I forgot to remind my boyfriend, and he ended up ejaculating inside me.
After that, I missed a dose, but I took it as soon as I remembered.
However, after finishing the entire pack, my period came 12 days late, and the bleeding has been very light—just a little bit, mostly only noticeable when I wipe after using the restroom.
So I would like to ask the doctor, is this my period? Should I continue taking the next pack of birth control pills?

Qi, 20~29 year old female. Ask Date: 2019/06/21

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I have polycystic ovary syndrome, so I sometimes take birth control pills.
Recently, I stopped taking them for a few months, and then my menstrual cycle became irregular, so I bought Dailian to take again.
In the first few days of taking it, I forgot to remind my boyfriend, and he ended up ejaculating inside me.
After that, I missed a dose, but I took it as soon as I remembered.
However, after finishing the entire pack, my period came 12 days late, and the bleeding was very light—just a little bit, basically only enough to stain the pad slightly, and I only noticed it when I wiped after using the bathroom.
So I want to ask the doctor, is this my period? Should I continue taking the next pack of birth control pills? Answer: First, take a pregnancy test.

Reply Date: 2019/06/21

More Info

When it comes to missed birth control pills and the subsequent effects on your menstrual cycle, it's essential to understand how hormonal contraceptives work and what to expect when you miss doses. In your case, since you have polycystic ovary syndrome (PCOS), managing your menstrual cycle can be particularly challenging, and the use of birth control pills can help regulate it.

Firstly, when you miss a birth control pill, especially in the first week of a new pack, the risk of unintended pregnancy increases, particularly if you have unprotected intercourse. Since you mentioned that you had unprotected sex after forgetting to inform your partner about the missed pill, it is advisable to take a pregnancy test if your period does not arrive within a week of when it was expected.
Regarding your menstrual cycle, the delayed onset of your period after restarting the pill can be attributed to several factors. Birth control pills work by providing consistent hormone levels to prevent ovulation and regulate your menstrual cycle. When you miss pills, your hormone levels can fluctuate, leading to irregular bleeding or spotting, which might not resemble a typical menstrual period. The light bleeding you described could be withdrawal bleeding, which occurs when the hormone levels drop after stopping the pills, or it could be a sign of an irregular cycle due to PCOS.

In terms of next steps, if you have confirmed that you are not pregnant, it is generally recommended to continue taking your birth control pills as prescribed. This means finishing the current pack and starting the next one on schedule, even if your bleeding is lighter than usual. Consistency is key in maintaining effective contraception and regulating your cycle.
If you experience significant changes in your menstrual cycle, such as prolonged irregular bleeding, severe pain, or if you suspect pregnancy, it is crucial to consult with your healthcare provider. They can provide personalized advice based on your medical history and current health status. Additionally, if you find that you are frequently forgetting to take your pills, you might want to discuss alternative contraceptive methods with your doctor, such as an intrauterine device (IUD) or implant, which can offer more reliable long-term contraception without the daily responsibility of taking a pill.

Lastly, managing PCOS often requires a comprehensive approach, including lifestyle modifications such as diet and exercise, along with medical management. Regular follow-ups with your healthcare provider can help monitor your condition and adjust treatment as necessary.

In summary, missed birth control pills can lead to irregular bleeding and potential pregnancy risks. If your period is delayed, consider taking a pregnancy test, continue with your birth control regimen, and consult your healthcare provider for personalized guidance.

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