Birth Control Pills: Concerns About Irregular Bleeding and Pregnancy Risks

Oral contraceptive pill issues?

Hello doctor, I started taking the oral contraceptive pill on the 5th day of my menstrual period during the first month.
There were still 3 pills left when I experienced bleeding (on 9/22).
The doctor said it wasn't my period, but possibly breakthrough bleeding, and advised me to finish the remaining 3 pills (by 9/24).
The bleeding lasted for 7 days (until 9/28), which I think was my actual period...
After finishing the first pack, I took a 7-day break and then continued with a new pack, but my period had already ended.
I started taking the new pack on the 4th day after my period (on 10/2), and then on 10/7, I had intercourse with ejaculation inside.
I would like to know what the chances of pregnancy are in this situation.
Also, if my period comes early, how should I correctly take the pills?

Huang S, 20~29 year old female. Ask Date: 2019/10/13

Dr. Huang Jianzhong reply Obstetrics and Gynecology

In the first month, I started taking the oral contraceptive pill on the 5th day of my period.
There were still 3 pills left when I experienced bleeding (on 9/22).
The doctor said it wasn't menstruation, but possibly breakthrough bleeding, and advised me to finish the remaining 3 pills (by 9/24).
The bleeding lasted for 7 days (until 9/28), which I assumed was my period.
After finishing the first pack, I took a 7-day break and then started a new pack, but my period had already ended.
I resumed taking the pills on the 4th day after my period (on 10/2), and then had sexual intercourse on 10/7 with ejaculation inside.
I would like to know what the chances of pregnancy are in this situation.

Answer: The chances of pregnancy are low.
Additionally, if my period comes early, how should I take the pills correctly?
Answer: Start a new pack.

Reply Date: 2019/10/13

More Info

When it comes to understanding birth control pills, particularly in the context of irregular bleeding and the potential risks of pregnancy, it's essential to grasp how these medications function and the implications of their use.

Birth control pills, commonly referred to as oral contraceptives, are designed to regulate hormonal levels in the body to prevent ovulation. They typically contain synthetic forms of estrogen and progestin, which work together to inhibit ovulation, thicken cervical mucus, and thin the uterine lining. However, irregular bleeding, often termed "breakthrough bleeding," can occur, especially during the initial months of starting the pill. This is usually not a cause for concern and often resolves as the body adjusts to the hormones.

In your case, starting the pill on the fifth day of your menstrual cycle may have contributed to the irregular bleeding you experienced. The bleeding you described after taking the pill for a few days could indeed be breakthrough bleeding rather than a menstrual period. It’s important to note that while on the pill, the body may react differently, and some women experience changes in their bleeding patterns.
Regarding your question about the risk of pregnancy after having unprotected intercourse on October 7, it’s crucial to consider a few factors. Since you started a new pack of pills after a seven-day break, if you took the pills consistently and correctly, the risk of pregnancy is significantly reduced. The effectiveness of the pill is highest when taken at the same time every day and without missing doses. If you had been taking your pills as directed, the chances of becoming pregnant from intercourse during the active pill phase are low, even if it occurred shortly after your period.

If your period comes earlier than expected while on the pill, it’s essential to continue taking the pills as prescribed. You should not skip any doses, as this can increase the risk of ovulation and, consequently, the risk of pregnancy. If you experience bleeding that seems unusual or if you have concerns about potential pregnancy, it is advisable to take a home pregnancy test or consult with your healthcare provider for further evaluation.

In summary, while irregular bleeding can be concerning, it is often a normal response to starting birth control pills. If you are taking your pills correctly, the risk of pregnancy is low, even after unprotected intercourse. Always consult with your healthcare provider for personalized advice, especially if you have any concerns about your menstrual cycle or the effectiveness of your birth control method. Regular follow-ups can help ensure that your contraceptive method is working effectively and that any side effects are managed appropriately.

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