Missed Birth Control Pills: Pregnancy Risks and Precautions

Pre-exposure prophylaxis (PrEP) missed doses?

Hello, Doctor.
I would like to ask about my experience with taking Yaz (this is my second pack).
In one week, I missed two doses (not consecutively).
One time, I took a pill more than 24 hours late (for example, I took my last pill on Monday at 8 PM and took two pills on Wednesday at 10 PM).
The other time, I took a pill less than 24 hours late (for example, I took my last pill on Monday at 8 PM and took one pill on Wednesday at 5 PM, then another pill at 8 PM).
In the following two weeks, I had unprotected intercourse.
I would like to know if there is a possibility of pregnancy.
Thank you, Dr.
Chang.

Shen, 20~29 year old female. Ask Date: 2019/12/23

Dr. Huang Jianzhong reply Obstetrics and Gynecology

During the use of Yaz (this is the second pack), I missed two pills within one week (not consecutively).
One time, I took a pill more than 24 hours late (for example, I finished taking the last pill on Monday at 8 PM and took two pills on Wednesday at 10 PM).
The other time, I took a pill less than 24 hours late (for example, I finished taking the last pill on Monday at 8 PM, took one pill on Wednesday at 5 PM, and then took another pill at 8 PM).
In the following two weeks, I had unprotected intercourse.
I would like to know if there is a possibility of pregnancy.
Answer: There is no possibility of pregnancy.

Reply Date: 2019/12/23

More Info

When it comes to missed birth control pills, understanding the risks and precautions is crucial for anyone relying on hormonal contraceptives for pregnancy prevention. In your case, missing two pills within a week, especially with one of those instances being over 24 hours late, does increase the risk of unintended pregnancy.

Birth control pills, such as the one you mentioned (Yasmin), work primarily by preventing ovulation. When pills are missed, particularly if they are missed in the first two weeks of a cycle, the hormonal levels can drop, potentially allowing ovulation to occur. If ovulation happens and unprotected intercourse occurs, there is a possibility of pregnancy.

Understanding the Risks:
1. Timing of Missed Pills:
- If you miss a pill and take it more than 24 hours late, the effectiveness of the birth control can be compromised. In your example, taking a pill late on Wednesday after missing it on Monday means that your body may not have the necessary hormone levels to prevent ovulation effectively.

- The second missed pill, taken within 24 hours, is less concerning but still requires caution.

2. Unprotected Intercourse:
- Engaging in unprotected intercourse during the time when pills were missed increases the risk of pregnancy. Since you mentioned having unprotected sex after missing the pills, this is a critical factor to consider.

3. Cycle Phases:
- The risk of pregnancy is higher if the missed pills occur during the first two weeks of the cycle. If you missed pills during the third week, the risk is somewhat lower, but it is still significant if you had unprotected sex.

Precautions to Take:
1. Emergency Contraception:
- If you are concerned about the possibility of pregnancy, consider consulting with a healthcare provider about emergency contraception options. These are most effective when taken as soon as possible after unprotected intercourse.

2. Continue Taking Pills:
- Continue taking your birth control pills as scheduled. This helps to restore hormone levels and can help prevent ovulation in subsequent cycles.

3. Use Backup Contraception:
- Until you have taken your pills consistently for at least seven days after the missed doses, consider using a backup method of contraception, such as condoms, to reduce the risk of pregnancy.

4. Consult Your Healthcare Provider:
- If you have concerns about your specific situation, it’s always best to consult with your healthcare provider. They can provide personalized advice based on your health history and the specifics of your birth control method.

Conclusion:
In summary, missing birth control pills can lead to an increased risk of pregnancy, especially if unprotected intercourse occurs afterward. Given your situation, it is advisable to take precautions, consider emergency contraception if necessary, and consult with a healthcare provider for tailored advice. Regularly taking your birth control as prescribed is essential for maintaining its effectiveness and preventing unintended pregnancies.

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