Concerns About Missing Birth Control Pills and Irregular Bleeding

Q: Concerns About Missing Birth Control Pills and Irregular Bleeding

Hello Amelia： 1. The design of oral contraceptives is to maintain a state of infertility in women by influencing the levels of estrogen and progesterone in the body (preventing ovulation and increasing cervical mucus). 2. If you remember to take the missed pil

Take more birth control pills?

Hello Doctor, my period started on March 30th, and I have been taking my medication on time every day.
On April 7th, I realized I missed one pill, so I took two pills instead.
However, when I was about to take another pill, it seemed like I misplaced it and couldn't find it on the floor.
I was worried about taking too many, so I took another pill later.
My period is supposed to last for 7 days, but today is the ninth day, and I still have a few drops of very dark brown discharge, which I feel is very close to black.
Is this normal? I want to ask if I took two extra pills, but accidentally took one more, will it affect the contraceptive effect or cause my bleeding to continue? What issues might arise in my body? I'm very anxious.
Thank you for your response, Doctor.

Amelia, 30~39 year old female. Ask Date: 2020/04/07

Dr. Hou Fangmin reply Pharmacology

Hello Amelia:
1.
The design of oral contraceptives is to maintain a state of infertility in women by influencing the levels of estrogen and progesterone in the body (preventing ovulation and increasing cervical mucus).

2.
If you remember to take the missed pill within 12 hours of the scheduled time, you can take it as soon as possible, and the contraceptive effectiveness will not be reduced.
Continue taking the next dose at the usual time.
If you remember the next day (after more than 12 hours), you should take two pills that day and then continue with your normal schedule and dosage.

3.
Regardless of whether the packaging contains 21 or 28 pills, there are only 21 active pills.
The 28-pill pack contains 21 active pills and 7 placebo pills.

4.
It is common to experience irregular bleeding during the first few months of starting oral contraceptives.
You should continue taking them as prescribed, and it usually takes about three cycles for your body to adjust, after which abnormal bleeding should stop.
If you still experience abnormal bleeding after three months, you should consult a gynecologist for appropriate management.

5.
If you accidentally take two pills and end up taking an extra one, it is unlikely to significantly affect contraceptive effectiveness.
If you continue to have menstrual bleeding, it may be a good idea to see a gynecologist to alleviate your concerns.
Wishing you peace and joy!

Reply Date: 2020/04/07

More Info

It's understandable to feel anxious about missing birth control pills and experiencing irregular bleeding, especially when it comes to your menstrual cycle and contraceptive effectiveness. Let's break down your concerns and provide some clarity.

When you take birth control pills, it's crucial to take them consistently and at the same time every day. Missing a pill can disrupt the hormonal balance that the pills maintain, which can lead to unexpected bleeding or spotting. In your case, you mentioned that you missed one pill on April 7th and then took two pills to compensate. This is a common practice, but it can sometimes lead to confusion regarding your cycle and the effectiveness of the contraceptive.

The dark brown or almost black discharge you are experiencing on the ninth day of your cycle is likely old blood. It's not uncommon for menstrual blood to appear darker as it takes longer to exit the body. This can happen at the end of your period or during irregular bleeding episodes. However, if this discharge continues or is accompanied by other symptoms such as pain or a strong odor, it would be wise to consult with a healthcare provider.

Regarding your concern about the effectiveness of your birth control after taking extra pills, it's important to note that taking two pills at once is generally not harmful, but it can lead to side effects such as nausea or breakthrough bleeding. If you accidentally took an extra pill, it shouldn't significantly reduce the contraceptive effectiveness for that cycle, especially if you are otherwise consistent with your pill regimen. However, if you continue to have irregular bleeding or if you miss more pills, the effectiveness could be compromised.

If you find yourself frequently missing pills or feeling uncertain about your birth control method, it might be worth discussing alternative contraceptive options with your healthcare provider. There are various methods available, including long-acting reversible contraceptives (LARCs) like IUDs or implants, which can provide effective contraception without the daily responsibility of taking a pill.

In summary, while missing a pill can lead to irregular bleeding and concerns about contraceptive effectiveness, taking extra pills occasionally is usually not harmful. However, if you continue to experience unusual bleeding or have concerns about your birth control method, it's best to consult with a healthcare professional for personalized advice and reassurance. Remember, it's always better to seek guidance when you're feeling uncertain about your health.

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