the Timing and Safety of Starting Birth Control Pills

The timing for taking the first dose of an oral contraceptive pill?

From 2018 to 2019, I took the contraceptive pill Qlaira for over six months.
My doctor instructed me to start taking it on the fourth day of my menstrual cycle, and I adhered to the schedule.
After stopping the medication for six months, my menstrual cycle returned to approximately every 30 days, except for an early period caused by taking emergency contraception.

This May, I began taking the contraceptive pill again, with my period starting on May 5.
I took Qlaira on the seventh day, May 11, and have been taking it regularly since.
Based on my calculations, I plan to stop taking the pills for seven days starting June 1.

From what I've researched, even though I had taken the contraceptive pill before, this is considered my first time taking it again after several months.
Typically, it is recommended to start taking it within five days of the onset of menstruation, and the instructions for Qlaira suggest starting between days 2 to 5.

I would like to ask the doctor: if I have been taking the pill consistently and had unprotected intercourse between May 30 and June 2 (after taking it for more than seven days), does the fact that I started taking it on the seventh day of my menstrual cycle increase the risk of pregnancy, and do I need additional protective measures?

Lin, 10~19 year old female. Ask Date: 2020/05/17

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the combined oral contraceptive (COC) must be taken at the same time every day, and correct usage can achieve a 99% effectiveness in preventing pregnancy.
It is recommended to start taking the contraceptive pill on the first day of your menstrual cycle.
If you begin taking the pill after the second day of your period, it is advised to use additional contraceptive measures for the first seven days of taking the medication.
Your situation should already be showing appropriate effectiveness.
Thank you! Wishing you peace and health, Dr.
Chang.

Reply Date: 2020/05/17

More Info

When it comes to understanding the timing and safety of starting birth control pills, it's essential to consider several factors, including when you begin taking the pills in relation to your menstrual cycle, the type of birth control pill you are using, and how consistently you take them.

In your case, you mentioned that you previously took a birth control pill (Qiliana) for over six months and then stopped for about six months. You started taking the pill again on May 11, after your period began on May 5. According to medical guidelines, it is generally recommended to start taking combination oral contraceptives (COCs) like Qiliana within the first five days of your menstrual cycle for immediate contraceptive effectiveness. If you start taking the pill after the first five days, it is advised to use additional contraceptive methods (like condoms) for the first seven days of pill use to ensure adequate protection against pregnancy.

Since you began taking the pill on the seventh day of your cycle, you should have used additional protection during the first week of taking the pill. However, since you have been taking the pill consistently and correctly for more than seven days, you should have achieved effective contraceptive protection. The effectiveness of COCs is very high (over 99%) when taken correctly, meaning that if you take the pill at the same time every day, the chances of becoming pregnant are significantly reduced.

It is also important to note that the effectiveness of birth control pills can be influenced by various factors, including missed doses, interactions with other medications, and gastrointestinal issues (like vomiting or diarrhea). If you have taken your pills consistently and have not experienced any of these issues, your risk of pregnancy is minimal.

Regarding your concern about needing additional protection due to starting the pill on the seventh day of your cycle, the key point is that once you have taken the pill for seven consecutive days, you should be adequately protected against pregnancy, provided you have taken it correctly. Therefore, during the period from May 30 to June 2, if you were taking your pills consistently, you should not need to use additional protection.

In summary, starting birth control pills can be a safe and effective way to prevent pregnancy when done correctly. If you have any doubts or experience any unusual symptoms, it is always best to consult with your healthcare provider for personalized advice. Regular follow-ups with your doctor can help ensure that your birth control method is working effectively and that any concerns you have are addressed promptly.

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