Concerns About Missing Period After Starting Birth Control Pills

I just started taking oral contraceptive pills, but after finishing a pack, my period hasn't arrived?

I am taking medication for the first time, so I am very nervous and have many questions.
My menstrual cycle has always been irregular.
I had my period from March 31 to April 7, then from April 26 to May 3, and again from May 20 to May 26.
I started taking the medication (Aijie) on May 29 and have been taking it regularly, only missing one day which I made up the next day.
I had intercourse with my boyfriend on June 6 and June 15, but there was no ejaculation.
Yesterday was the last pill, and according to the schedule, my period should have started today, but it hasn't come yet.
I am quite worried and would like to ask: 1.
I didn't follow the advice online that suggests starting the medication on the first or fifth day of my period; does this affect anything? 2.
Is it normal for my period not to have arrived yet? 3.
Is there a possibility of pregnancy? (The main reason I started taking the medication was to regulate my menstrual cycle because I experience significant discomfort during my periods, and my cycle is very unstable.)

Lin, 20~29 year old female. Ask Date: 2020/06/19

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the first time you take birth control pills, it is recommended to start on the first day of your menstrual cycle.
If you begin taking the pills after the second day of your period, it is advised to use additional contraceptive measures for the first seven days of pill usage.
It is best to take the first pill on the first day of your period and to take one pill every day at the same time for a continuous period of 21 days.
After completing the 21 pills, take a break for seven days, during which you will likely have your period.
Even if ejaculation does not occur during intercourse, there is still a chance of pregnancy, as pre-ejaculatory fluid may contain sperm.
If your period does not arrive within a week after stopping the pills, it is advisable to check for pregnancy.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2020/06/19

More Info

When starting birth control pills, especially for the first time, it’s common to have concerns about your menstrual cycle and the potential for pregnancy. Let’s address your questions and provide some clarity based on medical knowledge.

1. Starting Birth Control Pills: It’s generally recommended to start taking birth control pills either on the first day of your menstrual period or on the first Sunday after your period begins. Starting on the fifth day, as you did, can still be effective, but it may take some time for the pills to fully regulate your cycle and provide effective contraception. Since you mentioned that your periods have been irregular, it’s possible that your body is still adjusting to the hormonal changes introduced by the pills.

2. Missed Period: It’s not uncommon for women to experience changes in their menstrual cycle when they start taking birth control pills. Some may find that their periods become lighter, shorter, or even stop altogether. This is due to the hormones in the pills, which can suppress ovulation and alter the uterine lining. If you’ve been taking your pills consistently (with the exception of one missed day, which you promptly made up), it’s possible that your body is still adjusting to the new hormone levels. Missing a period in the first few months of starting birth control can be normal, especially if your cycles were irregular before.

3. Pregnancy Concerns: The likelihood of pregnancy while on birth control pills, especially if taken correctly, is quite low. Since you mentioned that you had intercourse but there was no ejaculation, this further reduces the risk of pregnancy. However, if you are concerned about the possibility of pregnancy, it’s advisable to take a home pregnancy test if your period does not arrive within a week of when you expect it.
In summary, your situation seems to be within the realm of normal responses to starting birth control pills. It’s important to give your body some time to adjust to the hormonal changes. If your period does not return in the next month or if you have any unusual symptoms, it would be prudent to consult with your healthcare provider for further evaluation. They can provide personalized advice and reassurance based on your health history and current situation.

Additionally, if your primary reason for starting birth control was to regulate your menstrual cycle and alleviate discomfort, it may take a few cycles for the pills to have the desired effect. Keep in mind that while hormonal contraceptives can help with menstrual regulation, they may not be suitable for everyone, and discussing any ongoing concerns with your doctor is essential.
In conclusion, while it’s natural to feel anxious about changes in your menstrual cycle and the potential for pregnancy, it’s important to remember that many women experience similar concerns when starting birth control. Monitoring your body’s response and maintaining open communication with your healthcare provider will help you navigate this transition more comfortably.

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