Common Questions About Birth Control Pills: A Guide for Women

Contraceptive pill issues?

Hello Doctor, I started taking the oral contraceptive pill on June 10, and that was my first time using this type of medication.
The brand I am using is Alesse, which comes in a pack of 21 pills.
I have three questions for you:
1.
It is mentioned that after taking 21 pills, I should stop for seven days, during which I will have my period.
Should I start the next pack of pills in accordance with the seven-day break (which means I might not start on the first day of my period), or should I continue to take the pill on the first day of my period?
2.
I take one pill every night before bed, but my bedtime varies; sometimes I take it at 11 or 12 PM, and other times it’s around 1 or 2 AM.
Will this inconsistency have a significant impact?
3.
During the seven-day break after finishing one pack of pills, do I need to use additional contraceptive methods? Thank you for your answers.

Ms. Chen, 10~19 year old female. Ask Date: 2020/06/27

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello,
It is recommended to start taking the medication on the first day of your menstrual period, ideally at the same time every day for a continuous period of 21 days.
After completing the 21 pills, take a break for seven days before starting the next pack.
Your period will occur during the seven-day break.
Combination oral contraceptives must be taken at the same time every day; correct usage can achieve a 99% effectiveness rate in preventing pregnancy, and no additional contraception is needed.

Thank you! Wishing you peace and health.

Dr.
Zhang

Reply Date: 2020/06/27

More Info

When it comes to birth control pills, particularly the combination oral contraceptives like the one you mentioned (Alesse), there are several important factors to consider for effective use. Let's address your questions one by one.

1. Starting the Next Pack After the 7-Day Break: The standard recommendation for combination birth control pills is to take the pills for 21 consecutive days, followed by a 7-day break during which you will typically have your withdrawal bleed (similar to a period). When you start your next pack, it is best to begin taking the pills on the same day of the week that you started your first pack, regardless of whether it coincides with the first day of your period. This means that if you started your first pack on a Monday, you should start your next pack on the following Monday, even if your period has not yet ended. This helps maintain a consistent hormone level in your body, which is crucial for the effectiveness of the pill.

2. Timing of Taking the Pill: Consistency is key when taking birth control pills. While it is ideal to take your pill at the same time every day, a few hours of variation (like taking it between 11 PM and 2 AM) generally does not significantly affect its effectiveness. However, if you consistently take it later than 24 hours from your last dose, it may reduce its effectiveness. If you find that your schedule varies greatly, you might consider setting an alarm or reminder to help you remember to take it at the same time each day. This can help ensure that you maintain the pill's effectiveness and reduce the risk of unintended pregnancy.

3. Need for Additional Contraceptive Measures During the 7-Day Break: During the 7-day break after completing a pack of pills, you are still protected from pregnancy as long as you took your pills correctly during the previous 21 days. However, if you missed any pills or did not take them as directed, you may need to use additional contraceptive methods (like condoms) during the 7-day break to ensure protection. If you are ever unsure about your contraceptive coverage, it’s always a good idea to consult with your healthcare provider for personalized advice.

In addition to these points, it's important to remember that while birth control pills are highly effective when taken correctly, they do not protect against sexually transmitted infections (STIs). Therefore, using condoms in conjunction with the pill can provide additional protection against STIs.

Lastly, if you experience any side effects or have concerns about your birth control method, don’t hesitate to reach out to your healthcare provider. They can provide guidance tailored to your specific health needs and lifestyle.

In summary, maintain consistency in taking your pills, start your next pack on schedule regardless of your period, and ensure you understand your contraceptive coverage during the break. This will help you effectively use your birth control pills and manage your reproductive health.

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