Missed Birth Control Pill: What to Do After Unprotected Sex?

Missed dose of emergency contraceptive pill?

Hello doctor, I have a question.
I am currently on my third pack of Nina birth control pills, which contain 2.0 mg of Cyproterone Acetate and 0.035 mg of Ethinyl Estradiol per tablet.
I usually take my pill at 11:30 PM every night.
However, I forgot to take my pill last night (the 8th day of the third pack) at 11:30 PM.
On that same day, I had unprotected intercourse at 5:00 PM and again at 10:00 AM the next morning.
After waking up at 11:00 AM, I remembered that I had forgotten to take my pill and took it immediately.
I also took my pill at the regular time (11:30 PM) that night.

I have read that if you take a missed pill within 12 hours during the second week, it does not reduce contraceptive effectiveness.
However, I am concerned because I realized I forgot to take the pill after having unprotected intercourse.
I am worried about the possibility of pregnancy and I am hesitant to take emergency contraception.
What should I do now? Is there any relation to my situation?

Shan Shan, 20~29 year old female. Ask Date: 2021/01/04

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it should be fine.
Taking the missed dose provides contraceptive effectiveness.
Wishing you good health.

Reply Date: 2021/01/04

More Info

When it comes to missed birth control pills and the subsequent risk of pregnancy, it's essential to understand how hormonal contraceptives work and what steps to take if a pill is missed. In your case, you mentioned that you are taking a combination birth control pill containing Cyproterone Acetate and Ethinyl Estradiol, and you missed a dose on the eighth day of your third pack. You also had unprotected intercourse after missing the pill, which understandably raises concerns about the possibility of pregnancy.

First, let's clarify the situation regarding missed pills. According to the guidelines for combination oral contraceptives, if you miss a pill and remember to take it within 12 hours of your usual time, the effectiveness of the pill is generally maintained. However, since you had unprotected sex after missing the pill, the risk of pregnancy does increase, especially since the timing of your missed pill coincided with sexual activity.

In your specific case, since you missed the pill on the evening of the eighth day and had unprotected intercourse that afternoon, you are correct to be concerned. The effectiveness of the pill may be compromised due to the missed dose, particularly because you had unprotected sex after the missed pill. Although you took the missed pill as soon as you remembered, the timing of your sexual activity is critical.

Here are the recommended steps you should consider:
1. Pregnancy Test: Since you are concerned about the possibility of pregnancy, it would be prudent to take a home pregnancy test if your period is late or if you experience any early signs of pregnancy. Most home pregnancy tests are reliable and can provide results as early as the first day of your missed period.

2. Emergency Contraception: If you are worried about the risk of pregnancy and it has been less than 72 hours since the unprotected intercourse, you may consider taking emergency contraception (Plan B or similar). This can help prevent pregnancy after unprotected sex, but it is most effective the sooner you take it after the incident.

3. Continue Taking Your Pills: Continue taking your birth control pills as scheduled. Consistency is key in maintaining their effectiveness. Make sure to take the remaining pills at the same time each day.

4. Consult Your Healthcare Provider: If you have further concerns or if you are unsure about what to do next, it is always a good idea to consult your healthcare provider. They can provide personalized advice based on your medical history and current situation.

5. Future Prevention: To avoid similar situations in the future, consider setting reminders on your phone or using a pill organizer. This can help ensure that you take your pills consistently and on time.

In summary, while missing a birth control pill can increase the risk of pregnancy, taking the missed pill as soon as you remember and continuing with your regular schedule is crucial. If you are concerned about the risk of pregnancy, consider taking a pregnancy test or consulting with your healthcare provider for further guidance. Remember, open communication with your healthcare provider is essential for managing your reproductive health effectively.

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