Managing Missed Birth Control Pills: What to Do After Forgetting

Contraceptive Pills - Management of Missed Doses After Stopping the Medication

Hello Doctor, I have been taking the 21-day oral contraceptive pill for 7 months now, and I usually use dual contraception methods.
However, I forgot to start the new pack after a 7-day break last time and only remembered to start taking it again on the 11th day.
I understand that this will render this month's pills ineffective and that I will need to use additional contraception.
Should I finish all 21 pills this month (which will be 3 days later than usual) and then take another 7-day break before starting the next pack, or should I stop taking the pills when I would normally stop and wait for my period to come? Additionally, does the 7-day break need to be adjusted? Thank you for your time and guidance!

Xiao Yu, 20~29 year old female. Ask Date: 2021/03/22

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello,
Oral contraceptives (COCs) must be taken at the same time every day.
Correct usage can achieve a 99% effectiveness rate in preventing pregnancy.
It is important to avoid missing doses, especially during the first 12 days of the regimen, as missing doses can significantly reduce contraceptive effectiveness.
If you forget to take the pill for two consecutive days, you should take two pills each day for the next two days, and then continue taking one pill daily.
If you miss three or more days, the contraceptive effectiveness for that month is compromised, and you should stop taking the remaining pills, wait a few days for your menstrual period to begin, and then start a new pack of contraceptives on the first day (or the fifth day) of your period.
During this time, it is advisable to use additional barrier contraception.
It is best to take the contraceptive pills at the same time every day for 21 consecutive days, followed by a seven-day break, during which your menstrual period will occur.

Thank you! Wishing you peace and health.

Dr.
Zhang

Reply Date: 2021/03/22

More Info

When it comes to managing missed birth control pills, it’s important to understand the implications of forgetting to take your medication and how to effectively navigate the situation. Based on your description, you have been taking a 21-day oral contraceptive pill regimen for seven months and have recently encountered a lapse in your schedule. Here’s a detailed guide on what to do next.

First, it’s crucial to recognize that missing a pill can compromise the effectiveness of your birth control. Since you mentioned that you forgot to start your new pack after a seven-day break and only resumed taking the pills on the 11th day, this does indeed put you at risk for unintended pregnancy. The general recommendation for missed pills is to take the missed pill as soon as you remember, and then continue taking the rest of the pills at your regular time, even if it means taking two pills in one day. However, since you are already past the point of missing the initial pills, the focus shifts to how to proceed with the current pack.

In your case, since you are already on the 11th day of the cycle, it is advisable to continue taking the remaining pills in the pack until you finish all 21 pills. After you complete the pack, you should take the usual seven-day break. During this time, you may not have a withdrawal bleed (your period) as expected, especially since your hormone levels may be disrupted due to the missed pills. However, it is essential to stick to the schedule of taking the pills daily until the pack is finished.

Regarding your question about whether to adjust the seven-day break, the answer is no; you should maintain the standard schedule. After completing the 21 pills, take the seven-day break as usual. This will help your body reset and allow for a more predictable cycle moving forward. It’s also important to use an additional form of contraception, such as condoms, during this month to ensure you are protected against pregnancy, especially since the effectiveness of the pills may be compromised.

If you find that you are frequently forgetting to take your pills, you might want to consider alternative contraceptive methods that require less daily management. Options include long-acting reversible contraceptives (LARCs) like IUDs or implants, which can provide effective birth control without the need for daily attention.

Lastly, if you have any concerns about your menstrual cycle or the effectiveness of your birth control after this incident, it’s a good idea to consult with your healthcare provider. They can provide personalized advice based on your health history and help you find a contraceptive method that fits your lifestyle better.

In summary, continue taking your current pack of pills until all 21 are finished, take the usual seven-day break, and use additional contraception during this month. If missed pills become a recurring issue, consider discussing alternative birth control options with your doctor.

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