Addressing Irregular Periods While Using Birth Control Pills

Regarding the issue of amenorrhea with the use of emergency contraceptive pills?

Hello Dr.
Wu, I would like to ask you: I have been taking Medroxyprogesterone for about three years.
Previously, I experienced significant premenstrual syndrome, but it improved a lot after starting the medication.
During the medication period, my menstrual cycle was very regular, starting about 3-4 days after stopping the medication.
However, in the past few months, it has become very unstable.
Earlier this year, after finishing an old pack, my period did not come, and I started the second pack after 7 days.
Halfway through that pack, my period started, leaving me confused about whether to continue or stop the medication.
So in June, I decided to stop taking the medication for a month, hoping to allow my period to return to normal before resuming.
My period started around July 6, and shortly after, I began a new pack of Medroxyprogesterone.
After completing the usual 21 pills, I stopped around July 28 or 29, but as of today (August 5), my period still has not arrived.
Additionally, I had unprotected intercourse with my boyfriend on the night of August 3, and I took the first pill of a new pack on August 4.
I am unsure if this is safe and whether I need to take emergency contraception.
Also, should I consider switching to a different brand of contraceptive in the future?

Niming, 20~29 year old female. Ask Date: 2021/08/05

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
For pregnancy concerns, please take a home pregnancy test or visit a gynecologist for evaluation four weeks after your most recent sexual intercourse.
2.
The menstrual cycle can be influenced by various psychological and physiological factors; if your period is more than two months late, it is advisable to consult a gynecologist for evaluation.
3.
It is recommended to try switching to a different brand of contraceptive pills.

Reply Date: 2021/08/05

More Info

Addressing irregular periods while using birth control pills can be a complex issue, especially for individuals who have previously experienced stable menstrual cycles on hormonal contraceptives. In your case, it seems that you have been using a specific birth control pill (美適濃) for about three years, which initially helped regulate your menstrual cycle and alleviate premenstrual syndrome (PMS) symptoms. However, recent changes in your cycle have raised concerns.

Firstly, it is important to understand that hormonal birth control pills work by regulating the hormones that control the menstrual cycle. When taken consistently, they typically lead to predictable menstrual periods. However, various factors can influence the effectiveness and regularity of these pills, including stress, changes in weight, illness, or even the body’s natural hormonal fluctuations over time.

In your situation, the irregularities you have experienced—such as missed periods and unexpected bleeding—could be attributed to several factors. One possibility is that your body may be adjusting to the hormonal changes after years of consistent use. Additionally, if you have recently stopped taking the pill for a month, this could also lead to fluctuations in your cycle as your body readjusts to its natural hormonal rhythm.

Regarding your recent sexual activity without protection, it is crucial to consider the timing of your menstrual cycle and the effectiveness of the birth control pill. Since you resumed taking the pill shortly after your period, you should be protected from pregnancy, provided you take the pills consistently and correctly. However, if you are concerned about the possibility of pregnancy due to the irregularity of your cycle, it may be wise to take a home pregnancy test if your period does not arrive soon.

As for whether you should continue with your current birth control pill or switch to another brand, this is a decision best made in consultation with your healthcare provider. Different formulations of birth control pills contain varying levels of hormones, and some may suit your body better than others. If you are experiencing significant side effects or irregularities, your doctor may recommend trying a different brand or formulation that could provide better regulation of your menstrual cycle.

In summary, it is essential to monitor your menstrual cycle closely and communicate any irregularities or concerns with your healthcare provider. They can provide personalized advice based on your medical history and current situation. If you continue to experience irregular periods or other side effects, it may be beneficial to explore alternative contraceptive methods or brands that may better suit your needs. Always remember that open communication with your healthcare provider is key to managing your reproductive health effectively.

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