Nausea After Missed Birth Control Pills: Key Insights

Vomiting after taking birth control pills?

Hello, Doctor.
My situation is as follows: I have been taking birth control pills regularly for over three years.
The last time I stopped and then resumed was in August of this year (I took the pills for nearly two years and stopped for one month).
I just finished my second pack recently.
I have always taken the pills very consistently and have never missed a dose until a few days ago.
Usually, I take my pills around 10:30 PM.
On October 8th, I was supposed to take the fourth-to-last pill of the second pack.
However, I was out drinking that night and had unprotected sex around 10 PM (without ejaculation).
Because I was drunk, my memory is hazy, but I remember returning home around 12:30 AM and taking the pill I was supposed to take on October 8th.
A few minutes later, I vomited, and since I was still intoxicated, I did not take a replacement pill.
It wasn't until the evening of October 9th that I recalled this incident and sought advice from a gynecologist I had never visited before.
The medication leaflet states that if a pill is missed in the third week, one can choose to either stop taking the pills immediately or take the missed pill within 12-24 hours and continue the cycle.
However, the doctor advised me to take two pills on October 9th, finish the remaining pills, and then stop for seven days before continuing.
Therefore, when I got home (still within 24 hours), I immediately took two pills and finished the last one on October 10th.
However, I have been experiencing strong side effects these past few days, including severe cramping in my lower abdomen and nausea.
Today is the third day since I stopped taking the pills, and I would like to ask: 1.
Was the doctor's advice correct? 2.
Since I have not had any sexual intercourse since the night of October 8th, my understanding is that if I took the missed pill and did not have sex afterward, the chance of pregnancy is almost nonexistent? 3.
My menstrual cycle usually starts on the fourth or fifth day after stopping the pills; will this cycle be disrupted due to the missed pill? 4.
Is the recommendation to "stop immediately" in the third week similar to the principle of stopping for seven days after completing 21 days of pills? Does this mean that the body treats the day I forgot to take the pill as the first day of a regular break, so the following days are equivalent to the usual break after completing a cycle? I have many questions and hope the doctor can clarify these for me.
Thank you very much.

L, 20~29 year old female. Ask Date: 2021/10/13

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, after taking the medication on October 10th, you should wait for your period to arrive, which typically occurs within a week.
If it hasn't arrived after a week, it is advisable to consult a gynecologist.
If your period does come, start taking the next pack of birth control pills on the fifth day of your menstruation.
Wishing you good health.

Reply Date: 2021/10/13

More Info

When it comes to missed birth control pills and the subsequent nausea you are experiencing, there are several important factors to consider. Let's break down your situation and address your questions one by one.

1. Correctness of the Doctor's Advice: The advice given by the doctor you consulted seems to align with standard practices for missed pills. When a pill is missed during the third week of a birth control pack, the general recommendation is to take the missed pill as soon as you remember, and then continue taking the remaining pills in the pack. If you miss a pill and are within 12-24 hours, you can still maintain contraceptive efficacy by taking the missed pill and continuing as normal. However, if you miss a pill and do not take it within that timeframe, it is advisable to use backup contraception for at least 7 days. The doctor’s suggestion to take two pills on the day after you missed one and then finish the pack is a common approach.

2. Risk of Pregnancy: Since you mentioned that you did not have any sexual intercourse after the incident on October 8th, the risk of pregnancy is significantly reduced. If you took the missed pill within the 24-hour window and did not engage in unprotected sex afterward, the likelihood of pregnancy is low. However, it’s important to remember that no contraceptive method is 100% effective, and missed pills can increase the risk of unintended pregnancy.

3. Menstrual Cycle Changes: It is not uncommon for your menstrual cycle to be affected after missing pills. Hormonal contraceptives can regulate your cycle, but any disruption, such as missing a pill, can lead to changes in your cycle. You may experience an earlier or later onset of your period, or it may be lighter or heavier than usual. If you typically get your period within 4-5 days after stopping the pills, monitor your body for any signs of menstruation, but be aware that it might not follow the same pattern this time.

4. Stopping the Pills: The recommendation to "immediately stop" the pills after missing one is indeed based on the principle of allowing your body to reset. When you miss a pill, especially in the third week, stopping the pills can allow your body to have a withdrawal bleed, similar to what happens at the end of a regular pill cycle. This is why the advice to treat the missed pill as the first day of your break can be helpful. It allows your body to process the hormonal changes more smoothly.

In summary, while missing a birth control pill can lead to nausea and other side effects, it is crucial to follow the guidelines for missed pills and to communicate with your healthcare provider about any concerns. If your nausea persists or worsens, or if you have any other unusual symptoms, it would be wise to consult your doctor again for further evaluation. Additionally, if you have concerns about potential pregnancy or your menstrual cycle, a pregnancy test may provide peace of mind. Always remember that your health and well-being are paramount, and staying informed about your contraceptive methods is essential for effective use.

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