Missed Birth Control Pills: What to Do When You Experience Unusual Bleeding

Missed doses issue

I have been taking the contraceptive pill Qlaira for the past year.
I forgot to take a pill on February 11, and on February 12, when I was supposed to take my pill, I took two instead.
However, I got my period on February 13.
Should I wait until the fifth day to start a new pack, or should I consider this as abnormal bleeding and continue taking the old pack? (I might have also forgotten to take a pill on February 10, but I won't be able to confirm that until February 14.)

Ms. Huang, 10~19 year old female. Ask Date: 2022/02/13

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, if you forget to take your medication one day, it is best to take it as soon as possible within twelve hours.
You should continue to take the regular dose for that day (taking two pills).
If you forget to take your medication for two consecutive days, you should take two pills each day for those two days, and then resume taking one pill daily until the entire pack is finished.
If you miss three days or more, the contraceptive effectiveness of that month's birth control pills is compromised.
You should stop taking the remaining pills and wait a few days for your period to start.
Begin a new pack of birth control pills on the first day (or the fifth day) of your menstrual cycle.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2022/02/13

More Info

When it comes to missed birth control pills and experiencing unusual bleeding, it's essential to understand the implications of missed doses and how they can affect your menstrual cycle. Based on your situation, it appears that you have been consistently taking the birth control pill, specifically the combination pill, for about a year. However, you missed a pill on February 11 and took two pills the following day, which is a common practice to make up for a missed dose.

First and foremost, it's important to recognize that missing a birth control pill can lead to breakthrough bleeding or spotting, especially if the missed pill was taken during the first half of your cycle when estrogen levels are higher. The bleeding you experienced on February 13 could be a result of the missed pill and the subsequent hormonal fluctuations. It's not uncommon for women on hormonal contraceptives to experience irregular bleeding when they miss doses.

In your case, since you are unsure whether you also missed the pill on February 10, it complicates the situation slightly. If you missed a pill and then took two the next day, your body might react with withdrawal bleeding, which can mimic a menstrual period. This is particularly true if your body is adjusting to the sudden change in hormone levels.

Now, regarding what to do next:
1. Continue Taking Your Pills: You should continue taking your current pack of pills as directed, even if you are experiencing unusual bleeding. This is important to maintain the hormonal levels in your body and ensure continued contraceptive effectiveness.

2. Monitor the Bleeding: Keep track of the bleeding. If it resembles your typical menstrual period in terms of duration and flow, it may just be a side effect of the missed pill. However, if the bleeding is unusually heavy or lasts longer than a week, you should consult with your healthcare provider.

3. Start a New Pack: If you are nearing the end of your current pack and the bleeding has stopped by the time you reach the fifth day, you can start a new pack as usual. If the bleeding continues, it may be wise to wait until it resolves before starting a new pack, but this is generally not necessary unless advised by a healthcare professional.

4. Consult Your Doctor: If you are unsure about your situation or if the bleeding persists, it’s always a good idea to consult your healthcare provider. They can provide personalized advice based on your medical history and current health status.

5. Consider Backup Contraception: If you are concerned about the effectiveness of your birth control due to missed pills, consider using a backup method, such as condoms, until you are confident that your hormonal levels have stabilized.

In summary, while missing a birth control pill can lead to unusual bleeding, it is usually manageable by continuing your current regimen and monitoring your symptoms. If you have any concerns or if the bleeding does not resolve, seeking medical advice is always the best course of action. Remember, maintaining consistent use of your birth control pill is key to its effectiveness, so try to set reminders or use a pill organizer to help prevent missed doses in the future.

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