Missed Birth Control Pill: What to Do for Continued Effectiveness?

Missed a day of taking the contraceptive pill?

Hello, Doctor: I have been taking Marvelon 21 for the third pack.
However, during the second week of the third pack, I missed a dose because I stayed overnight at the office.
The next day, after returning home, I checked the instructions and took two pills within 12 hours.
Is the contraceptive effect still effective? Or should I stop taking this pack and wait until the first day of my period to start a new pack? Thank you!

Zixuan, 20~29 year old female. Ask Date: 2022/05/06

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello,
Each type of combination oral contraceptive pill comes in different formulations.
It is important to take the pills as directed.
If you forget to take a pill, you should take it as soon as you remember, and continue taking the next pill at the usual time.
If you miss a dose of an effective pill for more than 12 hours, in addition to taking the missed pill, it is advisable to use an additional barrier method of contraception for the next seven days.
If you miss a pill for more than 24 hours, you should stop taking the current pack of pills and refrain from taking them for seven days (including the days you missed), then continue with the next cycle.
If you miss a pill and do not experience the expected withdrawal bleeding during the placebo period, you should consider the possibility of pregnancy.

Thank you! Wishing you peace and health.

Dr.
Zhang

Reply Date: 2022/05/06

More Info

When it comes to missed birth control pills, it's important to understand the specific guidelines for the type of pill you are taking and how to maintain its effectiveness. In your case, you are using a combination oral contraceptive pill (like the one you mentioned, "枚麗安21"). Here’s a detailed explanation of what to do after missing a pill and how to ensure continued contraceptive effectiveness.

First, if you miss a pill, the general recommendation is to take it as soon as you remember. If you remember within 12 hours of the scheduled time, you should take the missed pill immediately and continue taking the rest of the pills at your regular schedule. This means that if you missed a pill and took it the next day, you should continue taking the remaining pills as usual. In your case, since you took two pills the next day, you are still within the guidelines for maintaining contraceptive effectiveness.

However, if you miss a pill and it has been more than 12 hours, the recommendations can vary slightly depending on how many pills you have missed and when in the cycle you missed them. Since you mentioned that you missed a pill during the second week of the pack, the following guidelines apply:
1. Take the Missed Pill: Since you took the missed pill within 12 hours, you have done the right thing. Taking two pills the next day is acceptable in this situation.

2. Continue Taking the Remaining Pills: You should continue taking the rest of the pills in the pack as scheduled. There is no need to skip the rest of the pack or wait for your period to start a new one.

3. Backup Contraception: If you missed a pill and did not take it within the 12-hour window, it is advisable to use backup contraception (such as condoms) for the next 7 days to ensure you are protected against pregnancy.

4. Monitor for Breakthrough Bleeding: Sometimes, missing a pill can lead to breakthrough bleeding or spotting. This is usually not a cause for concern, but if it continues or is heavy, consult your healthcare provider.

5. Consult Your Healthcare Provider: If you have any doubts or if you missed more than one pill, it’s always a good idea to consult your healthcare provider for personalized advice. They can provide guidance based on your specific situation and health history.

In summary, since you took the missed pill within the appropriate time frame and continued with your regimen, you should still have contraceptive effectiveness. There is no need to stop taking the current pack or wait for your period to start a new one. Just ensure that you are consistent with taking your pills moving forward, and consider using backup contraception if you have any concerns about missed doses in the future. Always keep an open line of communication with your healthcare provider regarding any questions or issues you may encounter with your birth control method.

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