Emergency Contraceptive Pills: Timing and Effectiveness Concerns - Obstetrics and Gynecology

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Emergency contraceptive pill


Hello, doctor.
This month is my second pack of oral contraceptives, which I started taking on the fourth or fifth day of my period (I experienced breakthrough bleeding after taking Alesse for a month, so it was a bit difficult to determine when my period started.
The doctor switched me to Qlaira for the second pack).
One day, I took two pills because my hands were wet when I reached for the medication, and I was concerned that it might affect the efficacy of the pills.
I found information suggesting that this could cause my period to come a day early, so I just finished the remaining pills.
Will this affect the contraceptive effectiveness of the current pack and the subsequent packs? Additionally, I would like to ask you, the doctors I consulted told me to start taking the oral contraceptive on the fifth day of my period, so I also started my first pack on the fifth day.
However, I have seen some doctors say that the first pack should be started on the first day of the period.
Will this have any impact on the effectiveness of the medication going forward? Thank you!

yo, 10~19 year old female. Ask Date: 2022/11/23

Dr. Lin Manying reply Obstetrics and Gynecology


Hello, based on your description, here is the response: 1.
It may not necessarily have an impact; if you continue to take one pill daily as scheduled the next day, it will not affect you.
2.
You can take it on either the fifth day of your menstrual cycle or the first day, just follow your doctor's instructions.
Hualien Hospital, Ministry of Health and Welfare, cares about your health.

Reply Date: 2022/11/23

More Info


When it comes to understanding emergency contraceptive pills (ECPs) and their effectiveness, timing is crucial. ECPs are designed to prevent pregnancy after unprotected intercourse or contraceptive failure, such as a broken condom. The effectiveness of these pills is significantly influenced by when they are taken in relation to the menstrual cycle.

In your case, you mentioned that you started taking your second pack of birth control pills (BCPs) around the fourth or fifth day of your menstrual cycle. Generally, it is recommended to start taking BCPs at the beginning of your cycle (the first day of your period) for optimal effectiveness. However, starting on days four or five is still acceptable, especially if you are using a combination pill, as it can still provide contraceptive protection after a week of consistent use.

Taking two pills in one day due to concerns about the effectiveness of the medication can lead to confusion. While taking an extra pill occasionally is unlikely to cause significant harm, it is important to follow the prescribed dosage. Taking two pills in one day may not enhance the contraceptive effect and could potentially lead to side effects such as nausea or changes in your menstrual cycle. If you are concerned about the timing of your pills affecting your menstrual cycle, it is worth noting that hormonal contraceptives can indeed alter the timing and flow of your period.
Regarding your question about the impact of taking the first pack of pills on the fifth day of your period, it is generally advised to start BCPs on the first day of menstruation for immediate contraceptive protection. If you start taking them later in your cycle, it may take up to seven days for the pills to become fully effective. Therefore, if you had unprotected intercourse during that time, there could be a risk of pregnancy.

In terms of the effectiveness of your current pack and subsequent packs, as long as you continue to take your pills consistently and correctly, the contraceptive effect should remain intact. However, if you have any concerns about missed doses or irregularities in your menstrual cycle, it is advisable to consult with your healthcare provider. They can provide personalized guidance based on your specific situation and help you understand the best practices for using hormonal contraceptives.

In summary, while starting BCPs later in your cycle may not be ideal, it does not necessarily compromise their effectiveness if you take them consistently. If you have taken two pills in one day, monitor for any side effects and try to adhere to the prescribed regimen moving forward. If you have further questions or concerns about your contraceptive method, consider discussing them with your healthcare provider for tailored advice.

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