Birth Control Pills: Effectiveness and Switching Medications

Questions related to emergency contraceptive pills and medication switching?

Hello Doctor, I am currently taking Esmya (in my fifth month).
The main purpose of seeing the doctor was to regulate my menstrual cycle and suppress androgen levels, so the doctor prescribed Esmya for me.
However, the doctor specifically mentioned that although this medication has contraceptive effects, its primary purpose is not for contraception, which is also stated in the leaflet.
Now that I have a need for contraception, I would like to ask the following questions:
1.
Is the contraceptive effect of Esmya really weaker?
2.
If I plan to switch medications (currently considering switching to Yasmin), will there be contraceptive protection during this cycle after switching? Or should I take the new medication for at least 7 days, or to be safer, for a month?
3.
Regarding the timing of taking the medication, I usually take it at 11 PM, but recently I have been so tired that I often accidentally fall asleep after dinner.
If I wake up at 1 or 2 AM and take the medication then, will a delay of 3-4 hours significantly affect its efficacy?
Thank you for your assistance!

J, 20~29 year old female. Ask Date: 2023/08/01

Dr. Chen Zhiyu reply Obstetrics and Gynecology

It is advisable to consult and evaluate with a gynecologist before starting, stopping, or switching contraceptive methods.
Thank you.

Reply Date: 2023/08/01

More Info

Understanding birth control pills and their effectiveness is crucial for anyone considering their options for contraception. In your case, you are currently taking a medication called "Aisilian," which is primarily prescribed for regulating menstrual cycles and suppressing male hormones, with some contraceptive effects. Let's address your questions one by one.

1. Effectiveness of Aisilian as a Contraceptive: Aisilian, like many combination oral contraceptives, can provide contraceptive benefits, but its primary purpose in your case is not for birth control. Generally, the effectiveness of birth control pills is measured by their ability to prevent pregnancy when taken correctly. Most combination pills have a failure rate of about 0.1% with perfect use and about 9% with typical use. If Aisilian is not specifically marketed as a contraceptive, it may not be as rigorously tested for that purpose compared to dedicated contraceptive pills. Therefore, while it may offer some level of protection, it is advisable to consult with your healthcare provider about its reliability for contraception.

2. Switching to Aiki 21: If you decide to switch to Aiki 21, which is a dedicated contraceptive pill, it is essential to understand how to transition safely. When switching from one birth control pill to another, it is generally recommended to start the new pill immediately after finishing the current pack. If you do this, you should have contraceptive protection right away. However, if there is any gap between finishing Aisilian and starting Aiki 21, or if you start Aiki 21 on a different day than recommended, it is advisable to use an additional form of contraception (like condoms) for at least the first seven days of taking the new pill. This precaution helps ensure that you are adequately protected against pregnancy during the transition.

3. Timing of Medication: Consistency in taking your birth control pill is vital for maintaining its effectiveness. Ideally, you should take your pill at the same time every day. If you occasionally take it 3-4 hours late, it may not significantly impact its effectiveness, especially with combination pills, which have a wider window of effectiveness. However, if you miss a pill or take it significantly late, it is essential to follow the instructions provided with your medication. Generally, if you miss a dose, you should take it as soon as you remember. If it's close to the time for your next dose, skip the missed pill and continue with your regular schedule. In such cases, using backup contraception for the next seven days is a good practice.

In summary, while Aisilian may provide some contraceptive benefits, it is not primarily designed for that purpose. If you switch to Aiki 21, ensure you follow the guidelines for transitioning to maintain contraceptive effectiveness. Lastly, try to take your pills at the same time daily, but if you occasionally miss the exact time, follow the guidelines to minimize any risk of unintended pregnancy. Always consult your healthcare provider for personalized advice tailored to your health needs and circumstances.

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