Emergency Contraceptives and Pregnancy Risks: Your Questions Answered

Emergency contraceptive pills and the probability of pregnancy?

Hello, doctor.
I am not planning to get pregnant, so I have been taking Yaz 24+4.
This is the sixth month, and in the previous months, my period usually started on the 28th or 29th day.
Today is the 29th day, and my period has not arrived yet.
I have taken the pill every day without missing any doses, although occasionally I take it a little late, but never more than an hour late.
Will this affect the contraceptive effectiveness? This month, there was no penetrative intercourse, but there was mutual oral sex and fondling, and ejaculation in my mouth.
I am unsure if my boyfriend touched his own secretions and then touched my intimate areas, or if I licked his secretions and then he kissed me and performed oral sex on me again.
What is the likelihood of pregnancy? Is it normal for the timing of menstruation to vary each month when taking the contraceptive pill? If my period does not start today, should I still take the next pack of birth control pills tonight? Should I continue to wait for my period? Will this affect whether my period comes this month? Thank you, doctor.

Niming, 20~29 year old female. Ask Date: 2024/01/15

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the oral contraceptive pill must be taken at the same time every day.
When taken correctly, it can achieve a 99% effectiveness in preventing pregnancy.
If a dose is missed and there is no expected withdrawal bleeding during the subsequent pill-free interval, pregnancy should be suspected.
After finishing a pack of 28 pills, you should immediately start the next pack.
Thank you! Wishing you safety and health.
Dr.
Chang

Reply Date: 2024/01/15

More Info

Understanding emergency contraceptives and the associated risks of pregnancy is crucial for anyone who is sexually active and wishes to avoid unintended pregnancies. In your case, you are taking a combined oral contraceptive pill (the brand you mentioned, "Yaz," which contains drospirenone and ethinyl estradiol) consistently for six months, with a history of regular menstrual cycles occurring around the 28th or 29th day.
Firstly, it's important to note that taking your birth control pill consistently is key to maintaining its effectiveness. You mentioned that you occasionally take the pill a little late, but not exceeding one hour. Generally, for most combined oral contraceptives, a delay of less than three hours does not significantly compromise the contraceptive effect. However, if you miss a dose or take it more than 24 hours late, it could increase the risk of ovulation and, consequently, the risk of pregnancy.

Regarding your sexual activities, while you indicated that there was no penetrative intercourse, the concern arises from the possibility of pre-ejaculate fluid (pre-cum) containing sperm. If your boyfriend touched his own genital area and then touched you, or if there was any transfer of bodily fluids, there is a slight risk of pregnancy, although it is generally considered low in such scenarios. The likelihood of pregnancy from oral sex or mutual masturbation is minimal, especially if no direct ejaculation occurred in the vaginal area.

As for your menstrual cycle, it is common for the timing of your period to vary slightly while on hormonal contraceptives. The hormones in the pill can regulate your cycle, but individual responses can lead to variations in the timing of your withdrawal bleed (the period-like bleeding that occurs during the placebo week). If your period does not arrive on the expected day, it is advisable to continue taking your pills as scheduled. You should not skip the next pack of pills, even if your period is late. Continuing to take the pill maintains its effectiveness and helps regulate your cycle.

If your period does not arrive after a week of the placebo pills, it is recommended to take a pregnancy test to rule out pregnancy. If the test is negative and you continue to miss your period, consider consulting with your healthcare provider for further evaluation.

In summary, while your consistent use of the birth control pill significantly reduces the risk of pregnancy, factors such as timing of pill intake and the nature of sexual activities can influence this risk. It is always best to communicate openly with your healthcare provider about any concerns regarding contraceptive methods and menstrual irregularities. They can provide personalized advice and reassurance based on your specific situation.

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