Do You Need Emergency Contraception After Taking Birth Control Pills?

If you have taken emergency contraceptive pills, do you still need to take post-coital contraception?

On March 17, the first day of my menstrual period, I took the emergency contraceptive pill (Ella) on the fifth day (March 21), usually around bedtime (around 9 PM).
I forgot to take it on March 30, but I took one at around 5 AM on March 31.
Later, on March 31, around 7 PM, I had unprotected intercourse, and then I took another emergency contraceptive pill around 9 PM.
March 31 falls within the fertile window.
Should I take a second dose of emergency contraception?

Chen Xiaomei, 20~29 year old female. Ask Date: 2024/04/01

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, there is no need to take emergency contraception.
Wishing you good health.

Reply Date: 2024/04/01

More Info

When it comes to the use of birth control pills and the need for emergency contraception, it's essential to understand how these methods work and the timing of their use. Birth control pills, when taken correctly, are designed to prevent ovulation and thus reduce the risk of pregnancy. However, if there are lapses in taking the pills, such as forgetting to take a dose, the effectiveness can be compromised.

In your case, you mentioned that you typically take your birth control pill around 9 PM but forgot to take it on March 30 and took it the next morning at 5 AM. This is within the 12-hour window that is generally considered acceptable for most combination birth control pills, meaning you should still have adequate protection. However, since you had unprotected intercourse on the evening of March 31, it is crucial to consider the timing of your pill intake and your menstrual cycle.

March 31 falls within your "danger zone," as you indicated, which is the time when you are most fertile. If you had unprotected sex during this time and there was a risk of ovulation, the concern for potential pregnancy increases. Since you took your birth control pill on March 31 at your usual time, you may still be protected, but the risk is not entirely eliminated due to the missed pill.

Emergency contraception (EC) is most effective when taken as soon as possible after unprotected intercourse. There are different types of EC available, including the "morning-after pill," which can be taken up to 72 hours after unprotected sex, and some types can be effective up to 5 days after. The sooner you take it, the better the chances of preventing pregnancy.

Given your situation, it would be advisable to consider taking emergency contraception if you are concerned about the possibility of pregnancy. While your birth control pill regimen may still provide some level of protection, the missed pill and the timing of unprotected intercourse can create uncertainty. Emergency contraception can serve as a backup to further reduce the risk of unintended pregnancy.

In summary, while you may still be protected by your birth control pills, the missed dose and the timing of unprotected intercourse warrant consideration of emergency contraception. It is always best to consult with a healthcare provider for personalized advice and to discuss your specific situation, including any potential side effects or interactions with your current birth control method. They can provide guidance on the best course of action to ensure your reproductive health and peace of mind.

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