When to Start Your Next Birth Control Pill Pack - Obstetrics and Gynecology

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Emergency contraceptive pill


Hello Doctor, I started taking my first pack of 21-day birth control pills on March 7 (the fifth day of my period).
I finished the pack on March 27 and got my period on March 30.
Should I start my next pack of birth control pills on April 3 (the fifth day of my period) or on April 4 (after a 21-day course followed by a 7-day break)?

HJ, 20~29 year old female. Ask Date: 2024/04/04

Dr. Liu Fuping reply Obstetrics and Gynecology


Birth control pills have both benefits and drawbacks.
It is advisable to consult a gynecologist to obtain detailed information about the medication and usage instructions, and it is recommended to follow the directions on the packaging.
Generally, for a 21-pill regimen, the pills should be taken at the same time every day for 21 consecutive days.
After a 7-day break from the pills, you can start the next pack.
During this 7-day period, withdrawal bleeding (not a menstrual period) typically occurs, usually starting about 2-3 days after finishing the last pill.
When beginning the next pack, the withdrawal bleeding may not have completely ended.
Thank you.

Reply Date: 2024/04/04

More Info


When it comes to starting your next pack of birth control pills, it’s essential to follow the guidelines provided by your healthcare provider and the instructions that come with your specific medication. Based on the information you've provided, you began taking your first pack of 21-day birth control pills on March 7, and you finished that pack on March 27. Your period started on March 30.
In general, for a 21-day pill regimen, you take the pills for 21 consecutive days and then have a 7-day break during which you typically experience withdrawal bleeding, similar to a menstrual period. After this 7-day break, you would start your next pack of pills.
Since you mentioned that your period started on March 30, you would typically wait until the end of your 7-day break to start your next pack. This means you would start your next pack on April 3, which is the fifth day of your period. This is the recommended approach because it ensures that you maintain the correct cycle and hormonal balance.

If you were to start the next pack on April 4, you would be starting a day later than the typical schedule, which could potentially disrupt your cycle. It is crucial to maintain consistency in taking your birth control pills to ensure their effectiveness.
To clarify, here’s a step-by-step breakdown of what you should do:
1. Finish the First Pack: You completed your first pack on March 27.

2. Wait for Your Period: You got your period on March 30.

3. 7-Day Break: You will have your withdrawal bleeding during this time.

4. Start the Next Pack: You should start your next pack on April 3, which is the fifth day of your period.

It's important to note that if you start your next pack on the correct day (April 3), you will continue to have contraceptive protection. If you were to start on April 4, you might not have the same level of protection, especially if you have not taken the pills consistently in the past.

Additionally, if you ever miss a pill or are unsure about when to start a new pack, it’s always best to consult with your healthcare provider. They can provide personalized advice based on your health history and specific circumstances.
In summary, for your situation, you should start your next pack of birth control pills on April 3, following the 7-day break after completing your first pack. This will help ensure that you maintain effective contraception and keep your cycle regular. Always remember that consistency is key with birth control pills to maximize their effectiveness.

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