Delayed Periods While on Birth Control Pills

Emergency contraceptive pills - Menstruation has not yet arrived?

Hello, I have been taking the Yaz contraceptive pill (24+4) for six months, consistently at 11 PM without missing any doses.
My period usually starts on the afternoon of the 29th day, or on the first day of the new pack.
Today is the 29th day, but my period has not arrived yet.
Last month, my menstrual period was from March 11 to March 16, and on April 1, I performed oral sex on my boyfriend, during which he ejaculated in my mouth, and I subsequently took a shower and rinsed my mouth.

1.
Is there a significant risk of pregnancy if water flowed over my body while rinsing my mouth during the shower?
2.
If my period does not arrive today, should I continue taking the new pack of contraceptive pills?
3.
Can long-term use of contraceptive pills cause a delay or absence of menstruation?
Thank you.

Niming, 20~29 year old female. Ask Date: 2024/04/08

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello,
Oral contraceptives must be taken at the same time every day, and correct usage can achieve a 99% effectiveness rate in preventing pregnancy.
For those using a 28-day pack, if menstruation does not occur during the last 7 days, you can start the next pack immediately.
If menstruation still does not occur, it is advisable to consult a physician for evaluation.
The components of contraceptive pills work by suppressing ovulation to prevent pregnancy.
When the ovaries are in a suppressed state for an extended period, stopping the medication may lead to anovulation.
Therefore, it is recommended that women who have been using contraceptives long-term should ideally stop taking them six months prior to planning a pregnancy, allowing time for the ovaries to gradually return to normal ovulation before conception.

In the event that ovulation does not resume after a longer period (ovulation can be monitored using a basal body temperature chart), it is also advisable to seek assistance from a gynecologist for methods to restore ovulation.
Consequently, it is suggested that the duration of contraceptive use should not be excessively long.
It is best to consult a trusted physician for evaluation at least once a year after using contraceptives for a year, before deciding on the next year's usage, rather than purchasing them on your own each time.
While long-term use followed by cessation may temporarily affect ovulatory function, it is generally possible to restore it through ovulation-inducing medications.

Thank you! Wishing you peace and health.

Dr.
Zhang

Reply Date: 2024/04/08

More Info

When it comes to understanding delayed periods while on birth control pills, there are several important factors to consider. First, it's essential to recognize that birth control pills, such as the one you mentioned (24+4), are designed to regulate your menstrual cycle. However, individual responses to these hormones can vary significantly.

1. Pregnancy Risk from Oral Sex: Regarding your concern about the risk of pregnancy from oral sex, it's important to clarify that pregnancy cannot occur from oral sex alone. Sperm must enter the vagina to fertilize an egg. Since you mentioned that you rinsed your mouth and showered afterward, the likelihood of sperm reaching the vaginal area is extremely low. Therefore, the risk of pregnancy from that encounter is negligible.

2. Delayed Period and Continuing Pills: If today marks the 29th day of your cycle and your period has not yet arrived, it is generally recommended to continue taking your birth control pills as scheduled. Birth control pills work by maintaining hormone levels in your body, and skipping doses can lead to irregularities in your cycle. If your period does not arrive by the time you are supposed to start a new pack, it is advisable to take a pregnancy test to rule out pregnancy. If the test is negative, you can continue with your new pack of pills as usual.

3. Effects of Long-term Birth Control Use: Long-term use of birth control pills can indeed lead to changes in your menstrual cycle. Some women may experience lighter periods, missed periods, or even amenorrhea (the absence of menstruation) while on the pill. This is often due to the hormonal effects of the pills, which can thin the uterine lining and reduce the frequency of menstruation. If you find that your periods are consistently delayed or absent while on the pill, it is a good idea to consult with your healthcare provider. They can assess whether your current birth control method is suitable for you or if an alternative might be more appropriate.

In summary, while it is not uncommon for periods to be delayed while on birth control pills, especially if you have been consistent with your medication, it is crucial to monitor your body’s responses. If you have any concerns about potential pregnancy or the effects of the pill on your menstrual cycle, do not hesitate to reach out to your healthcare provider for personalized advice and support. They can provide you with the most accurate information based on your medical history and current situation.

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