Birth Control Pills: Missed Doses and Pregnancy Risks

Questions about contraceptive pills?

I previously asked about missing a day of medication.
Do I need to stop taking the medication and wait for my period to resume taking it? I currently have four days of medication left, but the doctor mentioned it could disrupt my menstrual cycle.
Should I stop taking it now? Additionally, I had sexual intercourse with my boyfriend yesterday, the 6th.
The first time we used a condom, but the second time we did not, although he withdrew before ejaculation.
What is the likelihood of pregnancy?

Kathy, 20~29 year old female. Ask Date: 2015/12/07

Dr. Lin Wenbin reply Obstetrics and Gynecology

Regarding the issue of contraceptive pills, please bring the remaining pills to your doctor for an evaluation, and adjustments will be made based on your health condition.
The withdrawal method during intercourse without using condoms has a poor contraceptive effectiveness.

Reply Date: 2015/12/07

More Info

When it comes to understanding birth control pills, missed doses can create confusion and concern, especially regarding the risk of unintended pregnancy. Let’s break down your situation and provide some clarity on how to proceed.

First, if you missed a dose of your birth control pill, the general recommendation is to take the missed pill as soon as you remember. If you remember on the same day, take it immediately. If you remember the next day, take the missed pill along with your regular pill for that day. If you miss more than one pill, the instructions can vary depending on the type of pill you are taking (combination or progestin-only). In most cases, if you miss a pill, it is advisable to continue taking the remaining pills in the pack as scheduled. You do not need to stop taking the pills unless advised by your healthcare provider.

Regarding your specific question about stopping the pills until your next period, it is generally not necessary to stop taking the pills after missing one dose. Stopping the pills can lead to irregular bleeding and may increase the risk of unintended pregnancy. Instead, continue taking your pills as directed, and if you have concerns about your cycle being irregular, discuss this with your healthcare provider.

Now, concerning the sexual activity you mentioned, using a condom during the first instance of intercourse provides a layer of protection against pregnancy and sexually transmitted infections. However, since the second instance did not use a condom and involved withdrawal (the "pull-out" method), there is still a risk of pregnancy. While withdrawal can reduce the chance of pregnancy, it is not a foolproof method, as pre-ejaculate fluid can contain sperm. The risk of pregnancy is higher if you have missed pills, as this can lower the effectiveness of the birth control method.

If you are concerned about the possibility of pregnancy due to missed pills and unprotected intercourse, consider taking a home pregnancy test if your period is late. Additionally, if you are worried about the risk of pregnancy, you might want to consult your healthcare provider about emergency contraception options, which can be effective if taken within a specific timeframe after unprotected intercourse.

In summary, continue taking your birth control pills as directed, even if you missed one. Do not stop unless instructed by your healthcare provider. If you have concerns about pregnancy due to missed doses and unprotected sex, consider taking a pregnancy test if your period is late and consult your healthcare provider for further guidance. It’s essential to maintain open communication with your healthcare provider regarding any concerns about your birth control method and its effectiveness.

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