Missed Birth Control Pill: Risks and Menstrual Cycle Questions

Forgot to take medication?

I would like to ask if I took the first pill on the first day of my period (December 11) and then forgot to take it on the first day of the third week (December 25).
I usually take my medication at 10 PM.
However, I had sexual intercourse in the morning on the 25th and did not take the pill that evening.
Is there a chance of getting pregnant? Also, after finishing the pills in the third week, will I start my period in 2-3 days, or do I need to wait for 7 days until I start the next pack for my period to begin?

Miss Liu, 10~19 year old female. Ask Date: 2016/01/03

Dr. Tian Yiwen reply Obstetrics and Gynecology

The chances of pregnancy are low but not impossible.
It is recommended to buy a pregnancy test two weeks later.
Try not to forget to take your medication; if you remember that you forgot to take it, take a dose as soon as possible.
Frequently forgetting to take the medication can affect its contraceptive effectiveness.
Usually, menstruation will occur 3-7 days after stopping the medication, but this may vary depending on individual physiology.

Reply Date: 2016/01/03

More Info

When it comes to missed birth control pills and the associated risks, it's essential to understand how hormonal contraceptives work and the implications of missing a dose. In your case, you started taking your birth control pills on the first day of your menstrual cycle (December 11) and missed a pill on the first day of the third week (December 25). You also had unprotected intercourse on the morning of December 25.

Risks of Missing a Pill
1. Increased Risk of Pregnancy: Missing a pill, especially during the third week of your cycle, can increase the risk of pregnancy. The third week is critical because it is when the hormone levels drop, signaling your body to have a withdrawal bleed (similar to a period). If you miss a pill and have unprotected sex, there is a possibility of ovulation occurring, which could lead to pregnancy.

2. What to Do After Missing a Pill: The general recommendation for missed pills is to take the missed pill as soon as you remember. If you remember the missed pill on the same day, take it immediately. If it’s the next day, take it as soon as you remember and continue with your regular schedule. However, if you miss a pill and have unprotected sex, you may want to consider emergency contraception, especially if you missed the pill during the third week.

Menstrual Cycle and Withdrawal Bleeding
Regarding your question about when to expect your period after finishing the third week of pills:
1. Withdrawal Bleeding Timing: Typically, after completing a pack of birth control pills, you will have a withdrawal bleed within 2 to 7 days after stopping the pills. If you finish the third week of pills and do not take the placebo pills, you may not experience a withdrawal bleed until you start the next pack.
2. Starting the Next Pack: If you follow the standard regimen, you would start your next pack after a 7-day break (if your pills include placebo pills). If you are on a continuous regimen (where you take active pills continuously without a break), you may not have a withdrawal bleed at all.

Recommendations
- Monitor for Symptoms: If you experience any unusual symptoms or a missed period after your expected withdrawal bleed, consider taking a pregnancy test.
- Consult Your Healthcare Provider: If you have concerns about missed pills, potential pregnancy, or how to manage your birth control effectively, it’s always best to consult with your healthcare provider. They can provide personalized advice based on your health history and the specific type of birth control you are using.

Conclusion
In summary, missing a birth control pill, especially during the third week, can increase the risk of pregnancy, particularly if you have unprotected intercourse. You should take the missed pill as soon as you remember and consider emergency contraception if you are concerned about pregnancy. After finishing your pack, expect your withdrawal bleed within 2 to 7 days, depending on whether you take a break or start a new pack immediately. Always consult with your healthcare provider for tailored advice and guidance.

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