the Timing of Pre-Pill Contraceptives: Your Questions Answered

Emergency contraceptive pill

Hello, I would like to ask about taking oral contraceptive pills.
A pharmacist mentioned that after finishing 21 pills, menstruation would typically start in about 3 to 4 days.
After finishing the pills, I should stop for 7 days before starting the next pack.
However, another pharmacist advised that for effective contraception, I should start taking the pills on the first day of my period after finishing the previous pack.
My period started on the 3rd day after finishing the pills.
Should I start taking the pills on that day, or do I really need to wait until the 7th day to start? Last time, I started the next pack on the 4th day of my period after finishing 21 pills.
Thank you!

Niming, 20~29 year old female. Ask Date: 2016/02/22

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, generally, oral contraceptives should be started on the fifth day of the menstrual cycle.
Wishing you good health.

Reply Date: 2016/02/22

More Info

When it comes to understanding the timing of pre-pill contraceptives, it's essential to clarify how these medications work and the best practices for their use. Based on your question, it seems you are currently using a combined oral contraceptive pill (OCP) regimen, which typically consists of taking 21 active pills followed by a 7-day break during which you experience a withdrawal bleed, similar to a menstrual period.

1. Understanding the Cycle: After completing a pack of 21 pills, you are correct that you should expect your period to start within a few days. This is due to the drop in hormone levels when you stop taking the active pills. The timing of your withdrawal bleed can vary, but it usually occurs within 3 to 7 days after finishing the last active pill.

2. Starting the Next Pack: The general recommendation is to start your next pack of pills after the 7-day break, regardless of whether your period has ended. This means that if you finish your 21 pills and your period starts on the 3rd day of your break, you should still wait until the 7th day to start your next pack. This ensures that you maintain the proper hormone levels and continue to have effective contraception.

3. Contraceptive Effectiveness: If you start your next pack on the first day of your period (which is what some pharmacists may suggest), it can still be effective, but it is crucial to follow the specific instructions provided with your contraceptive. Most OCPs are designed to be taken consistently, and starting the next pack on the 7th day after your last active pill is the standard practice to ensure continuous contraceptive coverage.

4. What to Do If You’re Unsure: If you have any doubts about when to start your next pack, it is always best to consult with your healthcare provider or pharmacist. They can provide personalized advice based on your specific situation and the type of contraceptive you are using.

5. Additional Considerations: If you have missed pills or have taken them inconsistently, it may affect the effectiveness of your contraception. In such cases, using a backup method (like condoms) until you have taken the pills consistently for 7 days is advisable.

In summary, after finishing your 21 active pills, you should wait for 7 days before starting your next pack, regardless of when your period starts. This practice helps maintain the effectiveness of the contraceptive and ensures that you are protected against unintended pregnancy. If you have any further questions or concerns, don't hesitate to reach out to your healthcare provider for clarification.

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