Annie asked
I have been on the oral contraceptive pill Rigevidon for about 3 or 4 years. I take the 21 pills in my packet and then have a pill free week. After reviewing the instructions today (for various reasons) I was slightly shocked and annoyed to find that I've only been giving myself a 6 day break rather than a 7, and taking the pill on the 7th day instead of the 8th. I've been doing this for at least a few months now. It doesn't appear to have affected my withdrawal bleed, and I obviously plan on rectifying the issue as soon as possible. There's a lot of info about shortening your cycle without problem, but it explicitly says that lengthening it is where there are real risks - I assume this issue is with lengthening it to longer than 7 days pill-free, not taking it a day later than I have been doing (on the correct day) from here on in. Do I just take my pill on the 8th day after my next break, and continue to do so after that?
Answer
Rigevidon (Levonorgestrel and Ethinyl Estradiol) is an oral contraceptives that is taken for 21 days followed by 7 tablet free days where a woman has withdrawal bleeding. You are correct in that the new pack of tablets should begin on day 8, giving you 7 hormone free days. Having 7 hormone free days will also have you starting your new pack of pills on the same day of the week each month.
Since you have been starting the new pack of pills on the 7th day and not the 8th, you have two choices:
- One is to continue on that schedule. Many women have shorter hormone free days than 7 days and there are even certain birth control pills that have less "off" days (e.g. Loestrin 24 Fe). Some products even have no inactive pills, and you take active pills continuously. There is no harm in this.
- The other option is on your next tablet free week, switch to starting the new pack of pills on the 8th day. You should not notice any difference, though spotting is always a possibility.
As for unintended pregnancy, you are protected as long as no tablets were missed in the previous pack and you do not go longer than a 7 day hormone free interval. If there are any doubts about this, back up protection should be used for 7 days. Below is some additional information on Rigevidon (Levonorgestrel and Ethinyl Estradiol) and missed doses.
What To Do When a Dose is Missed
According to the drug manufacturer, the following should be done if a dose of Rigevidon (Levonorgestrel and Ethinyl Estradiol) is missed:
- One tablet missed <12 hours: Take missed tablet as soon as you remember even if you need to take two tablets in 1 day.
- One tablet missed >12 hours: Take missed tablet as soon as you remember even if you need to take two tablets in 1 day. Also, back up protection will need to be used.
- More than one tablet missed: Talk to your doctor.
- If tablet missed is during the first week: Take missed tablet as soon as you remember and a barrier method of back up protection will need to be used for 7 days.
- If tablet missed is during the second week: Take missed tablet as soon as you remember. A back up method of protection is not needed as long as the previous 7 days of tablets were taken on time.
- If tablet is missed during the third week: Pregnancy risk is higher when tablets are missed in the third week. A back up method of protection will be needed for 7 days.
Oral contraceptives should always be taken at the same time each day for the best efficacy. It is always a good idea to error on the side of caution and use back up protection when there is any question of whether or not you are protected against an unintended pregnancy.
