How To Change Birth Control Timing

Ryanpo asked

Right now I take my birth control at the same time everyday late at night. I would like to start taking them earlier in the day. How do I make that transition with minimum risk to it's overall effectiveness. Could I gradually start taking them earlier and earlier? Would that work? If so how gradual should I make it? Thank you for your time and help in this! I really appreciate it.

Answer

It can certainly be concerning if you are looking to change the time you take your birth control pill (also known as an oral hormonal contraceptive) knowing how important it is to take them consistently for optimal effectiveness.

Fortunately, there are many different ways you can safely and effectively change the time of day that you normally take your birth control pill without altering the effectiveness of the pill.

Below, we discuss several methods.

Change Time With A New Pack

The easiest and simplest way to change the time of day you take your birth control pill is to:

• Start taking your pill at your new time when you start a new pack^[1].

If you are not taking birth control continuously (i.e. no placebo or pill-free period), this is the best method.

Again, once you are finished with your pill-free period, simply start the new pack at your new time.

With this method, there will be no decrease in effectiveness.

However, since you are altering your normal schedule, it is possible for you to experience slight spotting or breakthrough bleeding for one or two cycles until your body gets used to the new time.

This can happen anytime you switch how you normally take your pills.

It should be noted the above only applies for 'combined hormone' birth control pills (i.e. ones that contain both an estrogen and a progestin).

If you are taking a 'mini-pill', you may need to use back-up birth control for at least 48 hours anytime you change your usual time as the effectiveness of the pill may be decreased. This is according to the prescribing information for Ortho-Micronor, a popular progestin-only pill.^[2]

Later In The Day

If you want to take your pills later in the day, it gets a little more complicated. Below are recommendations only for combined hormone pills.

Less Than 12 Hours Difference In Administration Time:

If the time you want to change is less than 12 hours after your normally scheduled time (e.g. you want to change from 7 in the morning to 2 in the afternoon), you can safely do this, and there should be no decrease in how effective your pills are.

More Than 12 Hours Difference In Administration Time:

If the time you want to change is more than 12 hours (some sources say 24 hours) after your normally scheduled time (e.g. you want to change from 7 in the morning to 8 at night), your birth control pills may not be as effective. It would be recommended to use back-up contraception for at least 7 days if you wait more than 12 hours between doses.

If you do want to switch to a time that is more than 12 hours later than your usual time, it is best to just start the new time with a new pack.

It should be noted that most sources, such as the CDC, state that back-up contraception (e.g. condoms) need not be used, even if you are more than 24 hours late taking a dose!^[4]

However, multiple studies have shown that inconsistent pill usage decreases effectiveness. As the consequences of unintended pregnancy are great, it is important to be careful.^[5]