Kim asked
How do you safely change the day you start a new pack of birth control? I'm taking Sprintec.
Answer
It is relatively easy to change the day you start taking your next pack of birth control pills and it's a common need. To do so, you simply shorten the length of your "placebo" week and start your next pack of pills early.
It is critically important when you are changing the day of the week you start your birth control pills that you start taking your next pack early as opposed to starting it late. If you change days by starting your next pack late, that is considered "missing doses" and it will decrease the efficacy of your birth control pills. We discuss this further below.
Changing Birth Control Pill Start Day
For most individuals, the day of the week that you start your active pills (e.g. a Sunday) will also be the day you be scheduled to start on your "inactive" or "placebo" pills after your last active pill. From there, you will usually get your period within 1-3 days, making it easy to plan if you want to get your period on a specific day.
If you are looking to change the usual start day of your pills so you can get your period on a different day, simply do the following:
- After your last active pill, plan the day you would like to start your next pack.
- Take your placebo "inactive" pills until your new scheduled start date. When that day arrives, start on the active pills in the next pack and continue to take one pill daily.
- This means you will not be taking a full week of inactive pills. This is safe and will not increase your risk of pregnancy.
In your question, you mentioned you are taking Sprintec, which has 21 active pills, and 7 placebo pills. Below is an example of how you can switch to an earlier day:
- You have been on your pills for a few months and always start on a Sunday.
- You are looking to now start your pills on a Wednesday.
- You will be taking your last active pill on Saturday, are then are scheduled to begin on your inactive pills on Sunday.
- Take one inactive pill daily until Wednesday (i.e. Sunday, Monday and Tuesday). When Wednesday arrives, start your next pack of birth control pills.
- This means you will only will only be taking three inactive pills (on Sunday, Monday and Tuesday). This is safe and you will not be at an increased risk of pregnancy as you are not missing doses.
Remember that when switching days, you want to start early as opposed to late. If in the above example you took all your inactive pills and then waited until Wednesday, you would technically be missing two doses. This will put you at an increased risk of pregnancy as the efficacy of the pills will decrease.
There is no need to worry about missing days in your inactive week. There is no medical reason that you need to have your period every month and there are many birth control pills available that are known as "extended-cycle" products, meaning they either have a reduced number of inactive pills or omit them altogether (e.g. Amethyst).
It is important to note that anytime a change is made to how you take your pills, including starting them early, you can expect some spotting or breakthrough bleeding for a month or two. This is common. It should decrease and go away after you have completed a few cycles. It just takes some time for your body to adjust to the change.
Lastly, as stated above, starting your pills early will not increase your risk of pregnancy and you do not need to use back-up contraception.
