Nicole asked
I missed 4 days out of my first week of birth control because I finished my pack and couldn't get my next pack in time. I bled on the 3rd day of my sugar pill and it ended within the first day of taking a new pill in the first week. Since I missed I bled a bit longer. I started on Christmas and ended on the 31st. I didn't get birth control until January 2nd or 3rd. I did have unprotected sex a few times in that time frame. I am curious to find out my possibility of being pregnant and when I could possibly test.I know since I missed a few days of birth control my period won't be a good indicator since I'm sure I'll miss my period which would start on the 26th.
Answer
What to do if you miss birth control pills during your first week depends on the type of product you are using. The two types of oral birth control pills are:
- Progestin only pills (i.e. "mini pills")
- Combined hormonal pills (i.e. estrogen and progestin containing pills)
What To Do If You Miss Doses In The First Week Using Progestin Only Birth Control Pills
Progestin only pills contain the same amount of progestin in every pill. If you miss one or more doses in week 1, you should follow these directions:
- Take your missed pill as soon as you remember that you missed it
- Continue to take your pills at your regular time (this means you may end up taking two pills in one day)
- You must use back-up contraception if you are sexually active until pills have been taken on time for two consecutive days
It is important to note that progestin only pills have very little margin for error in regard to administration time. In fact, if you miss your regularly scheduled dosing time by more than 3 hours, that is considered a missed dose. Common progestin only pills include:
- Camila
- Errin
- Heather
- Jencycla
- Jolivette
- Nora-BE
- Norethindrone 0.35 mg
- Ortho Micronor
What To Do If you Miss Doses In The First Week Using Combined Hormone Birth Control Pills
Combined hormone birth control pills contain an estrogen and a progestin. The vast majority of combined hormone birth control pills recommend the below directions in the cases of missed pills in week 1:
Missed 1 Pill In The First Week
- Take your pill as soon as you remember
- Take the next pill at your regular time (This means you may end up taking 2 pills in one day)
- You do not need to use a back-up birth control method if you have sex
Missed 2 Pills In The First Week
- Take 2 pills on the day you remember and 2 pills the next day
- Continue to take 1 pill a day until you finish the pack
- If 2 pills are missed, there is a chance you may become pregnant if you have unprotected sex. You must use back-up birth control until you have taken “active” pills every day for 7 days
Missed 3 Or More Pills In The First Week
If you are a Day-1 Starter
- Discard the rest of the pill pack and start a new pack that same day
If you are a Sunday Starter
- Continue taking 1 pill every day until Sunday. On Sunday, discard the rest of the pack and start a new pack of pills that same day.
If 3 pills are missed, there is a chance you may become pregnant if you have unprotected sex. You must use back-up birth control until you have taken “active” pills every day for 7 days. In addition, missing 3 or more doses in the first week may cause you to not have your period this month. This is normal and generally your cycle returns to normal after 1 to 2 months.
Additional Notes Regarding Missed Doses In The First Week
If you had unprotected sex in any of the situations where pregnancy is a possibility, it may be prudent to take a pregnancy test. Generally, you can expect accurate pregnancy test results about one week after you are supposed to get your period. However, to be sure, you may want to schedule an appointment with your doctor.
The above directions cover the vast majority of birth control products. There are some products however, such as Natazia, that have specific directions for the particular product. Please refer to the prescribing information or patient insert for your particular product to verify the steps you should take if you miss doses in the first week of active pills.
