Kam asked
I started my combination birth control pill pack a day earlier, I was supposed to take it on Sunday but I started Saturday. I don’t want to change my usual start date...I want to continue starting my pill pack on Sunday. What should I do? I have 21 active pills and 7 inactive pills. Will I have to extend the days I’m not taking the pill and make it 8 days?
At a glance
- You could just continue to take all of the tablets as normal, and maintain a Saturday start day.
- Alternatively, it should be ok to skip 6 days of this month’s placebo tablets and then resume an active tablet that upcoming Sunday.
- Do not extend out your placebo period or your birth control will lose effectiveness.
Answer
Hi Kam and thanks for writing into us. I have two potential solutions for you.
The first and easiest is to just change your birth control cycle start date to Saturday. Continue to take one tablet daily at about the same time every day. You’ll use your last placebo tablet on a Friday, and then begin your new pack like normal on a Saturday.
However, I’m guessing that you want to avoid that since you specifically wrote in asking how you can restart on a Sunday. That’s no problem. We can work with that! Since you started taking your active tablets on a Saturday and mentioned that your birth control contains 21 active tablets, this means that you should finish your active tablets later in the month on a Friday. On the following day (now Saturday) take a placebo tablet then throw out the remainder. These are placebo tablets. They don’t contain any active medication. They are there to help track your days and keep you in the habit of taking one tablet every day. On Sunday, open up and begin and active tablet from your new pack.
It may seem odd to start your birth control 6 days early, but doing so puts you at no higher risk of pregnancy. Additionally there are a handful of “extended cycle” birth control options on the market that contain nearly 3 months of active tablets. Doing this may lead to a bit of breakthrough spotting, but this will typically resolve as your body adjusts to the change.
One other potential hurdle might be getting your prescription filled early. Assuming that you have insurance, we usually bill birth controls to insurance as a 28 day supply. Since you’ll need to start it early, your insurance may not cover it yet. You might need to pay out of pocket for this month’s birth control since you are moving the start day up by 6 days. I would recommend calling your local pharmacy a day or two beforehand to see if the refill is ok to go through.
Lastly, it’s not recommended to start your birth control late. If you waited an extra day, you are missing a dose and putting yourself at higher risk of pregnancy. I don’t recommend doing this, but if you choose to go this route and are sexually active, please use a form of backup contraception for 7 days after you begin your “active” birth control tablet.
Just remember, when you need to change a birth control day, always start early, never late!
References
- Practice Bulletin No. 110: Noncontraceptive uses of hormonal contraceptives, Obstetrics & Gynecology
- Amethia prescribing information, Dailymed
- Hormonal contraception for suppression of menstruation , UpToDate
