Caro asked
I've been taking Microgestin Fe 1/20 for 8 months now and have had no problems with it. For the last three days, I have had diarrhea in the morning and around night time (twice a day). Thursday night, I took my pill at 11:30 as usual and experienced diarrhea an hour later. The next morning (Friday) i had loose stool and around 5, I had unprotected sex. I took my pill again around 11:30 and experience very loose stool an hour later. Should I be worried that Thursday nights pill didn't work and I wasn't protected? Should I just take my pills as normal and not have sex for 7 days or should I go ahead and take Plan B?
Answer
There are recommendations available to guide us in situations where you are taking combined hormone oral birth control pills (i.e. contain both an estrogen and progestin) and have diarrhea for extended periods of time.
Below is a graphic provided by the CDC (Centers for Disease Control):
Per the CDC, if you have had diarrhea for less than 48 hours (two days):
- Continue taking your pills at the same time every day.
- There is no need to take an additional dose of your birth control pill.
However, in your situation, it appears you have had diarrhea for more than 48 hours. At this point, we are concerned with reduced absorption of the pills and the recommendations are as follows:
- Continue taking your pills at the same time every day.
- Use back-up contraception for while you continue to experience diarrhea and for 7 continuous days after your diarrhea has resolved.
- If you are on your last week of birth control pills, finish the week of pills, omit the hormone free week, and start right into your next pack.
Although there is a lack of data regarding just how much moderate to severe diarrhea affects your birth control pills, it may be wise to use emergency contraception (e.g. Plan B, ella) if you have had unprotected sex during the time you were sick as there is a theoretical risk of altered absorption of your pills and the consequences of intended pregnancy are great.
