Beth Lambie asked
Hi, took progesterone only pill as usual on Thursday. Had sex Friday morning. Realized when went to take pill Saturday that I hadn’t taken Fridays pill. Took them both on Saturday. Am I covered or do I need emergency contraception?
Answer
According to the manufacturer of Micronor, a progestin only contraceptive, if a pill is missed by 3 hours or more, the following should be done:
- Take the missed pill as soon as you remember that you missed it.
- Then go back to taking your progestin only contraceptive at your regular time.
- Be sure to use a back up method (such as a condom or spermicide) every time you have intercourse for the next 48 hours.
So, in this case, to protect against an unintended pregnancy, emergency contraception should be used. Below are some options that you may still be able to use for emergency contraception.
Plan B (Levonorgestrel)
Plan B (Levonorgestrel) is an over the counter emergency contraceptive that is most effective if taken during the first 72 hours of unprotected sex. Treatment is still considered moderately effective if taken within 5 days of unprotected intercourse. The most common side effects are:
- Fatigue
- Heavy bleeding
- Nausea
- Abdominal pain
- Dizziness
- Headache
- Breast tenderness
Plan B should not be used in patients who are already confirmed to be pregnant. Also, Plan B may be less effective in women who are obese with a BMI (Body Mass Index) > 30.
Ella (Ulipristal)
Ella (Ulipristal) is an emergency contraceptive that requires a prescription. It can be taken within 120 hours (5 days) of unprotected intercourse. Common side effects include:
- Headache
- Late menstruation (7 days or more than expected)
- Abdominal pain
- Nausea
- Painful menstruation
- Fatigue
- Dizziness
- Early menstruation (7 days or more than expected)
For women with a BMI (Body Mass Index) of 30 or greater, there is no concern of the drug being less effective.
Conclusion
Progestin only contraceptives need to be taken at the same time each day. When a dose is missed by 3 hours or more, back up protection should be used for the next 48 hours. If a back up method is not used, emergency contraception can be used for up to 5 days following unprotected intercourse.
