What about taking a pill 9 hours late? #315/15

Q         I have a question regarding taking a pill late in my third week (the last week of active pills) of Yasmin.  I normally take my pills at 7 AM, but I didn’t have a chance to take it this time until almost 4 PM.

I had intercourse the night before, so I am concerned about taking the pill late during my third week (day 15 of my pill pack).  Yasmin is a 28-day cycle pill.  I have read that if you do so, you must finish out your pack and then skip the placebo pills and start a new active pack of pills.  Do I need to do this and do I need to worry about pregnancy since I had intercourse a few hours BEFORE I was supposed to take my pill?

Love your website!  Keep up the great work.  Thank you!

A:       

Finish your active pills, your 21 active pills, ON SCHEDULE.  Then take your 7 placebo pills ON SCHEDULE.  You DO NOT need to use a backup contraceptive.  You do not need to use Plan B, the emergency contraception.My advice to you would have been exactly the same even if you took your pill a full day late.  You are going just great!

Below is information from the World Health Organization on late and missed pills:

MISSING PILLS

What can a woman do if she misses combined oral contraceptives (COCs)?

For 30-35 µg ethinylestradiol pills:

Missed 1 or 2 active (hormonal) pills or if she starts a pack 1 or 2 days late

  • She should take an active (hormonal) pill as soon as possible * and then continue taking pills daily, 1 each day.
  • She does not need any additional contraceptive protection.

Missed 3 or more active (hormonal) pills or if she starts a pack 3 or more days late

  • She should take an active (hormonal) pill as soon as possible * and then continue taking pills daily, 1 each day.
  • She should also use condoms or abstain from sex until she has taken active (hormonal) pills for 7 days in a row.
  • If she missed the pills in the third week, she should finish the active (hormonal) pills in her current pack and start a new pack the next day.  She should not take the 7 inactive pills.
  • If she missed the pills in the first week and had unprotected sex, she may wish to consider the use of an emergency contraceptive. 

For 20 µg or less ethinylestradiol pills:

  • If the woman misses 1 active (hormonal) pill or starts a pack 1 day late, she should follow the guidance above for “Missed 1 or 2 active (hormonal) pills or if she starts a pack 1 or 2 days late”.
  • If the woman misses 2 or more active (hormonal) pills or if she starts a pack 2 or more days late, she should follow the guidance above for “Missed 3 or more active (hormonal) pills or if she starts a pack 3 or more days late.” 

For both 30-35 µg and 20 µg or less ethinylestradiol pills:

Missed any inactive (nonhormonal) pills

  • She should discard the missed inactive (nonhormonal) pill (s) and then continue taking pills daily, 1 each day.

*           If a woman misses more than 1 active (hormonal) pill, she can take the first missed pill and then either continue taking the rest of the missed pills or discard them to stay on schedule.

Depending on when she remembers that she missed a pill (s), she may take 2 pills on the same day (one at the moment of remembering, and the other at the regular time) or even at the same time.

From the US Medical Eligibility Criteria Selected Practice guidelines – 2005

http://www.who,int/reproductive-health/publicanions/

Robert A. Hatcher MD, MPH

Emeritus Professor of Gynecology and Obstetrics

Emory University School of Medicine

Atlanta, GA

To learn more about the advantages and disadvantages of birth control pills, go to: www.managingcontraception.com.   You can order all of these books listed below from our website or by calling 404-875-5001. 

Key Words:  birth control pills, active pills, late, intercourse, concerned, Yasmin, cycle, placebo pills, pregnant, schedule 

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