What should I do if I miss a medication? What to do when a birth control pill is missed: action plan, possible options.

If I missed taking the birth control pill, what should I do, do I need to continue taking the drug and is pregnancy possible? Before prescribing oral contraceptives, most doctors immediately warn their patients that hormonal contraception is reliable only if the pills are taken on time, without much delay. But still, in the turmoil of days, many women at least sometimes forget to take a contraceptive.

The algorithm for further actions largely depends on the situation, the day of the cycle when the drug was not taken. So, if a woman missed taking the first birth control pill, that is, she was going to use this type of contraception, but took the pill only on the second day of menstrual bleeding, it's okay. According to the instructions, it is allowed to start taking up to the 5th day of the cycle, however, in this case, the next 7-10 days you need to use additional, barrier or chemical contraception, since pregnancy while taking contraceptives is possible in this situation. Well, after these days, in case of strict observance of the instructions, you can completely relax and surrender to feelings.

If you missed 1 birth control pill, you need to find out what to do from the instructions. If this is the first two weeks of taking the drug, then you just need to take the missed pill as soon as possible and then take protection for several days. If this is the last week of taking the drug, there are 7 or less tablets left, then you need not only to quickly take the missed pill, but also not to take a seven-day break before starting a new package of the drug.

If you missed 2 birth control pills from the beginning of the cycle, that is, the very first ones, there are several options for the development of events.
1. Continue taking the pills, but protect yourself for the next 10 days.
2. Do not take the drug further. But keep in mind that with the start of taking in the next cycle, side effects may appear that are characteristic of the first months of taking a contraceptive, when the body "gets used" to the new hormonal background.
But in any case, there is, albeit a small, probability of pregnancy due to errors in taking the drug. That is, the question of whether it is possible to get pregnant if you skip the birth control pill does not even require discussion, undoubtedly yes.

And the result of errors in taking the drug can be intermenstrual discharge, sometimes even severe bleeding, when you missed the birth control pill, your period went, but nevertheless you need to finish the package to the end.

And yet what to do if an unplanned conception occurs? Do these hormonal preparations affect the embryo? Doctors say that if a woman misses a birth control pill and becomes pregnant, then it is not necessary to have an abortion. You can leave the child. But, of course, during pregnancy, do not take any contraceptives. If the child is undesirable, it is possible to have an abortion, including medical abortion, if the gestational age allows and there are financial opportunities.

Hormonal preparations with contraceptive properties are recognized as the most effective method of preventing unwanted pregnancy. Properly taking birth control pills according to the manufacturer's instructions provides an effect in 98% of cases. But what to do if you missed 1 birth control pill?

The degree of reduction in the effectiveness of the contraceptive depends on the amount of time lost. If a woman has forgotten to take a birth control pill, then the correct solution would be the local use of barrier methods of contraception for up to 7 days. Further tactics will depend on the day of the menstrual cycle. Emergency measures are seen as an exception to the rule.

cycle day	What to do?	Additional methods of contraception
First week (1-7 days)	Take the missed tablet as soon as possible. Take the next pill in the pack at the usual time, even if it means taking two pills at once	Use condoms or spermicides for 7 days
Second week (7-14 days)	Take the missed pill. Take the next pill from the pack at the right time	Additional methods of contraception are not required if 1 tablet is missed and is required if 2 or more tablets were missed (within 7 days)
First week (14-21 days)	Take the missed tablet and continue to drink the drug as usual. Start taking a new package without a 7-day break. Or stop taking the pills from the current package and after a 7-day break start taking the pills from the next pack	Additional contraceptive measures are not required if the woman has not missed a pill in the last 7 days. It is necessary to use condoms or spermicides within 7 days if there have been violations in the last week in taking the drug
Fourth week, active tablets (21-24 days) - only for COCs containing 28 tablets
Fourth week, placebo tablets (24-28 days) - only for COCs containing 28 tablets	Throw away the missed pill. Take another pill at the usual time	Additional methods of contraception are not required

Mechanism of action of hormonal contraceptives

One-component preparations based on progesterone are taken at the same time. If for any reason the woman did not drink the medicine, then it is taken within the next 12 hours. Many gynecologists do not recommend drinking a loading dose of hormones for a short period of time due to the likelihood of side effects in the form of:

liver dysfunction;
functional disorder of the digestive system;
the appearance of intermenstrual bleeding or amenorrhea;
development of thrombosis;
violations of the microbial landscape of the vagina;
pressure increase;
weight gain;
migraine;
discomfort in the mammary glands.

A high dose of the hormone contained in one pill does not provide for its re-use ahead of time.

Monophasic contraceptives contain an equal amount of estrogen and progestogen, which remains unchanged throughout the course of use. These drugs include Regulon, Janine, Femoden, Silhouette, Gestodene, Logest, Rigevidon, Miniziston, Yarina, Jess. These funds are taken from the first day of the menstrual cycle. If at least one tablet was missed, then doctors recommend switching to spermicides or condoms for the next 7 days. A new package is drunk from 1 to 21 days of the menstrual cycle. After a seven-day break, they continue to drink a monophasic remedy even if menstruation has not stopped.

Actions for skipping a tablet are presented in the table:

Table 1

Oral contraceptives, which include natural estrogen (estradiol valearate), deserve special attention. In the pharmacological market, this group of hormonal agents is represented by Qlaira. Tactics when skipping one tablet of the drug in this case is different.

table 2

Missing the birth control pill requires the use of additional protection against unwanted pregnancy in the form of non-hormonal local contraceptives. In such cases, it is recommended to use a cervical cap along with a spermicidal gel, a condom or intravaginal suppositories Pharmatex, Benatex.

Biphasic contraceptives, consisting of estrogen and progestogen, are widely used among women of different ages (Femoston, Anteovin, Binordiol, Sequilar). In such preparations, the dosage of estrogen is the same in all tablets, and the dose of progestogen changes in the first and second periods of the cycle. Tablets should be taken from day 1 to day 28 of the cycle daily.

If, for any reason, a woman missed taking the medicine (lost or took a break), the missed pill should be taken as early as possible within 12 hours. If 2-3 days of admission are missed, the effectiveness of the contraceptive is significantly reduced. However, this is not a reason for refusing to use the drug. The medicine is continued to be taken to avoid the premature onset of menstruation. Spermicidal preparations are used topically for the purpose of prophylaxis during sexual intercourse during this period (Patentex, Oval).

Contraindications

When taking birth control pills with a high content of hormones, it is necessary to understand the degree of risk to the body. A sharp change in the hormonal background negatively affects all organs and systems.

Particularly sensitive to hormonal imbalance are women with existing systemic diseases of the endocrine, genitourinary system (diseases of the liver and kidneys, biliary tract, Crohn's disease).

The following factors are absolute contraindications to the use of emergency contraception:

the onset of pregnancy;
lactation period;
existing blood diseases (coagulation disorders, thrombosis, bleeding of unknown etiology);
severe liver disease;
individual intolerance to the drug;
diabetes mellitus (severe form);

The presence of at least one provoking factor creates the prerequisites for additional consultation with the attending physician.

Once disturbed, the natural level of hormones is subsequently difficult to recover. It can take months or even years to restore normal physiological parameters.

A decrease in efficiency is noted with functional disorders of the digestive system (Crohn's disease).

memo

Timely taken systemic contraceptive prevents unplanned pregnancy. Topical contraceptives reduce the chance of conception in the absence of systemic therapy. When deciding on emergency preventive measures, it is necessary to realistically assess the risk of complications due to a sharp change in hormonal levels. Consultation with a gynecologist will be the best option for resolving such a situation.

There are many methods of contraception. But the most effective are, nevertheless, contraceptive pills. They most reliably protect against unplanned or unwanted pregnancy. And if suddenly pregnancy still occurs when using them, the reason is not their effectiveness, but violations of the regimen, the rules for taking pills.

When using contraceptives containing hormones, in the vast majority of women, the menstrual cycle is disturbed or shifted and the next menstruation may be delayed. But if a woman missed the next appointment, then menstruation begins earlier, while bleeding can be quite plentiful.

The body reacts to the untimely withdrawal of the drug by a sharp decrease in the level of hormones, which provokes the rejection of the endometrium of the uterus. Many women are interested in the question of what to do if I missed the birth control pill, menstruation began? The answer in this case is simple - you should continue to take the medicine further, despite spotting. But if, after skipping the pill, menstruation did not occur, you should check for pregnancy.

What to do if there is a pass?

If you happen to miss a dose, take your medicine as soon as possible. Take the next pill as usual, at your usual scheduled time.

If you missed a dose twice, take 1 tablet that was missed every 12 hours. Then continue to drink them as usual, at the usual time for this. During this period, as well as in the next week, be sure to additionally protect yourself, in particular, use condoms.

If three or more pills have been missed, continue taking the next one from the pack as per your schedule until your period begins. All this time, be sure to protect yourself, use additional contraception. Be sure to take the tablets too. Although they will not be able to protect against pregnancy in the remaining days, they will help to regulate and prevent failures of your cycle.

If, during the period of missing the next birth control pill, for some reason you did not take additional contraceptive measures, did not protect yourself with a condom during sex, you need to use emergency contraception to avoid an unplanned pregnancy. To do this, you should visit a pharmacy and purchase a postcoital (emergency) contraceptive, which is called Plan B.

For adult girls, this contraceptive will be provided without a prescription, but if the girl has not yet reached the age of majority, a prescription from a gynecologist is needed to purchase an emergency contraceptive.

Once your period starts, start taking birth control pills as usual and try to remember to take them on time. Well, if you missed it, didn’t drink the birth control pill, then you need to follow the above tips.

Bleeding during contraception (not monthly)

Usually, the entire period when you are taking contraceptives, menstruation always occurs at the usual time, usually when you take a break at the end of taking the next package of the drug (break 7 days). However, many women note the appearance of small, scanty, and sometimes copious bleeding during the use of tablets. They are especially strong when a woman for some reason missed taking another pill.

These discharges resemble menstruation, but they are not. The fact is that contraceptive drugs contain enough hormones that block ovarian function and the body cannot produce hormones on its own. Therefore, if there was an abrupt withdrawal of the drug, destruction begins, followed by rejection of the endometrium (the inner lining of the uterus). In this case, bleeding is observed, similar to regular menstruation.

Small bleeding even with regular, daily and accurate use of contraceptives occurs due to a change in the ratio of the hormones estrogen and progesterone. While the body "gets used to" this, the first months of using the drug may experience slight discharge. This is considered normal, and there is no reason to worry. Usually everything returns to normal after a couple of months of regular use of the drug.

But if spotting has been observed for more than 3 months, there is cause for concern. The drug you are currently taking may not be right for you. Therefore, you should contact your gynecologist and the doctor will prescribe you exactly the means of protection that suits you best. Be healthy!

Hello. I have been taking contraceptive Jess for a year now. Always in the evening. The day before yesterday I missed a pill, but the evening before yesterday I had sex. I seem to be on the 14th day of the cycle - I don’t know what to do? Yesterday, when I was taking a pill, I noticed a pass, but I took a pill, today I also drank it, but my friend says that I can get pregnant. What to do??????

Yanina, 32 years old

There's an answer

Responsible Yulia Viktorova obstetrician-gynecologist

Yanina, the instructions for the preparation contain detailed recommendations for such cases. If the delay in taking the pill was less than 12 hours, then the contraceptive effect of the background is not reduced, in this case, you need to take the drug as soon as you remember, and the next pill - according to the schedule. If the delay in admission is more than 12 hours, then the likelihood of pregnancy increases. In this case, for reliability, it is necessary to use additional contraceptives.

Not a single contraceptive gives a 100% guarantee of non-pregnancy. What should you do? Do not be nervous. You should know that pregnancy can occur anyway. There is only one reliable way of "protection" - complete abstinence. Nature can take her own, despite all human attempts to deceive her. We advise you to read the article

An exciting topic for a modern woman has been and remains the topic of pregnancy prevention. This is not to say that for a woman she is completely undesirable. Just everything has its time. And the best and quite convenient means for this are modern contraceptives (hormonal).

For some time, a Western European commercial was very popular, talking about a lot in terms of not only sexual, but also moral education. Mom, escorting a high school student to school, kisses her daughter and puts birth control pills in her bag. After all, anything can happen at the age of 16. What can't you do for a child just to avoid an abortion!

Our girls, I think, are not all surrounded by such care. And they themselves are not inclined to think about it. Of course, they do not claim that the pregnancy will “dissolve”, but they certainly sometimes dismiss it with the thought “I hope you are lucky - God will save you ...” But they should know that it was God who thought through and gave people the mystery of this process - the conception and birth of a new person. So it will definitely happen!

What to do? Buy contraceptives yourself (what a word!) - but self-treatment is dangerous. Yes, and in the pharmacy they will most likely offer to come to them with their mother. Go to a women's clinic? You might occasionally meet someone you know. There is still a way out - in our cities there are family planning offices or even maternity and childhood centers, where they will not refuse consultations. And if you meet even a teacher in this Center, you can always refer to self-education. As a result, only praise.

Dosing regimen

A girl can take contraceptives from the moment of her puberty. In an earlier period, it does not make sense to do this - pregnancy can only occur in an organism that has matured in the sexual sense. Tablets are taken one at a time, daily at the same time for 21 days or 28 days, depending on the type of drug. If the package contains 21 tablets, they should be taken from the 1st day of menstruation until the package is empty. After that, a break is made for 7 days. If the package contains 28 tablets, you do not need to take a break, but you should immediately start taking the drug from a new package. After drinking the 21st tablet (that is, at the end of the cycle), a reaction similar to menstruation is observed for 7 days.

At a young age, you should start with taking those drugs that contain hormones in small doses. And it is better to use condoms altogether, which will also protect against sexually transmitted diseases.

Forgetfulness interferes

It is easier with older women - they know where to go, which doctor to visit, how to take contraceptives correctly. The problem is different - forgetfulness and weak self-organization interfere. The result is an irregular intake of contraceptives. What should I do if I forgot to take my birth control pill?

The principle of action of the drug is that its concentration in the body must be constantly maintained at the same level so that its action is carried out continuously.

Note! If the correct dose of the drug is not taken on time, its concentration may decrease, and the likelihood of pregnancy increases. Therefore, additional precautions will be required, such as the use of a condom.

Barrier precautions against the background of regular sexual intercourse are especially necessary if the pill has been interrupted for 2-3 days or more. And after 5-6 days of renewed use, sexual intercourse is already acceptable without barrier measures of protection.

You can take the missed pill when you remember about it, and take the next one according to the established schedule, i.e. in one day you will take two tablets instead of one. The concentration of the drug for this period of time is maintained, because the effect of the tablet is designed for at least 20 hours. It is generally accepted that additional measures to prevent pregnancy should not be taken if the delay in taking the pill was no more than 12 hours.

But there are times when 2 or even 3 tablets are missed (that is, two or three days are missed). The doctor in this case advises: you should drink the missed two tablets as soon as possible, and take 2 tablets on the next appointment according to the schedule (that is, the next day). For example, an appointment was missed on Saturday and Sunday. So, two tablets should be taken on Monday and two tablets on Tuesday. In such cases, spotting is not uncommon, which should be a signal for you to use additional protection measures.

Note! If you miss taking 3 or more tablets, the use of additional measures is inevitable and mandatory. In addition, you should think about replacing this type of contraceptive with another.

Detailed recommendations on how to remedy the situation in case of interruption of the contraceptive drug can always be read in the instructions that come with any package of pills. Still, it never hurts to trust your doctor and consult if you have a break in taking your medication.

It should also be remembered that when taking certain drugs for a long time, there may be a decrease in their effectiveness.