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Missed pills and late periods

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Clare asks:

I have been taking birth control for about 9 months now. I normally take my pill in the morning, although sometimes I forget and take it at night. By reading your information, I was told that was okay. Whew. Not recommended but okay.

I am currently on the third day of my green pills (not the active ones obviously) and I still have not received my period. This is not normal for me, because I normally get my period on the second day of the green pills. Tell me what to do/think of this? PLUS, two days before starting my period I had sex, unprotected. And the day before that as well. (My partner and I are both clean (FOR SURE)). In addition, nine days before having sex I missed a pill. I remembered the next day when taking my next pill..so I took them both as it read on the directions to my pills.

Why am I late or missing it? Please help.

Sarah replies:

It is important to understand that the each pill in your packet has basically enough hormones for 24 hours. When you're late or miss one, your hormone levels can drop. So then what ends up happening is that when you take the late (or missed) pill and then take your next one at what is supposed to be at your regular time, you end up with more hormones in your system (because it wasn't 24 hours between pills).

The result is lots of ups and downs in the level of hormones you're putting into your body. When you have lots of ups and downs like that, it's not surprising that your body might get a bit confused. So it's certainly possible, especially if you've had several late pills (when you take it at night instead of in the morning) and the missed pill, that your body has been thrown off a bit by the hormone fluctuation. That could easily explain the lateness of your period. Also, understand that the more often you have late or missed pills, the more likely it is that your efficacy could be compromised. So if you have had lots of lateness (not sure exactly what you mean by "sometimes") with the missed pill, then it is at least possible that you might have some small risk.

There's nothing you can really do to start your period. If you're worried about pregnancy, you can go ahead and take a pregnancy test now. Doing so won't make you pregnant or not, but it can take some weight off your mind! I'd also suggest that you talk with your doctor about whether another method of contraception will work better for your lifestyle. If you are having several late pills a month (when you take it in the evening rather than in the morning), then that's a really good sign that this is not a method that fits for you. And there are many other methods available, like the patch or ring for instance, that you don't have to think about every day. I'll link you to our article about birth control choices that might help you find another method that will work for you.

If you do want to stick with the pill, then you really need to make it a priority to take it at the same time each day. Further, if you find that you're late or missing a pill, it would be wise to go ahead and backup with a condom or some other method so that you won't have pregnancy worries when you get to the end of the month.

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