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» Got Questions? Get Answers. » EXPERT ADVICE » Emergencies and Crises » Missed pill? (Page 1)

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stayclassy812
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Im in a dilemma because I'm unsure if I missed a pill this cycle. I've never missed a pill before or even taken one late, I'm very strict with it. The thing is, one thursday, I checked to make sure I took my pill & I found out that thursdays pill was still there, so I took it immediately. This was at one in the afternoon and I take my pills around 7 in the morning. The problem is, I remember taking a pill that morning as well as the morning before so Im not sure what day I missed a pill. Upon closer inspection of my pill pack, I noticed one was missing at the end. I dont know if I accidentally took a pill from the end of the pack by mistake which would explain why Thursdays pill was still there or if I took an extra pill from this pack LAST cycle.


I'm very good with my pill and I've been on it for nearly two years and this is the first time something like this happened. I know for a fact that I would remember if I took an extra pill from this pack last cycle and that I couldnt have missed a pill seeing as how I always doublecheck to make sure I take it and its the first thing I do when I wake up. I want to be on the safe side though and ask, if I did miss a pill and I made it up with two pills several days later (Im not sure if/when I missed a pill), how would this affect my next cycle? Would I be back up to complete effectiveness the first day I start up again or should I back up for the first 7 days or even the whole cycle?

Greatly appreciate your help!

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Heather
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If you missed a pill and made it up during the cycle you missed it, then it should not have any impact on the effectiveness of the NEXT pill pack.

That said, our experience over the years is that very few of our users who do not wish to become pregnant feel comfortable using only one method of contraception alone: most feel a lot better always backing up with a second method. That's not surprising, since two methods are much more effective than one. And of course, when that method is condoms, those also provide STI protection the pill does not.

So, you may want to think about backing up regardless, if for no other reason than if and when mistakes like this happen, as they'll tend to now and then, you'll be able to know you don't have to worry about it, since you already back up.

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stayclassy812
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We vary between backing up with withdrawal and condoms! [Smile]

Does it matter if I did not make up the pill immediately after the day I missed it and I can count on the full effectiveness of the pill upon starting up my next cycle? I like to know that I can count on my "backup" method completely.

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Heather
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When you miss a pill, you want to make it up as soon as possible. If you do so later on, it might impact the effectiveness of THAT cycle, where the pill was missed.

It should not, however, impact the following cycle, so long as the placebo period between the last pack of pills and the next was not more than 7 days.

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Heather Corinna, Executive Director & Founder, Scarleteen
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stayclassy812
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Ok I see, so if Im understanding you correctly:

1. if I miss a pill and make it up immediately after, it will not greatly impact the effectiveness of the cycle that it happened.

2. if I miss a pill and there was a period of time between making it up, such as days, then it might impact the effectiveness of the current cycle but NOT the next cycle so long as it was made up?

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Heather
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1. It might impact it, it might not. But certainly, one missed pill that is made up should not "greatly" impact it. In fact, typical use effectiveness rates (and for the combined pill, that's 92% effectiveness in one year) take a missed pill now and then into account.

2. Yep, so long as the pills were made up in the previous cycle, and the placebo period between that one and the next was no longer than 7 days.

[ 12-19-2012, 04:41 PM: Message edited by: Heather ]

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Heather Corinna, Executive Director & Founder, Scarleteen
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Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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stayclassy812
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Ok, thank you so much for your help!

Hope you have a wonderful holiday season!

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Heather
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You're so welcome, and holiday wishes right back atcha! [Smile]

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Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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stayclassy812
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So sorry, back again!

There was just something I wanted to clarify again---I understand that if a pill was missed, as long as it was made up in that cycle, it wont affect the next cycle although if it was made up maybe a week later from the day it was missed, does that still apply? I'm unsure if/when I missed the pill so just want to cover all my bases!!

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Robin Lee
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HI There,

So long as you start your new pack of pills on time--that is, the day after you finish the previous pack--effectiveness shouldn't be comprommised.

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Robin

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stayclassy812
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the day after I finish the previous pack, both active pills and the 7 day break?
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stayclassy812
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What if the first active pill was the one missed and it was made up a week or so later?

I intend to use condoms as a backup but Im a lot more comfortable relying on two methods which is why I wanna double-check on the effectiveness of my pills [Smile]

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Heather
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If the first active pill was the one missed, then for that cycle, you may well have had less effectiveness from your pill.

But that still isn't likely to have any impact on the next cycle.

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Heather Corinna, Executive Director & Founder, Scarleteen
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Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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stayclassy812
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So with the use of condoms, I can count on the full effectiveness of my pills again this next cycle, regardless of whichever pill was missed since it was made up, which will protect me from both pregnancy and STI's?
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Heather
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If, in this cycle, you take all your pills as directed and don't miss any, then yes, you can figure you'll have the full effectiveness your pill can offer.

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Heather Corinna, Executive Director & Founder, Scarleteen
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Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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stayclassy812
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the new cycle, right?

I plan on setting up two alarms on my phone so as not to miss any and to make sure!!

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Heather
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Yep. [Smile]

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Heather Corinna, Executive Director & Founder, Scarleteen
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Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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stayclassy812
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I started my new cycle on Monday of this week and received my withdrawal bleed last week wednesday. I usually receive it Wednesday night or Thursday morning. It was a lot heavier than usual, with lots of clots. Usually I am already spotting by Sunday or Monday morning and finished by Tuesday. This time, I am still spotting and its already Thursday. Is that something to be concerned about? Ive hear about breakthrough bleeding before and how it is a sign of decreased efficiency in the pill, is that what this could be? Or is this just part of my withdrawal bleed/normal spotting that isnt anything to worry about.
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Robin Lee
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Sounds like it's just part of your withdrawal bleed.

Also, even if it is breakthrough bleeding, that's not a sign that the pill is less effective. It's just a side effect of taking the pill, like any side effect of any medication.

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Robin

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stayclassy812
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Although if it continues longer than normal, I should just chalk it up to spotting? So spotting on the pill is a normal side effect and is just as effective?
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Robin Lee
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Correct. If you're still spotting by, say, next week, you might want to give your doctor's office a call and just check in with them, but right now what you're describing doesn't sound like anything to be concerned about.

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Robin

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stayclassy812
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Oh ok, if it does continue by next week, what should I bring up to my doctor? Just so I know!!
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Robin Lee
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You can just let them know that you got your withdrawal bleed as usual but that you've been bleeding for two weeks (which is what it will be by that time if i understand what you're saying here) and you want to know if there's anything to be concerned about.

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Robin

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stayclassy812
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I see, thank you. It isnt bright red blood, its only when I wipe, like teeny tiny bits left over. In regards to my effectiveness, my pill is still effective? Sorry, this is the first time over two years that this happened so Im a bit worried.
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Onionpie
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Yes -- if you haven't missed any pills this cycle, your pill will still be effective. A missed pill only affects the cycle it was from, with the only exception being if it makes the week off the active pills (ie. the week of placebo pills) longer than 7 days. So, for example, if you were to miss the last active pill in the pack and not make it up until the next cycle.

Does that make sense?

This article might help explain this some more:
How do birth control pills really work, even during the placebo period?

[ 12-28-2012, 12:07 AM: Message edited by: Onionpie ]

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stayclassy812
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I meant because I might be spotting or experiencing breakthrough bleeding. My withdrawal bleed is lasting longer than usual, really mild spotting, like teeny tiny bits of brown blood when I wipe.
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Robin Lee
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Since you started your new pack on time, it's unlikely that the protection you get from the pill is compromised. As heather said above though, people often feel more at ease using a second method of contraception. So, if you're feeling extra-anxious about this, I suggest talking to your partner about consistently using a second method.

Again, the bleeding is not an indication that the pill is less effective as a contraceptive.

Here's some information on why spotting might occur when taking the pill:

http://today.msnbc.msn.com/id/20248689/ns/today-today_health/t/breakthrough-bleeding-usual-when-pill/#.UNyHhbZzG_E

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Robin

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stayclassy812
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Im a bit concerned that my withdrawal bleed has lasted this long, I started on Wednesday and usually end by Tuesday, Monday & Tuesday are usually spotting. Its been less and less now, not bright red blood, only really small bits of brown tissue I would say, super tiny and only when I wipe. I had sex on Friday and since then, its gone. Last night, saturday, I found a small bit of yellow/brown discharge after a day of no spotting. I woke up today and there was nothing. Is it normal to have this type of withdrawal bleed last longer than usual? It may be due to my missed pill last cycle.
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Robin Lee
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Even when someone is on hormonal birth control, and hence having their cycle regulated by those hormones, there can still be variations in withdrawal bleeds from time to time, just as there can be variations with menstrual periods. The hormones that are in the pill control reproductive capacity, but they're not the only hormones that impact that part of our bodies; so the fluctuations of other hormonal processes can and do impact withdrawal bleeds.

With the spotting tapering off the way you're describing, it sounds like you're probably just about at the end of this bleed, and I think you can chalk it up to being an anomaly. If you find you start bleeding heavily again, or this type of withdrawal bleed happens again, you certainly can mention it to your healthcare provider. [Smile]

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Robin

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stayclassy812
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So nothing to be concerned about then? [Smile] my pill is working just fine and effective and it was just a longer withdrawal bleed than usual?
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Robin Lee
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As we discussed above, this doesn't reflect anything about your pill's function as a contraceptive. If you're feeling like you need more security with your birth control, you can add a second method when you engage in sexual activities that have a risk of pregnancy.

If you're feeling like something isn't right in your body, you certainly can talk with a healthcare provider about that; you're the best judge of what is going on with your body.

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Robin

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stayclassy812
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I spoke to a healthcare provider!! She said a mishap with my pill last cycle shouldnt affect my next cycle, that diarrhea is only a concern when it occurs over several days (I had a loose stool on my first day of this cycle) and a withdrawal bleed that lasts longer than usual, in this case, 8-9 days, is fine. She said my effectiveness isn't compromised, this is all what you have told me here as well, am I right? [Smile]
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Robin Lee
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You've gotten the same information from us and from her...how secure are you feeling with that information?

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Robin

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stayclassy812
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Very secure! Thank you!

There was something I was wondering about though, do normal bowel movements close to the taking of the pill, around an hour or so after, have any effect on the pill? From my research and what I've been told, its only severe diarrhea so soon to taking the pill and over the course of a few days that does.

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Robin Lee
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What you might find helpful in answering this question is to do some research on how digestion works in general. That will give you a good sense of how *anything* (food, medication, etc) moves through our bodies.

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Robin

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