I forgot to take my birth control pills for several days, how soon can I test?

I have been on Loestrin 24 Fe for about 8 months now, I had totally forgotten to take my birth control pill from Day 13-now. To be honest with you I noticed this when I was supposed to be on Day 20 after having unprotected sex with my husband on Day 20 and again on Day 26. When would be a good time for me to test for pregnancy? I tested Tuesday and yesterday and they were both negative, but I am not too sure if I tested too early. I should be on my period since Wednesday the 26th but so far today is the third day that AF is a no show (although I have really bad cramping), and I know I might still get it tomorrow since that is still part of the menstrual days. I would really like your opinion on this matter.
Sarah replies:

Generally speaking, when you start missing pills in the middle of a cycle (especially if you miss lots of pills) some weirdness with your withdrawl bleed is to be expected. By not having those extra hormones in your body, it's impossible to guess what was going on with your natural hormone levels. In short, you've really confused your body here. So it's pretty much impossible to guess if you'll have a period or when one will show up.

You can take a pregnancy test and expect an accurate result a minimum of 14 days after the last time you had unprotected contact. Based on your description, I'm not sure exactly when that would be for you, but just count about 10 days from the last time you had sex and test then. You can re-test in a week if your period still hasn't shown up. You can also see your doctor or health care provider for a test anytime after that 14 days, if you wish.

Usually when you miss more than 3 days worth of pills, you should toss out the rest of the current pack and start a new one. However, since you've missed so many and have had unprotected sex, it would probably be good to make sure you're not pregnant before beginning a new pack. (This is not because the pills would necessarily do any harm to a pregnancy, but because it's pretty pointless to take the pill when one is pregnant.) You can find the patient information for Loestrin 24 Fe here (scroll down to page 22 of the document for the patient summary). If you are unsure about what to do in your specific situation, call your health care provider for more information. You will want to make sure that you are using a backup method of contraception (like condoms) until you begin taking your pill again and it would probably be wise to backup the entire next cycle while your body sorts itself out again. If you and your partner have not been tested lately, this would also be a good time to get up-to-date on your STI screenings. (Remember that even in monogamous, committed, or long-term relationships of any sort, it is still wise to get regular screenings and stay up-to-date on both of your sexual health care.)

Also, I'd strongly encourage you to head back to your health care provider to talk about a different method of birth control that might suit you better. Missing that many pills, even if it has not been a problem for you in the past, is a good sign that this method just isn't fitting well into your lifestyle. There are so many options available these days, like the patch, ring, or injection, that you don't have to remember everyday. You've also got non-hormonal options available, like a diaphram, Lea's Shield, or condoms, that you should be able to find something that works for you. You may wish to check out our article: Birth Control Bingo!

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