Brief Answer:
detailed answer below.

Detailed Answer:
Hello and welcome,
I am Dr Madhuri a Consultant Obstetrician and Gynecologist and will be helping you with your queries.
It seems you had a mild bleeding on 14th July, and you are already on althea pills.

Please remember as long as you are using oral contraceptive pills as per instructions there is no need for any other contraception [ no need to use condoms to prevent pregnancy, however we do recommend them to prevent sexually transmitted infections]. You are already protected from pregnancy by the pills.

Another thing is that day 7 is a relatively infertile part of the cycle and chances of pregnancy on this day are very very low even if contraception is not used. So there is no need to use additional contraception if you are already on pills.

Please check if you have been taking the althea pills as per the instructions provided and also if you had missed any pills in the past 7 days that you were supposed to take. If you have taken them as per schedule then there is no need to take the emergency pill.

Nordette is a pill similar to althea but has a different progesterone [ levonorgestrel] and ethinyl estradiol as the estrogen hormone. You will need to take the yuzpe regimen for emergency contraception which is 4 pills of nordette. However althea already contains estrogen hormone similar to nordette so you will unnecessarily be exposed to a lot of estrogen.

Once you are using althea there is no need for the nordette and it may also cause side effects like nausea, vomiting and even blood clots.

There is no literature to use emergency pills while on oral contraceptives as both have an additive effect in terms of the adverse effects profile. Even if you do decide to use [ not recommended] it use only 3 pills as the estrogen in your regular althea would be additive.

So according to me : nordette is not needed as it was a safe period when you had sex with very low chance of pregnancy even without a contraceptive and also you are already on ongoing contraception [ althea].

Please do not worry.
Hope this satisfies your query.
Thanks for using HCM.     
Feel free to ask any more questions that you may have.
Dr Madhuri Bagde
Consultant Obstetrician and Gynecologist

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Brief Answer:
detailed answer below

Detailed Answer:
Hello and welcome,

I understand the problem.

Since you have already taken the pills I will not recommend taking at least the althea pills now as it would mean a lot of doses of hormones. Use condoms for the rest of the cycle.

About the timing of the pills: the pills work best if they are taken daily at the same time. Delay in taking one or two pills does not make a difference but if repeated delays are there then the effectiveness may decrease.Taking them just before going to bed works best as there is lesser chance of forgetting the pills. Also the peak levels occur at night and so adverse effects like nausea are decreased. So try this if possible in the next cycle.

Please remember that if you use the pills regularly then they provide excellent protection and there is no need for any other method.

About the bleeding: now that so much hormones have been taken, there may be bleeding earlier than expected. However since this is the initial phase of the menstrual cycle just day 7-8, there may not be any withdrawl bleed and sometimes even the next period may be delayed. So this is unpredictable. You will just need to wait and watch for this.

Hope this helps answer the query.

I am always here for any further queries.

Dr Madhuri

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Brief Answer:
Understand your issue.

Detailed Answer:
Hello and welcome back,

I am extremely sorry but as a gynecologist I cannot recommend this.
However I would like you to understand that since there has been a handling of the hormones, the efficacy of the pills as well as the safety is questionable now.

I do understand that you have done this earlier [ I am glad that you informed me as it takes courage to do this] and there was no problem but it is a slight risk that I would not want my patient to take. So please think over it again.

If you still decide to take the althea then most likely they will begin regular protection from seven days after all your current pills are over. Even about this we cannot be absolutely sure as unfortunately there are no such studies for me to help you with. So use condoms for atleast 7 days after completing the nordette.

I do understand your issue, but effect as well as safety profile of althea are debatable now. So please rethink.

Dr Madhuri

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Brief Answer:
Effects explained

Detailed Answer:
Welcome back,

The risk that we all do not want is that of blood clots as a high dose of hormone is taken. Other issues are with liver and a number of others like Acne, Oily skin, Breast tenderness,Depression Tiredness, fatigue, Cholestatic jaundice and so on. Though they are common with long term use but higher doses can lead to liver and blood disturbances about which we are most concerned.

Though the risk is not very high but clots are difficult to handle. They may travel and block important blood vessels and hence we always exercise caution while using these drugs.

So I hope you will understand this issue. I do know that you want to continue the pack and I would have recommended it if the nordette had not been taken.

I am extremely sorry but unfortunately this is how things stand.

So please think well before you decide.

Take care and feel free for any further queries.

Dr Madhuri

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