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Dr. Andrew Rynne

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Can missing hormone pills for two days lead to pregnancy after unprotected sex?

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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3132 Questions

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Posted on Sat, 4 Nov 2017 in Pregnancy
Question: I'm on the pill and I got up to the stage where I should take the sugar pills. However after two days my period still hadn't come and I was going to my boyfriend's so instead I started taking the hormone pills again. Long story short we had unprotected sex and he didn't pull out. I'm terrified that I may be pregnant due to the two days I didn't take hormone pills. Is it possible or am I freaking out over nothing ? Would I still be protected after missing the two days ?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 9 minutes later
Brief Answer:
You are covered.

Detailed Answer:
Hello and welcome,

If you used an entire pill pack before this without missing any pills, and then started a new pack after 2 days of no hormones, you will be covered for birth control. So no worries. It will be like you had done the usual cycle only didn't get your period.

If you miss 2 of the hormone pills in a row, that is a different story. But the 2 pills you missed were sugar (no hormone) so it won't interfere with contraception.

If, next time, you don't get a period after 2 days of no hormone pills, talk with your doctor as the amount of hormone might not be the right balance. But that doesn't mean you aren't being covered in the meantime.

I hope this answers your question. Please let me know if I can provide further information.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 5 minutes later
Should I allow myself to have my period or continue taking the hormone pills ? Thank you for answering you've helped me a lot.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 12 minutes later
Brief Answer:
Information

Detailed Answer:
It would be best to continue the hormone pills and then have a period at the end of this 2nd pack during the sugar pill days. This would be the least disruptive thing to do. It will not hurt you to have skipped a period if this is a standard combined (estrogen and progestin) pill used for contraception. It will not hurt you if it is a "mini-pill" (progestin only) either. It can be a problem if you were prescribed a contraceptive pill for other reasons as some of them should not be used in this way.

When women take a combined hormone contraceptive pill continuously, skipping the sugar pills and period, there can sometimes be some break through bleeding or spotting during the month. This does not mean that it is not working however.

To see if a particular formulation is going to work out well symptom wise, it usually takes 2-3 months. It will be protecting you from pregnancy, but your body may have a getting-used-to-it span of time in those first few months. I'm throwing that in here for your information because sometimes if there are side effects or unexpected things like delayed or absent periods, it can take a couple months to see if that is going to continue to happen. If it does, then talk with your doctor to try a different formulation.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 13 minutes later
okay, so I'll take them as normal. I didn't have one yesterday so should I take two today ? One now and then one later at the usual time I take them? Just to double check, would signs of pregnancy show while I'm on the pill in the unlikely case I did get pregnant ? I know you said I'd be covered but I can't help but worry despite it.

When is the soonest I can do a test just for complete peace of mind? The intercourse was two days ago. I've also read that sometimes it's better to do multiple tests, like a week or so after the first one. Is this true? Sorry, I just want to be absolutely certain as this is scary and not something I want to risk.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 54 minutes later
Brief Answer:
Information

Detailed Answer:
If you started the new pill pack already and just skipped taking a pill yesterday, then yes, take two today as you described.

A blood pregnancy test can be taken as early as 7-12 days after the date of possible conception.

A urine home pregnancy test usually is usually not recommended until 14 days after the date of possible conception, and is most accurate 1 week after that (21 days after conception).

The reason some people take multiple tests is that while a pregnancy test might turn positive at 14 days after conception, if it is negative but the person might still be pregnant, it will be even more likely to turn positive 1 week after that because there would be more hCG hormone which is what the test detects.

But again, hormonal contraception is 99% effective, and you didn't skip any of it. You just skipped a couple of days when you would have been skipping them anyway. It's just that your period didn't have time to come, and that won't effect it's protection.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 4 hours later
Would it be okay if I let myself have my period rather than taking the pills? I know you said to continue taking them, but I think I'd spend the entire month extremely stressed about everything and whether or not I'd get my period. Sorry you have to deal with such an anxious person, ahaha. So if possible, I'd love to be able to let my period come. I won't be having sex during this time at all and won't until consecutively taking the pill for at least 7 days after my period.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 3 hours later
Brief Answer:
Thoughts on this

Detailed Answer:
It would be ok for you to go ahead and have a period but there are two things to keep in mind:

1. The next pill pack won't be a full pack if you used the one you just started, so after your period, start a brand new pack so that you will have the full month of pills.

2. Once stopping the hormone pills give yourself 5 days before worrying that the bleeding hasn't come yet. It may take even longer since you have just started on this type of birth control, and the cycle is a bit messed up.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 36 hours later
okay ! thank you. I have one more question. If it had been the hormone ones I'd skipped what would the chances of being pregnant be ? Also how effective is taking multiple birth tablets in the place of plan b/ the morning after pill? For mine it said to take four and then another four 12 hours later. Just curious!
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Answered by Dr. Bonnie Berger-Durnbaugh 23 minutes later
Brief Answer:
Information

Detailed Answer:
Your chances for getting pregnant depends partly on when you missed your pills and whether the 2 that were missed were in a row, and if you had unprotected intercourse during the time you skipped the pills.

The highest risk of ovulation happens the hormone-free interval (the time when you take sugar pills or there is a break between hormone pills) is prolonged for more than seven days. This can happen because of a delay in starting your pack or by missing hormone pills during the first or third weeks of birth control pill use.

When a woman isn't on the pill, around day 5 after the start of her period, one of the follicles on the ovaries is selected for maturation. So delaying starting the pill for 1 week after the period starts can allow the body to be working towards ovulation.

If you are on the mini-pill (progestin only), missing pills or even taking them at different times of the day can be an issue and increase the likelihood of ovulating.

If you are on the more traditional combination pill (estrogen + progestin), it isn't as critical as with the progestin only pills, but you should still check the patient information that came with your pill packs regarding what to do if you miss 2 doses.

It is wise to use a back-up method such as a condom or abstain from intercourse for at least a week after you miss your pill(s). Depending on the recommendations of the brand of pill you are taking, it may be recommended to use an emergency contraceptive such as Plan B (if you weigh less than 165 pounds) or XXXXXXX Even more effective is a copper IUD if inserted within 5 days of unprotected intercourse. Also, it won't mess you up hormonally like throwing an emergency contraceptive hormone like Plan B into the mix (which is a high dose of of progestin and can delay periods).

I don't have any statistics on whether taking multiple birth control tablets would be more effective or less than taking an emergency hormonal contraceptive. In most cases it would be thought to be similar as it is providing an increased hit of hormones which is basically what emergency hormonal contraceptives are.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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