ALICE!!!

If I lost a birth control pill down the sink and I just resumed with the next day's pill right away, although I will be missing one pill at the end of my 28 day cycle, is that OK? Can I just do an eight day placebo week, instead of seven, and then start my next pack like normal? Or should I start the next pack one day early? Or what?

HELP! I'm confused....

Dear HELP! I'm confused...,

Take a deep breath! While it may be confusing, rest assured that you aren’t the first (and won’t be the last) to experience a lost birth control pill. To best inform your next steps, speaking with the health care provider who prescribed the pills may be your best bet. They’ll be able to tell you what to do more definitively, as they’ll be more familiar with your specific circumstances. This is because their recommendations will vary based on many factors, including the specific formulation of your oral contraceptives and which pill in the menstrual cycle was missed. For example, the effects of a lost pill may be different if it’s lost in the middle of the cycle rather than if it’s lost right before the placebo week. An additional factor to be aware of is that some brands of pills are multi-phasic, meaning that pills in a single pack of birth control have differing levels of hormones. Depending on which pill you missed (or which "phase" pill it was), they may have different recommendations about how to proceed. In some cases, you may be able to simply resume taking pills at your regular time the day after missing a pill. In others cases, skipping even one pill (or extending the placebo week) could reduce the effectiveness of the method; it really depends on the type of oral contraceptive you take.

While reaching out to your health care provider is key, an in-office visit is not generally required to determine a solution. If you can provide enough information over the phone, they may be able to work out a solution without you needing to visit in-person. In addition to contacting them, you can also look for the patient information that comes with each pack of pills (usually a small, folded piece of paper), which may provide some information about your pill’s formulation and what to do if you miss or lose a pill.

When you miss a pill, you may reduce the effectiveness of your birth control. If you’re still intending to prevent a pregnancy, it’s wise to use a backup method of contraception for up to seven days after you’ve resumed your regular pill schedule. Speaking with your health care provider can provide further guidance as to the necessity of backup methods while getting your birth control back on a routine. Using another form of contraception until that time will help reduce your chances of pregnancy.

If you had sex without backup contraception before having an opportunity to resolve the missing pill, you may want to consider emergency contraception (EC). There are a few available emergency contraceptives on the market right now. EC pills are one option, with various formulations available over-the-counter and by prescription. These can also be taken up to five days after unprotected sex, but the effectiveness of these ranges based on the brand. For more information, check out Emergency contraception basic information. Another option is the copper IUD (ParaGard). This is the most effective form of EC but requires more planning, as it needs to be inserted by a health care provider within five days of unprotected sex.

Knowing what to do when a pill goes down the drain can be stressful, but speaking with a health care provider can help ease your worries and get your schedule back on track.

Take care,

Alice!

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