"Missed Pill"

[endplusone]

Hello,

I have been taking Ortho Tri-cyclen Lo for three years, and for the past two months have been taking the regular Cyclen in order to offset/skip my period while I was on vacation.

I have never missed a pill, or have never been late in starting a new pack. However, on Saturday I forgot to take my pill at the usual time and didn't end up taking it until 12.5 hours later. I typically take my pill at 0800 hrs, however I didn't end up taking it until around 2030 hrs that day.

It also happened to be the last active pill in the pack.

I consulted the manual that comes with the birth control and it said pregnancy is more likely to happen if the first or last active pills are missed, so I ended up abstaining from sex.

Here are my questions...

What the manual didn't define was, what constitutes a "missed pill"? Did I actually miss a pill, or was it just late?

Following this week of placebo pills, when I start my new pill pack on the Sunday, does this mean I should be using a "back-up" method of contraception for the first week again?

Thank you for your help!

[Redskies]

That's not very helpful of the manual to not actually say what a missed pill is!

For combined pills, a missed pill is a pill that's not been taken within 24 hours of when you were due to take it.

A late pill is one that's taken more than 12 hours after you were due to take it, but within 24 hours. So, what you had with the last pill in your pack was a late pill.

With just one late pill, you should still have a good level of protection from your pill. However, if it's very important to you that you don't become pregnant, then using a back-up method for the first 7 days of your new pack (and/or not having that kind of sex, like you've done) is a good fail-safe. It really depends on what you most want to do and feel most comfortable with. If a bit of perspective helps, for a whole year of use, the pill is about 91% effective in typical use. Typical use includes things like occasionally having late or missed pills, so it's probably a good benchmark for you right now. If 91% over a year feels good enough for you, feels like a level of risk that's okay with you, you could choose not to use a back-up. If it doesn't feel enough for you and you want to make the chance of pregnancy as small as possible, then using a back-up for 7 days of the new pack (and backing up or not having that kind of sex, like you've done, during the placebos) is a good choice. Too, using a back-up usually isn't any big hassle