Birth Control Questions! :)

[Aly_]

Hi! I am on Ortho Tricyclen 28. I just have a couple of general questions regarding the pill that I could not find online (since they're pretty specific, and albeit, maybe a little silly to ask haha :p)

First off, I generally take it between 9:30am to 11am. I am pretty sure that taking it 12 hours is late, but is it okay to take it within this time frame window? I used to be super anal down to the minute, but I've found taking it between these times help me remember as part of my routine. Also, I know that on the day I commute to school, I have to get up a tad earlier, and I don't like bringing my pills with me (in fear of losing them). So, I was thinking about taking it sooner, like right before I leave the house on those days (such as at 8am?) I've always read about taking them late, but never about what happens if you take it a tad early?

Also, I was wondering, I hate taking my placebo sugar pills. Don't ask me why, but I just do! The last 7 days of the pack contain no active pills, so I just generally do not take them. I just like having that break lmao. I know they're also good for keeping the pill-taking attitude consistent, but I am always on time for my first pill pack of the following month. I asked my doctor if I can do a 21 day pack, but she hasn't gotten back to me. Is it okay that I am not taking those last 7 placebo sugar pills, or do they actually contain something that I may need?

Next, if a person is on the birth control pill, and is pregnant, do they still experience the withdrawal bleed? I know that the withdrawal bleed those last seven days isn't really a period, but if one was pregnant, would there be no bleed during that time to let the person know that they are pregnant? Or, is that not the way birth control works? I know birth control stops ovulation altogether (if taken correctly), and you cannot be pregnant if you aren't ovulating, but I just wanted to know if a pregnant person taking hormonal birth control would still bleed as normally, or not (since I guess that would cause their hormones to be out of whack).

FINALLY, do people who use IUDs see the string of it all the time? Or is it internal, and doesn't stick out the way a tampon string does. When my coworker described it, I was under the impression that you could see the string at all times. Sorry if this is genuinely a dumb question!!!!! Thanks

[Alexa]

Hey Aly! Thanks for writing. And, just for starters - your questions are never silly! We are happy to answer them as best we can.

If an expanded window for taking your birth control pills in the morning helps you to remember taking them, go for it! Taking your pill at the same time every day is mostly to help you form a consistent habit and stick to it. If flexibility allows you to do that, then that's what's important - not that your pills are *precisely* 24 hours apart.

Placebo pills are just as you said - sugar pills that only help you to keep up your consistent habit of taking a pill at the same (relative) time each day. In some cases, they may also contain iron or vitamins that are particularly beneficial to your body when beginning your period, but nothing critical. Again, it's always recommended to follow the schedule and take them because it can help you to keep the habit up - but if you're sure that you can do that without taking your sugar pills, then you don't have to take them.

Your question about pregnancy while on the pill is an interesting one, since if you are taking the pill consistently, there is a very low chance of becoming pregnant. You may bleed lightly or spot in your first trimester of pregnancy, but I wouldn't call this a "withdrawal bleed" - it is just a normal part of early pregnancy and doesn't really have to do with your birth control pills. It may have to do with the egg implanting in the lining of your uterus, for example. Despite the fact that some spotting is normal, I would always recommend checking in with your doctor if you are experiencing bleeding during a pregnancy. If it is heavier than spotting - for example, if it can soak a panty liner - you should certainly speak to a doctor to eliminate any potential concerns.

Alright! We've gotten to the IUDs!
The short answer is no. If you have an IUD you will not see the string hanging from your vaginal canal. It's pretty high up there, usually resting right against your cervix. You or your partner may encounter the string during sex or masturbation, but it usually goes unnoticed. If you choose to get an IUD, your doctor will likely tell you to "check your strings" every few months just to make sure your IUD is still in place.

I hope this helps! Thank you for your questions.