Scarleteen

1.My girlfriend has been on birth control pills (combined) for 4 months. She has done a great job taking the pills as directed but she isn't a perfect user. There was this one time when she took her active pill 12 hours late. From Scarleteen's excellent resources, I know that combined pills have a 12-hour grace period, but what is the best follow-up action when it is more than 12 hours late but it's not considered missed (eg 13 hours late)?

2. The pack of pills she is on has arrows that guide her through her cycle of pill use. It has 4 rows, the first three are active pills and the last is placebo pills. She always starts a new pack on "Friday" of the first row and goes along the arrows and finishes the pack on "Thursday" of the FIRST ROW (After the fourth row, the arrow goes back to the first row to finish off the active pills before the one taken on "Friday"). This month, when she was on her placebo period, we noticed the "Thursday" pill on the first row, which should be the one to be taken last in the pack, is missing. So she either took two pills in one day by accident or switched it with pill from another day. There's no way of telling what mistake she made exactly which is why I got a bit paranoid. What I want to know is if I can be reassured that:
i) she is not pregnant if she gets her withdrawal bleeding during placebo period
ii) risks from one particular cycle will not carry over to future cycles forever so a new cycle/new pack will kinda reset the risks she incurs from her mistakes such as late pills or missed pills. She just started a new pack and I have decided to back up (withdrawal method) for 14 days just to be safe. Is this the right thing to do? What do you think I should do?

Thank you very much in advance for your time and reply. The work you guys do is really great and meaningful. Please keep this up!!

Hi, and welcome to the boards!

For your first question: After 12 hours, the pill is considered 'missed', so your girlfriend should just take the next pill at the normal time as usual.

For your second question, yes, she's not pregnant if she gets her withdrawal bleed, and after this bleed you can be sure that she's not pregnant, and therefore any 'risks' are moot and won't carry over.

While you don't have to use a backup method because of any risk from her taking two in one day/switching pills, using two forms of contraception is always useful, and you can find out more about that here: The Buddy System: Effectiveness Rates for Backing Up Your Birth Control With a Second Method

Hi Ruth

Thank you for the prompt reply! I have some follow-up questions after reading your response.

1. I am pretty sure a combined birth control pill is considered "late" after 12 hours and "missed' after 24 hours. I read about it all the time in Scarleteen's forum. Could you consult with Heather? She helped me through a troublesome situation about the pills once. http://www.scarleteen.com/birth_control ... ation_pill
Also, am I right in saying the follow-up action for a late pill or a missed pill is to take the late/missed pill as soon as you remember and take the next pill at the normal time as usual?

2. I would like to know a bit more about the reasons behind "risks not carrying over to a new cycle". Could you elaborate? Is it because withdrawal bleeding signifies the shedding of the uterus lining which ensures no pregnancy can take place? But what if she ovulates because of that mistake she made?

Thanks!!

Re: your first point - you're absolutely right. That was my mistake, there. A late pill should be taken as soon as it's remembered, yes. I very much apologise for the misinformation.

For your second point, if your girlfriend were to ovulate because of a missed or late pill (which, for just one, would be unlikely), that egg would be lost during the withdrawal bleed. Taking the pill as normal from that point on would stop ovulating from happening during that next cycle, so that mistake doesn't 'carry over', as it were. Does that make sense?

Yes. Thank you very much for clearing it up.

In regards to the second point, although starting a new cycle by taking active pills again will reset the risks from previous cycle, how many days should we wait before we can have sex without the need to back up (condom, withdrawal etc.)? Also, in the case of ovulation, does birth control pills still play a part in preventing pregnancy from happening?

Cheers!

If you back up from until the first seven days of active pills have passed, you should be confident that the pill is working to it's full effectiveness again. As for in case of ovulation, the pill also works in two other ways, too - to thicken cervical mucus so sperm cells are less able to get to or into the cervix, and by making the lining of the uterus less hospitable for a fertilized egg to implant in. So yes, even if your girlfriend ovulated, there is still protection in place.

Thanks Ruth! I feel much better and reassured with this new knowledge.