Conflicting info about vomitting and effectiveness

[Girltuesday2015]

Hi, I think this is straightforward. I may be compromised from vomiting after taking my pill. Here is my timeline. I take my pills at night.

Saturday - took my second to last pill in my pack.
Sunday - had unprotected sex with ejaculation in the morning.
I didn't take my pill Sunday night. I took it about 8 hours late on Monday morning.

3 hours after I took it, I vomited bile (hangover - I learned my lesson).

It's now Tuesday and I'm on day 2 of my placebo week. Should I take plan B? Am I at risk?

[Sam W]

Hi Girltuesday,

With the pill, it's usually absorbed within 2-3 hours of taking it, so if your vomited outside of that window, you can assume the effectiveness was not compromised. If you feel like it's right on the border and you're concerned, then Plan B is an option. Too, if you want to avoid worries like this in the future, it would be sound to back-up with a condom, just in case something happens.

[Girltuesday2015]

Does it make any difference that I missed my pill by 8 hours? We have not had sex since. I am really conflicted because my period is soon but I have plan b ready. I have about 2 more hours to take it.

[Heather]

Nope. Combined oral contraceptives leave that kind of room for time variations.

There isn't anything Plan B can do your pill doesn't do already and more effectively, and all the more so if you're at the end of the window for using it, when it is far less effective than your pill.

If you don't already back up with condoms as a standard practice, I'd suggest you seriously consider it. Not only do the provide important protection from infections, when you have things like this happen, as they will, you don't have to worry for even a minute. Not bad for a tiny piece of latex!

[Girltuesday2015]

Omg. Thank you. The pharmacist told me I'm in extreme risk of pregnancy since I was late and threw it up. I'm so conflicted. I'm just nearing my 72 hour window. What should I do?

[Girltuesday2015]

And it was my last active pill before my placebos, so I couldn't make it up.

[Heather]

I really can't say more than I already did, but how about putting a call into your prescribing physician? That's whose word I would put above all others.

But personally -- and I have worked in contraceptiuon for almost 20 years now, if it helps to know -- I'm feeling unconcerned about the timing of all this. Absorption of any medication does not usually take 3 hours.

If there's a next time though (and here's where I do one more nudge to just use condoms again, last time, I promise), know you can always borrow a pill from your next pack to make up a missed pill or one you feel you may not have digested. If you aren't given refills ahead of time so you always have an extra pill pack, that's always something you can ask for, as it's standard practice just to make sure people don't have a lapse with pills in the event of a phramacy not having stock, etc.

[Girltuesday2015]

Thanks, Heather! I called my pharmacist (my doctor was unreachable) and she said I was at risk for pregnancy since it was the last pill of my pack.

So I got Plan B since I was in my 72 hour window. I got busy at work and took it around hour 75. Would that make a difference? I was also spotting when I took it (I'm close to my period). I recognize that it was probably unnecessary but the pharmacist spooked me.

Thank you again for your help.

[Karyn]

I'm so sorry the pharmacist freaked you out: that's pretty poor service, in my opinion. A few hours in the timing of taking Plan B won't likely make much of a difference, if any, especially because it wasn't really necessary. Regardless, you've taken it now, so there's really nothing else you can do.

[Girltuesday2015]

Thank you. I'm assuming my period will not come as expected, correct?

Also - I want to add, I'm usually VERY good with my pills. This is the only problem I've had and I thought I was doing it all right.

[Sam W]

That can be hard to predict, because while one of the side effects of Plan B can be that it throws off your cycle for a bit, it will interact with everybody's body differently. All you can do is hang tight and be patient, and do a little self-care while you wait.

[Girltuesday2015]

Thanks, I'm really trying. I'm pretty upset at the care I received at the pharmacist. He first told me that if I feel pregnancy symptoms, I can just take Plan B and it will take care of it. I told him, "no, it works in 72 hours only" and then he tried to tell me again that wasn't true.

Also, I was wondering -- I was told the last ACTIVE pill in the pack (the one I missed) is the most dangerous to miss. I tried looking at my leaflet for what to do when that happens. The only thing it says is that if I missed (1) pill in weeks 1,2,3 to just take it when I remember and continue the pack as normal. For the future - do you have any information on what to do when it's the last pill of the pack and you don't have one to make it up with?

[Sam W]

I'm sorry you had that experience with the pharmacist. It's totally understandable to be upset by that.

Our general advise is to go by what it says on your pill pack leaflet. So if the leaflet advised just to take it when you remembered (or continue with the pill sequence), regardless of which pill it was, then that was the thing to do.

[Girltuesday2015]

Alright. Sounds like I did everything I could possibly do.

I'm just sitting around waiting for my period to start again. I was spotting yesterday and when I took Plan B, it just stopped which was quite annoying.

When can I test?

[Redskies]

You can expect a pregnancy test to be accurate once your period is late - "late" means five days after the last day you would've expected it.

Just to make sure a few things are properly clear, both for you and for anyone reading along: what the pharmacist said about taking emergency contraception if you have "pregnancy symptoms" is utter, utter hogwash. (I am baffled that, how and why any pharmacist would say that, frankly.) Emergency contraception works by preventing a pregnancy from happening, so there wouldn't be any "pregnancy symptoms" at the time it should be taken. If someone's had a risk and wants to take emergency contraception, the right thing to do is to take it as soon as possible - because it's more effective the sooner it's taken - and certainly not wait for any "symptoms", which also certainly wouldn't happen that early even if someone were to become pregnant.

Emergency contraception is still effective beyond 72 hours: it becomes less effective as time goes on, but it's still advised up to 120 hours. (Sometimes people know a 72-hour rule because there are some countries - all of Europe, for example - where Plan B equivalents are only licensed up to 72 hours. A newer, different type is available beyond that, though.)

Some different pill brands advise slightly different action in the event of missing a pill in a different week. You can go with what yours says. If you're wanting to be extra-careful, we suggest backing up with condoms after you've made a pill mistake until you've taken a full week in a row of active pills correctly. Of course, you can also back up with condoms as standard, for extra security

But, as everyone else here has said, we're not seeing any concern here about your original pill in the first place.

Waiting for a period in a pregnancy scare can definitely be tough. To help you through it a bit more bearably, Self-Care a La Carte has some suggestions and guidance.

[Girltuesday2015]

I was reading online how missing the last active pill in the pack is the WORST and puts me at high risk. I'm trying to wrap my head around that. I know the rule is you shouldn't go more than 7 days without hormones. So, with that logic, I should start my next pill pack early and it would have never been a problem. Right? I'm not a doctor and I'm not sure how that works.

My thought is that I took my last pill Saturday at around 10pm. Which is my usual time. I had sex Sunday morning. I "missed" Sunday's pill. If everything went wrong, I should still be protected if I start a day earlier, correct?

Thank you for that link, I will check it out.

[Girltuesday2015]

I'm sorry to be such a pest, I know there are so many other users to help.

I'm really nervous because my period was starting Wednesday, I took plan b. And now my cm is clear like it always is. Can it make me skip my period? I'm freaking out.

[Heather]

It's okay: honestly, this pharmacist sounds to me like they haven't done any training or education with EC, and I'm not surprised you're feeling like you are.

By all means, Plan B can alter periods, both with timing, including skipping sometimes, or with changes in things like level of flow or PMS symptoms.

Again, I personally highly doubt there were any issues with your pill. My best advice is to shift to backing up with condoms, moving forward, so you don't have to go through something like this again (and get the infection protection they can give that your pill can't provide), and just take care of your mental health right now to get through this. Digging yourself into an anxiety hole by reading everything on earth about your pill or EC will tend to stand counter to that self-care, rather than supporting it, so how about getting offline and doing some things that aren't about this that you know will either comfort you, distract you, or both?

[Girltuesday2015]

Thank you.

I checked my pill packet and it said 3-4 hours for absorption. Still no sign of my period and I start my pills tomorrow Should I be worried? Are the packets more conservative? Should I start my pills tomorrow

[Redskies]

Getting or not getting your withdrawal bleed during the placebo week doesn't make any difference to when you start your next pack. Whether you had a bleed or not, you should start the next pack when you were due to start it, after the correct number of placebo days for your pill brand.

Like Heather said, it's not at all unusual for Plan B to cause some temporary menstrual wonkiness. So, it's not a big surprise and it's no cause for concern that you haven't had your bleed.

I understand that the conflicting things the pharmacist said will've shaken you up and made you extra sensitive around this; we're happy to help you recover from that, but staying in a worry loop with you isn't going to achieve that, and would only help keep you stuck, which obviously we don't want to do! So, I need to set a limit with you now and ask you not to ask us any more about this pill not-really-mishap.

Like Heather, I'd really suggest that you do what you can to focus LESS on this than you have been. If you'd like any support in figuring out or doing some self-care things - like I linked you to just above - we'd be very happy to talk with you about that.

[Girltuesday2015]

Thank you. I wanted to update this for other paranoid chicks who find this post.

I'm actually really glad about the boundaries set because it helped me relax and stop thinking about it as much.

Anyway, I started my period last night. It's much lighter than usual, but it's on time with cramps and everything. So if it walks like a duck, talks like a duck ...

Also, this situation started a convo between me and my SO. We are going to use condoms and then slowly move to withdrawal. I also put two alarms on my phone for my pill. Thanks!