Missed Pills and Early Period

Cynthia Flynn's picture
Experts: 

QUESTION

Dear Midwife,
I take the 21 pack of Microgestin and missed two pills in a row (last day of the 2nd week and first day--Sunday--of the 3rd week). I have not found any information online or on the pill package saying what to do in my particular circumstance, especially given that my period started yesterday--Monday, the second day of the 3rd week. It is not light bleeding but a full fledged period. I took two pills on Monday and one pill today. I have not had intercourse and will not this week. But, I would like to know what I should do:

a) Take one pill per day until this Sunday and start a fresh pack on Sunday.
b) Take another pill today (2 total for today) and do as option a.
c) Stop taking pills until Sunday and start a fresh pack on Sunday.
d) Stop taking active pills until Sunday, skip next week (as it would have been my inactive week anyway) and start a fresh pack the Sunday after.

Please let me know what to do as I am quite worried about my health, I don't want to be pumped on hormones if it is dangerous for me during this period. I really appreciate your time and answer.

Thank you.

ANSWER

The answers to your questions should have been given to you when you started the pill, and I'm surprised they are hard to find on-line (I'll have to check). If you are having a full-fledged period, start your next pack of pills within seven days of when you started bleeding. If you usually start a pack on Sunday, you can start it on the next Sunday that comes up, as long as it is no more than 7 days after the start of the bleeding. If you do not wish to become pregnant, you can create more security by using condoms or abstaining for the first 7 pills of the new pack. Then you would take the new pack like normal and hope you get back on track.

The problem is that you might already have conceived. I'd suggest a pregnancy test now and another in two weeks. Taking pills in very early pregnancy will not hurt the baby, but if you test positive, of course you should stop the pills. But only if you test positive.

I also tell my own clients that if they miss more than two pills in a year (not a month), then this is not the method for them. I would also suggest that you consider another method if you are not pregnant and don't want to be.

P.S. You should have been told that if you miss two days of pills in a row, then you take two pills as soon as you find out you are behind and two pills the following day, and use condoms until your next period.

-- Cynthia, CNM. PhD.