Ask Dr. Sally: Took the Wrong Pill

We received our first question from a reader today!

Just realized I took my pill today (Wednesday) but I took the wrong day’s pill (Friday).  What now?  Are they pretty interchangeable at that part of the month?  I take a generic version of Yaz.WrongBirthControlPill

Let me alleviate your concerns!  Yaz is a combination birth control pill, which means there is a combination of both estrogen and progestin hormones.  This is the most popular type of birth control pill and a minority of women use progestin-only pills.  Among the combination birth control pills, there are many different formulations.

Yaz has 24 “active” pills, all with the same doses of both hormones, and 4 hormone-free or “placebo” pills at the end of the pack.  The two active pills are the exact same.  So in this case, the fact that the wrong day was punched out and taken does not make any difference.  It’s just important to remember this and continue taking one active pill a day until you are back on track later this week.

For women taking other birth control pills, the response to this question would depend on the formulation.  Some pills have different doses of hormones every week or sometimes the dose changes after just a couple days.  Your pharmacy, doctor’s office, and community or family planning clinic are resources if you find yourself with a contraceptive mishap.  When asking a question, be sure to let your pharmacist, doctor, or other clinician know which birth control pill or other method you are on…know the medication name!  This way, you’ll get an answer specific to the medication you are on…and this goes for all medications, not just birth control.

Thanks for sending us your question.  Don’t be shy to ask your pharmacist any questions about your birth control pills or other birth control methods.  We look forward to answering many more questions!

Remembering Your Birth Control

Many popular birth control methods are very effective if taken perfectly, but that effectiveness goes down drastically with typical use.  Perfect use means that the method is used consistently and correctly.  This is not as easy as it sounds for many people despite their best intentions.  For this reason, medical researchers have studied the effectiveness and failure rates of the various birth control methods.  For example, birth control pills are 99.7% effective with perfect use.  But in fact, 9% of women will become pregnant within the first year of using the pill and only 91% of women using the pill will have the desired effect of not becoming pregnant with typical use.  Even more drastic is the difference between the reported 98% effectiveness of male condoms with perfect use when the reality is that 18% of women using male condoms will become pregnant within the first year and only 82% will not become pregnant with typical use.  Many women and their partners may not be aware of these differences.

This distinction is important for two reasons:

First, you will want to consider this when selecting the right birth control method(s) for you.  To select the right birth control method(s) for you, prospective users (women and their partners) should be aware of the effectiveness of all the available methods.  In addition, you will want to be aware of how long the method works/how frequently you have to use it and potential side effects.  More information to come on this to help you make important decisions.

Second, you will want to use your selected method(s) of birth control consistently and correctly.  Now you may be wondering what it means to consistently and correctly use your birth control method.  Let’s use the most popular methods of birth control as examples again.

For birth control pills, this means taking a pill consistently every day and not missing days between pill packs.  Pills are taken correctly if taken at the same time every day.  Studies have shown that women may be missing up to 5 pills per cycle, on average, and many women have gaps between pill pack refills at the pharmacy.  It’s important to look at your daily routine and find a time when it would be easy to take your pill at the same time every day.  Is it easiest to take your pill… First thing when you wake up? As your morning coffee is brewing?  When you’re feeding the dog?  When you brush your teeth in the evening? Right before bed?  If you don’t have a daily routine or can’t find a time to consistently take your pill at the same time, the pill may not be a good birth control choice for you and there are other options that don’t require daily action on your part.  Once you find a time that works, you can set up convenient reminders.  Bedsider offers a free service to send you convenient text message reminders for your pill, patch, ring, or injectable birth control method.  Set up your reminder now.  Not only are these messages helpful reminders, they are also very entertaining:

Bedsider Text Message Reminders

Bedsider Text Message Reminders

For condoms, you need to be sure to use a condom consistently with each act of sex and correctly following these instructions from Planned Parenthood:

Hopefully this information will help you use your birth control to maximize its effectiveness!  As always, I welcome your comments, questions, and suggestions for future posts.


References:

  1. Trussell J. Contraceptive failure in the United States. Contraception 2011;83:397-404.
  2. Hou MY et al. Using daily text-message reminders to improve adherence with oral contraceptives: a randomized controlled trial. Obstet Gynecol 2010;116:633-40.
  3. Castaño PM et al. Effect of daily text messages on oral contraceptive continuation: a randomized controlled trial. Obstet Gynecol 2012;119:14-20.
  4. Pittman ME et al. Understanding prescription adherence: Pharmacy claims data from the Contraceptive CHOICE Project. Contraception 2011;83:340-5.

Other Uses for The Pill

While millions of women use birth control for just that, more than 1.5 million women (that’s 14% of pill users) are using it solely for another heath reason.

Many women using the pills for birth control also rely on the pills for other purposes, mainly menstrual cramps/pain, menstrual regulation, and acne.  Some pill users are either not currently sexually active or have never had sex.

So you can see there are lots of health benefits to birth control pills!

Other Benefits of Birth Control Pills

 


References:

  1. American College of Obstetricians and Gynecologists (ACOG). Noncontraceptive Uses of Hormonal Contraceptives. Practice Bulletin No. 110. Obstet Gynecol 2010.
  2. Jones RK. Beyond Birth Control: The Overlooked Benefits of Oral Contraceptive Pills. New York: Guttmacher Institute, 2011.