What to do if there is a violation of the contraceptive regimen. What to do if you miss a birth control pill

No woman is safe from skipping contraceptive in due time: sometimes this happens due to unpredictable circumstances, and sometimes due to forgetfulness. However, impaired contraceptive use does not always lead to unwanted pregnancy. By following certain rules, a woman can prevent the conception of a child.

For various hormonal contraceptives Actions for missing a pill are different. Let's take a closer look at all the possible options.

Scheme for COCs containing 21 tablets

For example contraceptive drug Yarina.

If less than 12 hours have passed since the pill was taken, the contraceptive effect of the drug remains. You need to take the missed pill immediately. The next tablet is taken at the usual time.

If the dose is delayed by more than 12 hours, the effectiveness of the drug decreases. The more tablets in a row are missed and the closer the missed tablet is to the beginning or end of the dose, the higher the likelihood of an unwanted pregnancy.

If a woman forgets to take more than 1 pill from the package, she should consult a gynecologist.

If you miss 1 tablet, you need to take into account the period in which this happened:

1-7 days

You need to take the drug as soon as possible, even if you have to drink 2 pieces at the same time. The next tablet is taken at the usual time. It is recommended to use a barrier method of contraception for the next 7 days. Pregnancy cannot be ruled out if sexual contact occurred within a week before the woman forgot about contraception.

8-14 day

As soon as a woman remembers about COCs, she should immediately take a pill, even if she has to take 2 tablets. The following applies as before. The contraceptive effect remains if the girl took the drug correctly within 7 days before the forgotten pill. Additional contraception is not required. When 2 or more tablets are missed, a barrier method of contraception must be used for 7 days.

15-21 days

If a woman has taken her medication correctly during the week before missing a pill, there is no need to use other methods of contraception. The girl must adhere to one of the options:

1. Accept forgotten pill as quickly as possible, even if you have to take 2 pills at once. Further administration of the drug is carried out at the usual time. Start using the COC from the next package immediately after finishing the previous package. In this case there will be no interruption or menstrual-like bleeding.
2. Stop taking pills from the current pack and take a break for 7 days, and then start taking pills from a new pack.

Continuous use of the drug (two packages at once) increases the risk of breakthrough bleeding, but this condition is not dangerous and does not require treatment.

Scheme for COCs containing 28 tablets

Using the contraceptive Jess as an example.

If the delay does not exceed 12 hours, the contraceptive effect does not weaken. You need to take the pill quickly and use the rest of the pills in the pack as usual.

The contraceptive effect of COCs decreases if more than 12 hours have passed. The more pills you miss and the closer the skip is to the phase of taking inactive pills, the higher the risk of getting pregnant.

Use of oral contraceptive taking into account missed time:

1-7 days

Take the drug immediately, even if you have to take 2 tablets at once. Subsequent use of COCs is carried out as usual, but within a week you need to use a barrier method of protection. The chance of conception increases if sexual contact occurred within 7 days before missing a contraceptive.

8-14 day

A woman needs to take the last forgotten pill as soon as she remembers, even if she needs to take 2 pieces. Then the drug is used as usual. Barrier contraception will be needed if a woman has previously violated the COC regimen or missed more than 1 tablet. You will have to use a condom for 7 days. If the drug was taken correctly and there were no gaps in this cycle, additional protective measures are not required.

15-24 day

The approaching phase of taking inactive pills increases the likelihood of unwanted pregnancy. The problem can be prevented by adjusting the schedule for using COCs. Adhering to one of the two proposed schemes, a woman will do without additional contraception. An important condition counts correct technique medication for a week before missing the pill.

1. Take the forgotten pill immediately, even if you have to take 2 tablets at once. Further use of the contraceptive occurs as usual until it is spent active tablets. The four inactive pills are discarded and the woman begins taking the COC from the next pack. In this case, there will be no menstrual-like bleeding.
2. Stop using the drug from the current package and do not drink COCs for 4 days. Then continue taking the contraceptive from the next pack.

ABOUT probable pregnancy says no menstruation due date. You need to contact your gynecologist before starting to take pills from a new package.

Regimen for COCs based on natural estrogens

Using the example of the Klaira contraceptive.

If you missed taking pills for less than 12 hours, no additional protective measures are required. You need to take the pill as soon as possible. Next, the drug is taken according to the usual regimen.

If a woman forgets to take the white inactive pills, no additional measures are required. Protection against unwanted pregnancy is not reduced, so the missed pill must be taken as soon as the woman remembers it. In the future, the contraceptive is taken according to the usual regimen.

If more than 12 hours pass from the moment of use of the drug, its reliability from conception is reduced. A forgotten pill is taken as soon as a woman remembers it, even if it is implied simultaneous administration 2 pieces. Then the use of the drug is continued according to the previous scheme.

The rules for taking a missed pill depend on the phase of the cycle:

• Day 1-2: immediately take the dark yellow tablet, the next one as usual.
• 3-7 days: reception pink pills occurs according to the same scheme, but additional contraception is used in the next 9 days.
• Days 8-17: taking light yellow tablets as usual in combination with additional means of protection.
• Days 18-24 (pale yellow pills): use a COC from a new calendar pack (with 1 tablet), and use it for the next 9 days barrier agent protection.
• Day 25-26 (red pills): the missed contraceptive is taken immediately, and the next dose is taken at the usual time.
• Day 27-28 (white pills - placebo): use of the drug continues as usual, and the forgotten pill is thrown away.

The more pills a woman misses and the closer the missed pills are to the time of taking inactive pills, the higher the risk of conception (if sexual contact occurred within a week before skipping the COC).

Mini-pill

Using the drug Charozetta as an example.

If less than 12 hours have passed since you missed the pill, you need to take the forgotten drug as soon as possible. Subsequent use of the contraceptive continues as usual.

The contraceptive protection of the drug is reduced when a woman takes a break between two pills for more than 36 hours. She should use barrier contraception for a week.

Birth control pills are oral contraceptives, preventing unwanted pregnancy. To achieve the effect, you must take the drug regularly at the same time, without skipping.

A break in taking birth control pills is allowed for up to 7 days. During this period, the mucous layer of the uterus is rejected, and a menstrual-like reaction develops.

The contraceptive effect of the drug remains during the break, provided that the pills were previously taken correctly.

Instructions for skipping birth control pills

The course of action depends on the chosen drug and the day of the cycle in which the woman forgot to take the contraceptive.

COCs based on ethinyl estradiol

If there is a break in taking the drug was less than 12 hours, you need to take the missed pill as soon as the woman remembers about it. Contraceptive effect persists, additional measures to protect against unwanted pregnancy are not required.

If there is a break in taking COC was more than 12 hours, you should use the instructions for skipping a tablet included with the medicine. The contraceptive effect is reduced, and an unplanned pregnancy may occur.

Action plan:

• First week. You should take the missed pill as soon as possible, even if you have to take two pills. The next tablet should be taken at the usual time according to the instructions. Additionally, it is recommended to use a condom or other means of barrier contraception over the next 7 days.
• Second week. You need to take the missed pill as soon as the woman remembers about it. Additional contraception is not indicated, but only if up to this point the woman has taken the drug correctly and without omissions. If there were any errors, you should use a condom for 7 days.
• Third week. There are two options: 1) take the missed pill, use a condom for 7 days, start new packaging without a 7-day break; 2) take a 7-day break and after that start taking pills from a new pack. In any of these situations, intermenstrual bloody issues from the genital tract.

Important aspects:

• It takes at least 7 days to achieve a contraceptive effect.
• The break between taking pills should not be more than 7 days.
• The closer the missed pill is to the 7-day break in taking the drug, the higher the likelihood of an unwanted pregnancy.
• If vomiting or diarrhea occurs within 4 hours after taking the tablet, absorption of the drug will be incomplete. You should focus on the scheme proposed when skipping a pill.

COCs based on natural estrogens

Actions to take when missing a pill are considered using the drug Qlaira as an example. It contains estradiol valerate -. If a woman is taking another contraceptive based on active substance, she is advised to follow the instructions included in the packaging of the drug.

If you miss taking the drug for less than 12 hours, its effect is not reduced.. No additional measures are indicated.

If the absence was more than 12 hours, you need to proceed according to the following scheme:

• 1-17th day. Skipping dark yellow, pink or pale yellow tablets. It is recommended to take the forgotten pill as soon as possible. Then use additional contraception (condom) for 9 days.
• 18-24th day. Skipping pale yellow tablets. You should throw away the current package of the drug and start taking tablets from a new pack without skipping. Do not forget about additional contraception over the next 9 days.
• 25-26th day. Skipping the red pills. Take the missed tablet as soon as possible. Additional funds No medications are indicated.
• 27-28th day. Skipping the white pills is a placebo. It is recommended to throw away the forgotten pill and continue taking the drug as usual. Barrier contraception is not required.

Mini-pill

The contraceptive effect of purely gestagenic drugs lasts up to 36 hours.

Action plan:

• If one tablet has been missed for no more than 12 hours, you should take another dose of the drug. The contraceptive effect is maintained; additional protection is not required.
• If the break in taking pills is more than 12 hours, you need to use barrier contraceptives for the next 7 days.
• If a pill was missed during the first week of taking the contraceptive, pregnancy should be excluded.

Rules for stopping birth control pills

Indications for discontinuation of contraception:

• Pregnancy planning.
• Treatment incompatible with (surgery, immobilization, etc.).
• Changing the form of contraceptives.
• The woman's reluctance to continue taking the drug.
• The appearance of unwanted side effects that are dangerous to health and life.
• The onset of pregnancy while taking the drug.

In all situations except the last two, the contraceptive is canceled only after completing all the pills from the package. You cannot interrupt the course. It is recommended to take all the tablets from the package according to the instructions, without skipping them. Abrupt withdrawal of the drug threatens hormonal imbalance and development uterine bleeding .

Emergency withdrawal of the drug is allowed if unwanted side effects that are dangerous to the woman’s health occur. You should stop taking the contraceptive and consult a doctor immediately.

If pregnancy occurs while taking the drug, you must first consult a gynecologist and only then stop taking the drug. The doctor may prescribe other hormonal medications to maintain pregnancy.

During gestation, contraceptives are not used, but accidental use of the drug is not dangerous for the fetus, does not lead to developmental defects and is not an indication for abortion.

It is not recommended to take breaks in taking medications. A healthy woman can take the drug for as long as she needs it. There is no need to take a break of 1-3 months every year or every five years. In such a short period you can only get hormonal disbalance and unplanned pregnancy.

Ovulation after stopping birth control pills

After stopping the drug, a menstrual-like reaction develops. The effect of the contraceptive lasts up to 7 days. If after a break the woman does not resume taking the drug, its effect on the body decreases. Hormonal changes develop, leading to the maturation of follicles and the start of ovulation. On average, the release of an egg from the ovary occurs 14-18 days after discontinuation of the drug.

Most women manage to conceive a child within 1-6 months after stopping the contraception. The older the woman, the less often ovulation occurs in the ovaries, and the more longer period recovery. If after a year of sexual activity without using contraceptive pregnancy does not occur, you need to consult a doctor.

Birth control pill withdrawal syndrome

After stopping taking birth control pills, certain changes occur in a woman’s body:

• Recovering hormonal background.
• Follicle maturation begins.
• Ovulation occurs.
• The endometrium is preparing for possible implantation fertilized egg.
• The viscosity of cervical mucus decreases.

Possible problems:

• Delayed menstruation. It is observed for up to 35-40 days, less often up to 2-3 months.
• Return premenstrual syndrome.
• Deterioration of skin and hair condition.
• Mood changes.

All these symptoms are temporary, and usually the woman’s condition stabilizes within 3-6 months. Special treatment not required. If amenorrhea lasts more than 2 months, a consultation with a gynecologist is indicated.

On average for recovery menstrual cycle it takes 1-3 months. During this period, the likelihood of conceiving a child increases significantly. In medicine, this phenomenon is called the rebound effect. Superovulation occurs, and often two or more eggs mature at once. Possible multiple pregnancy.

The rebound effect is used in gynecology to treat some forms of endocrine infertility. Prescribing COCs for 3 months followed by discontinuation of the drug promotes pregnancy. Majority healthy women are able to conceive a child already in the first spontaneous cycle after stopping taking COCs. If pregnancy is unwanted, care should be taken.

Hello. I accept birth control Jess already a year. Always in the evening. The day before yesterday I missed a pill, but the evening before yesterday I had sex. I think I’m on day 14 of my cycle - I don’t know what to do? Yesterday, when I took a pill, I noticed a gap, but I took the pill, today I also took it, but my friend says that I can get pregnant. What to do??????

Yanina, 32 years old

There's an answer

Answers Viktorova Yulia obstetrician-gynecologist

No contraceptive provides a 100% guarantee that pregnancy will not occur. What should you do? Do not be nervous. You should know that pregnancy can occur in any case. There's only one reliable way“protection” – complete abstinence. Nature can take its own course, despite all human attempts to deceive it. We advise you to read the article

The risk of missing a dose of the drug can be serious, doctors say. Now you will learn why you should never skip taking your medications and how to stick to your schedule.

Sometimes it's hard to remember how you lived before taking the pills. Every day you look at the calendar where it is written down when you should take your medications, and you wonder when it will be empty and there will be no reminders. Or you are worried about the side effects and want to just quit everything or at least take a break.

Medicines don't work for those who don't take them.

What results will patients get with? Deterioration of condition, increased need for medical care and hospitalization. Errors in treatment lead to further destruction of the joints. The consequences are decreased function, increased pain, decreased ability to work and independence.

Let's look at a condition like RA, which cannot be treated with medications. If patients do not take their medications properly, they will see worsening symptoms, more falls, and a decrease in their ability to manage these. active image the life they want. And if you can't move and take part in life, you may develop depression.

Why are drugs rebelling?

Three obstacles remain to the effectiveness of drugs: price, complex administration, and faith in the drugs.

The higher the cost, the fewer people take medications. If you pay out of pocket and don't see results, you'll be disappointed.

For many, remembering to take their medications throughout the day—or even making it a priority—is difficult. This is especially problematic for people with additional problems such as depression, dementia or having to care for someone else.

Many people with arthritis also need to take medications to treat other conditions. People are tired of chronic illnesses. Constantly reminding and monitoring the disease requires a lot of energy.

Taking injectable antirheumatic drugs such as this adds problems. It's painful and difficult. You can't blame those who would like to take a break from treatment.

Some stigmas against medications also hinder adherence. People may be afraid of side effects or think this medicine doesn't work.

They may also believe erroneous information they receive from friends, family, or the Internet. Or have a certain cynicism towards medicine. If they think the doctor is prescribing too much, they may refuse the appointment themselves.

Preparing for the regimen

No one can argue that the reasons for missing medications are too common. But there are also many reasons—most notably, health and happiness—to work to overcome the barriers you face.

If you are one of those who do not take your medications as prescribed, think about why you are doing so. If you are deterred by the cost, side effects, or doubts about the effectiveness, or even the fact that you don't trust your doctor, talk to him openly about it. They should offer you a replacement, a lower dose, advice or information about how the drug will help manage your symptoms, or even find a way to change your lifestyle so that you can stop taking the drug.

How to follow the regime

Gather reliable information

Patients must actively participate in treatment. Ask your doctor questions. If something is not clear, ask for clarification or consult additional sources.

Don't put up with side effects

Your doctor should offer you similar drug that does not produce side effects, or show that they decrease significantly as the body adapts to the drug.

Ask about long-acting or combination medications

They may or may not be superior in value, side effects and effectiveness, but they may not be taken as often. In general, a simpler regimen is followed much more often than a complex one.

Use chips

One of the reasons people don't take their medications is because they forget whether they took them or not. The researchers found that older adults were able to remember better when they performed a familiar task—taking a medication—at the same time as an unusual movement, such as tilting their head. Other tricks: pill organizers, calendars, computer alarms, medication diaries, text messages and charts.

Contraceptive drugs (oral contraceptives) protect against unwanted pregnancy only if the woman strictly follows the schedule for taking them. The instructions for each of these remedies usually describe in detail what regimen should be used to take the remedy and what to do if several doses are missed. The algorithm of actions depends on which group the drug belongs to.

Violation of the regimen for taking combined oral contraceptives

Combined oral contraceptives (COCs) are drugs containing artificially synthesized analogues of the hormones estrogen and progesterone. Tablets are sold in blisters (plates) of 21 or 28 pieces. To prevent a woman from getting confused about the dosage schedule, the pills are numbered.

Labeling by day allows you to avoid confusion in your contraceptive dosage regimen

Reception principle hormonal drugs simple: one tablet a day for 21 days, then a 7-day break between courses. Even if there are 28 tablets in a blister, only 21 of them contain hormone-like substances. The remaining 7 pieces are placebos, harmless mixtures that manufacturers add so that a woman takes one tablet a day and is guaranteed not to make a mistake with the start date of a new course.

Options for violating the COC dosage regimen:

• if a woman forgot to drink birth control pill on the first day of the course, it is allowed to start a new blister from the second (or even from the 3-5th) day. But for at least seven days during sexual intercourse, additional contraception (condoms) must be used;
• If one tablet is not taken from the 2nd to the 21st day, the woman should drink it immediately after she remembers it. It takes 36 hours for the hormones contained in COCs to leave the body. Therefore, if no more than 12 hours have passed since the missed dose, additional contraception will not be needed. If the interval is more than 12 hours, you will have to take 2 tablets on one day (one missed, the second on schedule) and then use additional contraception for 7 days;
• If a woman forgot to take 2 contraceptive pills from the 2nd to the 14th day, it is recommended to take 4 pills over the next two days: the first when she remembers, the second as scheduled, the third after 12 hours, the fourth as scheduled. Too much hormone can sometimes cause nausea. You must use barrier contraception until the end of the course;
• if two doses are missed in the period from the 15th to the 21st day or three or more doses are missed from the 2nd to the 21st day, the started blister is thrown away and a new one is started. During such intervals, there is bleeding, and when you resume taking the drug, the menstrual cycle will fail. You will have to use additional contraception for at least 7 days.
• if the blister contains 28 tablets, and a dose is missed from the 22nd to the 28th day, the extra tablets are thrown away, no additional measures are needed.

Violation of the regimen for taking progestin-only drugs (mini-pills)

Pure progestin preparations (PPCs, mini-pills) contain minimal doses of progestin or desogestrel - synthetic analogues progesterone. Mini-pills are slightly less effective than COCs, but they are prescribed during lactation, and also when a woman is contraindicated combined contraceptives. You need to drink one tablet of ChPK daily, certain time. Interruptions in reception are unacceptable.

Options for violating the ChPK regimen:

• In the instructions for the drug it is always written what maximum time You can postpone your appointment. Progestin pills are usually allowed to be taken within three hours of the intended time. For products containing desogestrel, this period is 12 hours. If a woman remembers to take a pill within the specified time, then no additional measures are needed;
• if one or more days are missed, the risk of conception increases significantly. It is necessary to return to the previous regimen (take one tablet per day), and use additional contraception until the start of your period.

Emergency contraception

If, after a woman forgot to take a contraceptive pill, unprotected sexual intercourse occurs, an unplanned pregnancy is very possible. Therefore, it is recommended to take the drug for 1–3 days after sexual intercourse. emergency contraception. But these remedies are most effective in the first 24 hours. If your period does not come on time, it makes sense to take a pregnancy test or consult a gynecologist.

However, you need to remember that taking emergency contraception is only permissible in exceptional cases. Such tablets have a lot of contraindications: they are harmful to the liver and provoke the formation of blood clots.

To avoid having to take medications that are harmful to your health, it is better to strictly follow the regimen for taking combined or purely progestin medications. In case of deviation from it, it is necessary to use barrier contraception.