Monday March 28 2016

Contraceptives: what happens when you miss a dose?

The pill is the most popular method of birth

The pill is the most popular method of birth control for women.  

By Stella Nakakande

Contraceptives have been covered before but the questions keep coming. It is once in a while that people ask for Pilplan yet a strip is Shs1500 but will come in droves for an emergency contraceptive that costs between Shs7,000 and Shs10,000. These contraceptives are made of hormones and come as combined, that is with oestrogen and progesterone and then there are those that only contain progesterone alone. This time we will look at contraceptives and what happens when one misses a doze and next week we will review emergency contraceptives.

Combined oral contraceptives
It is recommended that if one or more tablets are missed from the inactive tablets (red), then the person does not require any additional contraceptive precautions. In this case, one should go ahead taking the tablet ignoring the tablet or tablets that were missed.

If it so happens though that one is missing all the inactive tablets and the next pack is not started on time, then it is imperative that they start as soon as they remember and then additional contraceptive methods like a condom are recommended for the next seven days The critical time when it comes to these contraceptives, like microgynon, is when one misses or forgets to take a pill at the beginning of the cycle or at the end. If there is a delay of more than 12 hours after the usual time of taking the pill, then the contraceptive protection in the cycle in question is reduced and this increases the risk of one becoming pregnant especially in the critical times. A missed pill can be defined as one that is 24 hours or more late.

If the woman misses one tablet, then they should take an active pill as soon as one remembers even if it means taking two tablets at the same time and then continue with normal pill taking. When one misses two or more pills especially among the first seven in a packet, it is recommended that they take it as soon as they remember and resume normal pill taking. However, it is advised that additional contraception by use of a condom or abstinence for the next seven days is used. If these seven days extend into the inactive section, the inactive section or pill free interval is skipped and a new pack in the active area on the next day is started instead.

Progesterone-only oral contraceptives
These are taken starting from day 1 and are taken at the same time every day. The recommendation for the use of other methods of contraception is extended to 14 days if the dose is delayed by three hours or more. The pill should be taken as soon as one remembers and continue the usual schedule.
If one is changing from combined oral contraception, then they start taking the Progesterone-only pill on the day after cessation of the combined oral without a break. It is recommended that it is taken three weeks after childbirth.

The writer is a pharmacist