Patient: Hello, I have a question regarding birth control. I’ve been taking a combined pill (ethinylestradiol/gestoden) regularly. Last Saturday morning, my boyfriend and I were fooling around in bed, without having actual intercourse. However, there was some lubrication liquid on his penis. At one moment, he started fingering me. I know he was touching himself previously, but not sure if he had any pre-cum on his fingers before putting it in me. That evening, I took my 10th pill regularly. However, this Wednesday, I was supposed to take my 14th pill around 10pm and I forgot. I remembered it on Thursday and took it at 11.30am, so 13-14 hours late. Now I am worried that I might have ovulated due to taking the pill late, even though the leaflet says that the efficacy is maintained during the second week, if I only missed 1 pill. And I didn’t really miss it, but I did take it too late. Could I have ovulated and still had viable sperm in my body after 5 days, which could lead to conception? I also know that the pill makes the cervical mucous “hostile environment” for the sperm, so that should mean it would not live that long inside of me? But I am still worried. I continued with my pills regularly and should get my period in nine days, but I think I will go crazy by then.Many thanks in advance for your help.
Doctor: Hello,Thanks for the query to ATD for an opinion,If you have missed your pill on day 14 and taken 1 pill after 1 3-14 hrs on thursday, ideally you should have taken 2 pills, but as you are continuing the pill pack which is the right thing to do, i feel still you would be protected as you had been regular and as you mentioned cervical mucous would have been rendered hostile for sperm penetration and it wouldn’t have survived for 5 days. Second thing which should be remembered is that the combined pills prevent growth of dominant follicle as well and hence there are minimal chances of ovulation as the follicle may not have grown to size enough to rupture and cause ovulation.I still feel you are safe, however just to allay your anxiety you may opt for a serum beta hcg test done. This test is done 7 days post intercourse and is sensitive enough to detect pregnancy before missed periods.A positive test or high levels of hcg would confirm pregnancy and less than 1ng/dl levels would indicate a negative test and shall rule out pregnancy completely. You should take thirstiest to rule out pregnancy. If negative then you should continue using your pills as scheduled and consider that you are pregnancy safe.I hope i have answered your query in detail,wishing you good health,Regards
Comments / Follow Ups
Patient: Hello, dear doctor,
thank you so much for your answer, you really re-assured me. There is only one thing that I did not understand. You said that I should have taken two pills on thursday. I did take my late, 14th pill on Thursday 11.30am and then my 15th pill regularly at around 10pm on Thursday. Should I have taken two at 11.30? The leaflet said not to take more than two pills in one day.
Many thanks and kind regards
If you have taken two pills on the same day then its fine . Ideally, if you wouldn’t have taken the 14th pill in the morning 1130hrs then at 10pm you should have taken 2 pills together. But its fine as you took the missed pill as soon as you remembered and followed it up with the scheduled pill for the 15th day. You stand pregnancy protected.