Hi I have been on the pill since I was 13

Patient : Hi I have been on the pill since I was 13 and I am not 32. Every time I come off pill for 7 days I bleed with in 2-3 days I have been off now for 7 days and due to start taking pill again today however I have not bleed. I have done pregnancy test which was negative however I have been on antibiotics from dentist and been sick this month. I am wondering weather to start pill again today also I have had a ectopic pregnancy 6 years ago and was wondering will it show pregnant on a test or not if it is ectopic ? I haven't felt well for the past 3 week with sore tummy and head aches .
Doctor :   Hello, Thanks for the query to ATD for an opinion, If you have been on regular oral contraceptive pills and now ha ve been off pills for 7 days and yet no bleeding then you should wait for your bleeding to start again and till then adopt an add on method of barrier contraception like condoms. The day you have your withdrawal bleed, from the day2 of menses you can start your fresh pack. The fact that you have been on antibiotics for past week causes decreases in efficacy of pills and can cause delay in menses, hence it would be wise to wait for the withdrawal. Thirdly, the urine pregnancy test would be reliable only after 7 days from missed periods. Ideally a serum beta hcg test can rule out pregnancy for sure even if its an ectopic pregnancy, still the hcg levels shall rise and would show a positive result if there is a pregnancy. So it is suggested that you should get a serum beta hcg test done tomorrow and if negative wait for the menses to return. I hope i have answered your query in detail, Wishing you good health, Regards

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