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Missing a day on OCPs

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I take Orsythia birth control pills (21 day active pills; 7 day placebo). In the first week of the new pill pack, I realized that I took 2 pills by mistake in the same day. I realized it on Saturday night when I saw that Saturday's pill was already missing from the pack. Therefore, I didn't take a pill Saturday night. I was sick (vomiting) on Sunday and Monday, which may have been due to this, as well as taking antibiotics. I took the Sunday pill as normal and have been taking each pill this week so far as normal. Am I missing a day now and do I need to make up for that? I am having spotting/light bleeding and some cramping, which leads me to believe I'm behind a day now in the pill cycle. Not sure what to do.

Category: OBGYN

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Category: Infertility Specialist
 23 Doctors Online

Hello
Thanks for writing to us with your health concern.
See, basically when you double up on a day ( take 2 pills by mistake in one day ), the next day, you are supposed to take the pill as usual. This is because the pill has to be taken every 24 hours.
Since you missed that pill which should have been taken by right on Saturday, do not worry.
The nausea could very well be due to the double up, then skipping a dose , and also due to the antibiotics.
You are NOT a day behind now.
Continue taking the pills regularly as per schedule without taking any extra pill.
The cramping and spotting also is due to the estrogen let down which temporarily occurred when you did not take the pill on Saturday.
continue taking the pill pack ( 1 tablet daily ) and the symptoms will abate.
Of course, you should use a backup method of contraception this cycle as a slip in the first two weeks of the new pack use, leaves you unprotected.
Take care.
Please feel free to discuss further.


Patient replied :

I will be entering Week 3 of the pack on Sunday and then Week 4 is the placebo week. Will I still get a bleed during Week 4 (as I usually do) even though there was a slip-up in Week 1 with the overdose and then the missed pill? Thanks so much.


Thank you for the appreciation.
Yes, if you take the remainder of the pill pack ( active + placebo ) without any more mistakes, you would get a period as per schedule as you always have.
Take care.


Patient replied :

I'm still spotting (as I would expect) but have also been having some left lower back pain and pain in my left leg (thigh/knee) over the past few days. I'm not sure if it's related to the missed pill incident, imbalance of hormones, or if it is kidney related. My body seems very sensitive to all this. Could the drop in estrogen as you mentioned above have caused all this? I definitely feel "off" after having gone through the pill overdose/missed pill, etc. and am just wondering if I should expect to feel like this into the next week (going into Week 3 on the pill pack).


Hi
As there is no burning micturition / urgency in urination, I would least suspect kidney related problem.
The pain and discomfort could very well be due to the estrogen drop.
Taking the pill regularly for a few days more should make it alright if that is the real reason.
So wait and watch for a few days.
All the best.


Dr. Aarti Vazirani
Category: Infertility Specialist
Experience: 
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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