health

Do you really need to take the combined Pill at the exact same time every day?

Every woman who’s used the Pill knows you’re recommended to take it at the same time every day. But unless you’re a real-life Femmebot, chances are you haven’t always succeeded in doing this.

Life just gets in the way sometimes. You might accidentally sleep in and bypass Pill o’clock by a few hours. You might hop on an international flight and cross time zones, throwing your hourly schedule into disarray. It’s also possible to just forget.

Regardless of the cause, we’ve all felt that panicky stomach-drop on realising what’s happened. Because if we don’t take the Pill at precisely the same time, obviously it won’t work and we’ll be pregnant in no time… right?

“You actually don’t really need to take the Pill at the exact same time every single day, except for the mini pill,” explains Dr Ginni Mansberg, a Sydney GP with more than 20 years of experience.

Listen: Mia Freedman has a Mirena. And she wants to tell us all about it. Post continues after audio.

“The reason why we [doctors] say to take it at the same time every day is because if you’re a bit of a space cadet, and you only do things if you’re in a routine, the knowledge that you can take it any time, any place means you won’t take it very effectively. It’s more for your convenience, and so you don’t forget, than anything else.”

Before we go any further, there’s an important distinction to make here: the quote above pertains to the combined Pill. However, women who use the mini pill do need to take it at the same time, within a two-hour window, every day. This is because it works differently.

“The mini pill’s only got progesterone in it, it doesn’t have any oestrogen in it. So it won’t suppress your ovulation at all, but it’ll just thicken up the mucus in the cervix and make it more difficult for the sperm to get up there,” Dr Mansberg says. So, if you take it outside of the specified window, there’s a chance it won’t work as effectively.

This narrow two-hour window doesn't apply as strictly to the combined Pill. "How you know this is because we give you seven Pill-free days with the vast majority of Pills, and guess what? You don't ovulate," Dr Mansberg says.

"That artificial 'period' we give you isn't really a period, it's just a withdrawal bleed from oestrogen. You don't ovulate in that time. As long as you get back on the pill after those seven Pill-free days, you're not going to get pregnant. And yet people freak out about missing one pill."

It is a good idea to aim to take your pill at roughly the same time every day, so you get in the habit of taking it daily. Keeping your packet in a visible spot, or setting yourself an alarm, will help you remember. However, if you're crawling into bed at 10.30pm and suddenly realise you forgot to take your tablet at lunchtime as you usually do, don't write it off altogether. Just keep calm and take it as soon as you realise within 12 hours.
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"If you get home at night and realise your Wednesday pill is still in the packet, just take it then. It's fine. If you work out the next morning there are two pills there when there should only be one, eg. it's Thursday and you've got the Thursday and Wednesday pills there, just take both of them," Dr Mansberg says.

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If you miss more than two pills, you'll probably start experiencing breakthrough bleeding, even if you try to continue taking your pills as usual.

"That's why we say if you've missed more than two pills, forget it — write that month off, call it a period, throw that pill packet out and start again," Dr Mansberg says.

Dr Mansberg says this need to start over isn't about having a Surprise Baby. It's because having ongoing breakthrough bleeding for the rest of the month isn't going to pleasant for you.

Forgot to take the Pill? It's OK, take two today.

"It takes quite a long time for your body to ovulate after not being on the pill," Dr Mansberg says.

"Of course, there have been exceptions. But for 99.9 per cent of women, if you take your [active] pills and you miss seven [by taking sugar pills] to have a period, you won't get pregnant. Most pill 'failures' are from people not taking it properly."

It's also important to know that if you are a bit of a space cadet and you really struggle to remember to pop your pill every day, there are other birth control options that don't require your daily attention. There's the intra-uterine device (IUD), for instance, which lasts for five years; or the NuvaRing, which you take out and replace every three weeks. The best part? The company will send you a text reminding you to do this.

As always, if you have concerns or you want more information, have a chat to your GP or call Family Planning Australia.

What kind of birth control do you use?

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