If you are switching from the combined pills to progestin-only pills (POPs), take the first POP the day after you finish the last active combined pill. Do not take any of the 7 inactive pills from the combined pill pack. You should know that many women have irregular periods after switching to POPs, but this is normal and to be expected.

If you are switching from POPs to the combined pills, take the first active combined pill on the first day of your period, even if your POPs pack is not finished.

If you switch to another brand of POPs, start the new brand anytime.

If you are breastfeeding, you can switch to another method of birth control at any time, apart from combined hormonal contraceptives (CHCs). According to USMEC guidelines, CHCs, including “the pill,” patch, or ring, should be avoided 21 days postpartum. During this period, progestin-only pills (POPs) and barrier methods are safe.

During 21-42 days postpartum, CHCs become a viable option if the patient has no additional risk factors for a blood clot.

Greater than 42 days postpartum, CHCs, POPs, and barrier methods are all approved for use while breastfeeding.

There is a BIG difference between perfect use and typical use in the world of contraceptives. Most hormonal contraceptives are 99% effective with perfect use, but typical use (human error), makes it more like 91% effective. The pill, patch, and ring all share roughly the same effectiveness. Other more effective options do exist such as the implant, IUDs, or sterilization. These methods require medical intervention and procedures which can be painful, expensive, and permanent. Knowing the difference and your options are very important for your future hormonal health and fertility.

Deep breaths, these things happen. Take it as soon as you remember and take the next pill when you were originally scheduled to take it. If you take both the pills at the same time, great, if you suffer from side effects and are worried about taking two at a time, you can space this out a little throughout the day. BUT REMEMBER TO TAKE TWO PILLS. No additional back-up contraceptives or emergency contraceptives are typically needed.

Okay, get it together; still, these things happen. Take the next pill as soon as you remember and continue taking the pills at the usual time, even if it means taking two pills on the same day. You will need to use back-up contraception or avoid sex until you have taken the pill for 7 consecutive days. Emergency contraception should be considered if you have had unprotected sex in the past 5 days, especially if the missed pills were within the first week of your cycle. If you want to wait until after your period to restart taking the pill, then use back-up contraception. If you restart the pill within 5 days of the beginning of your period then you can stop using back-up contraception. If you wait to restart it more than 5 days after the beginning of your period, then you need to continue using back-up methods until you have taken the pill for 7 consecutive days.

Timing is more important with progestin-only pills than it is with combined pills. A pill is considered missed if it is taken 3 hours late for a progestin-only pill.  If you are within 3 hours late in taking your pill, take it as soon as possible and continue business as usual. If you are more than 3 hours late, then take the pill as soon as you remember and then again when you were normally scheduled to take it, even if it means taking two pills in a day. You should use back-up protection or avoid sex until you have taken the pill on time for 2 consecutive days. You should consider taking an emergency contraceptive if you have had unprotected sex in the past 5 days.

Discontinue your pill pack and begin again after your period. In the meantime you need to use back-up protection or avoid sex. If you start the pill pack within 5 days of when your period started then there is no need for back-up contraception after you restart the pill. If you start it more than 5 days after the beginning of your period then you need to use back-up contraception or avoid sex until you have taken the pill on schedule for 2 consecutive days.

If the vomiting and diarrhea continues for less than 48 hours, then keep taking your pill at the usual time. There is no need to take an extra dose, and you do not need to use back-up or emergency contraception. If the vomiting or diarrhea continues for more than 48 hours then you should avoid sex or use back-up contraception until you have taken the pill for 7 consecutive days without vomiting or diarrhea. If you have had unprotected sex within the past 5 days then you should consider emergency contraception.

Try to take another pill as soon as possible. Use back-up contraceptives or avoid sex until you have taken the pill for 2 days consecutively without vomiting or diarrhea. Consider emergency contraception if you have had unprotected sex within the past 5 days.