Why did three different people in my ob-gyn office give me three different answers to this question? (Micronor birth control pill)

April 20, 2010 2:17 PM

I'm dealing with some pretty typical just-starting-the-pill anxiety. I was prescribed Micronor today and instructed to start taking them right away (instead of waiting for a particular point in my cycle).

First nurse said use backup for the entire first pack. Second nurse said I'd be good to go without the condoms after one week. The third nurse overheard my conversation with the second nurse and said I'd be good after 48 hours (2 pills). Googling seems to produce a pretty even number of these three answers. So, some questions for folks who have been down this road before me:

1. what gives with the discrepancy? Is there really no one answer to when this sucker will start preventing me from getting knocked up?

2. Any other good anecdotal advice, aside from "take the pill at exactly the same time every day," (that's been covered), would be greatly appreciated. Mostly I'm trying to figure out a good start time that ensures the greatest success of taking it at the same minute daily. Any other info (with food or without? Any adjustment issues with skipping periods?) would be a bonus.

posted by kella to health & fitness (10 answers total)

Err on the side of caution and use back up for the month. (Do you really want to risk having a baby!?)

One piece of advice I would give is to give the pill a few months before deciding if it is the right one for you. You might experience weight gain, mood swings, or feel like you turned into a monster at first. Usually, the side effects will level out after the first few packs. (Or, if they don't after that, then you might considering switching to a different dosage, brand, etc).
posted by too bad you're not me at 2:32 PM on April 20, 2010

I don't know the answer to your first question, sorry, but I mostly dropped in to assure you that you that you don't need to worry too much about timing, etc. Once you're taking it, there are all sorts of easy instructions for (the very occasional!) days where you're 8 hours late or accidentally skip a pill or whatever.

I always try to take mine around my usual dinner time, but if you're within the same hour or so, you're Fine. I've heard some women say that they prefer to take it with food because otherwise they get queasy, but I've never had a problem taking them without food, water, or anything else.
posted by ldthomps at 2:33 PM on April 20, 2010

Regarding question 2: I found the best time to take it was when I brushed my teeth in the morning. Easy to remember and make part of my routine, plus it probably falls around the same time give or take a few hours every day.
posted by platinum at 2:33 PM on April 20, 2010

Read the instructions for Sunday Start in your pill pack booklet/call your doctor's office and ask for a clarification. If you really want to be safe, do a month, but I've never heard of any pill that requires an entire month of back-up contraception, usually it's a week (with all the pills I've been on).
posted by ishotjr at 2:33 PM on April 20, 2010

The pill booklet can be found here. Click on "Full US Prescribing Information". It's a PDF.

It says "It’s best to take your first POP on the first day of your menstrual period. If you decide to take your first POP on another day, use a backup method (such as a condom
and/or a spermicide) every time you have sex during the next 48 hours." under the heading "Starting POPs". (POP stands for progestin-only pill, like Micronor.)
posted by skyl1n3 at 2:36 PM on April 20, 2010 [1 favorite]

Oh, also. When I was on the pill, I was also working shift work, so I set a cell phone alarm for the same time every day to remind me to take it. The only issue I ever had was that I was taking a pill with estrogen, which made me nauseous if I didn't eat it with a few bites of protein-rich food.
posted by skyl1n3 at 2:38 PM on April 20, 2010

I was on the same pill, and I found that 9pm worked well. I didn't want to take it in the morning because I get up early for work during the week but like to sleep in on weekends, so there wasn't a good consistent time. Taking it with dinner would have been a problem if I had to work late unexpectedly, or if I wanted to go out to eat with friends. For me, 9 was the balance between after-dinner and before-going-out that left me the most flexibility in my schedule.

I also wrote down the time I took it (down to the minute) on the calendar every night. The extra element in my routine helped me remember, and it was reassuring to look back and have proof that I took it on time all month.
posted by Fifi Firefox at 2:46 PM on April 20, 2010

Seconding the phone alarm! Set it to daily and you'll never forget (unless you leave your phone at home or something.)
posted by too bad you're not me at 2:46 PM on April 20, 2010

Micronor is a progestin-only pill, so please be aware that some of the above replies seem more directed toward the more commonly prescribed combined oral contraceptives. With combined oral contraceptives, you can miss a dose one day and double up the next. With POPs, you can't.

With POPs, you *do* need to worry about timing. I recently started taking one (in an attempt to deal with metromenorrhagia) and the advice I was given by my OBGYN was that it needs to be taken within the same 3-hour window every day for it to be most effective. She also told me use backup for the entire first pack; I did notice that the patient insert only said 48 hours, but who wants to take a chance on something like that? It also makes a difference whether you start taking it on the first day of your period, or choose a Sunday start.

I'm pretty scatterbrained so I've got Google calendar reminders sent to both my phone and my email at 7, 8, and 9pm daily. I carry the pill pack with me *everywhere* since I never really know where I'm going to be at that time. I chose evenings because I wanted to take it with a meal to minimize stomach upset - so far this has worked well.

As far as adjustment issues with *skipping* periods - I wish! The first month, instead of getting a period, I spotted for 16 solid days. Spotting for a long while seems to be pretty common as you adjust to it; my doc told me to give it at least 3 months before giving up. In my case, spotting was far preferable to the heavy bleeding I'd been getting before, so I've stuck with it into Month Two and am hoping it gets better.
posted by chez shoes at 3:39 PM on April 20, 2010 [2 favorites]

chez hit it right on the head. a progestin only pill is a lot different than the combined pills that most women are on and you need to be super dilligent about taking it at the same time every day. I would definitely use backup for the first pack, and frankly, if you miss a pill or are even off several hours, I would still use backup. These type of pills are really a PITA to take because they do require such prescision, so they are usually only prescribed to ladies who can't take the combined pill for other reasons (like they are breastfeeding, etc). so, I'm assuming this is the case for you: if not, I would definitely recommend asking your doc to put you on an est/progest pill because there is more room for error with those. good luck.
posted by Carol@ILPoisonCenter at 4:30 PM on April 20, 2010 [1 favorite]