BCP at any old time, or...

March 2, 2012 8:24 AM

[BCP filter] Taking the pill at different times each day: how risky am I being?

I know I'm "supposed" to take the pill around the same time every day, and I have a time I shoot for -- 10am. Generally my strategy is to take it as soon as I remember after waking up, and this is around 10, so I set that as my target time. BUT sometimes I don't remember because I'm busy, or stressed, or on the road for work and don't have water, or whatever. I rarely miss a day altogether (like once every two months). My packaging says even if I miss one day (and take the missed pill the next day) I'm still protected. So I assume it doesn't *really* matter what time of day I'm taking the pill, that it's only for regularity and keeping a fairly consistent level of hormones in my body. But am I actually putting myself at high risk of getting pregnant? Getting pregnant right now would be categorized as a disaster, so if I am leaving myself open to risk, I'd rather know about it so I can figure out how to reduce the risk factor.

posted by DoubleLune to health & fitness (26 answers total)

I don't know if you're going to get a concrete answer except 'it's more effective when you take it at a regular schedule."

Just try your best to take it at the same time, and set an alarm if it helps you.
posted by rachaelfaith at 8:29 AM on March 2, 2012

Not a doctor, but to my knowledge it is a bit risky to vary that much. Probably not catastrophic, but it's probably putting the efficacy below the "99.whatever%" that is advertised. I know this month I was about 4 hours late with a pill and it caused some breakthrough bleeding, which never happens otherwise. So, it would seem my body notices, at least. If getting pregnant now would be a "disaster" as you say, I would definitely try to be more consistent with the time I was taking it. Or double up with condoms, etc.
posted by annie o at 8:29 AM on March 2, 2012

I think you've moved from the perfect use, less than 1% chance of pregnancy in a year, to the imperfect use, 9% chance of pregnancy in a year, according to Planned Parenthood's numbers. I too am about there, so I always use a second form of birth control (generally condoms, sometimes pulling out, which is sufficiently effective as a second form for me at 4/27% risk depending on how well you do it, and we do it well).
posted by brainmouse at 8:30 AM on March 2, 2012 [4 favorites]

If you are having sex, you are risking getting pregnant. PERIOD.

Each brand of BCP is different. My wife was on one brand last year that said "if you miss your pill by 5 hours, you are not protected." Others, like yours, say something like you did: "just take two the next day or as soon as you remember, and you are fine."

But, again, if you are having sex, you are at risk of getting pregnant. PERIOD.
posted by TinWhistle at 8:31 AM on March 2, 2012

Depends on the kind of pill. It's really important to take the progestin-only pills at the same time every day. See here.

If getting pregnant would qualify as a disaster, then just set a daily alarm on your cell phone and be done with it.
posted by amro at 8:32 AM on March 2, 2012

IANAD, I believe it depends on what kind of pill you're taking. I started taking the mini-pill (progesterone-only) recently and was told that I had a 3 hour window in which to take the pill, for it to remain effective.
posted by noxetlux at 8:32 AM on March 2, 2012

Depends on the type of pill, evidently. Progestin-only pills MUST be taken at the same time every day or you increase risk of pregnancy; for other pills, it may be less risky to take at an earlier or later time each day.

As I understand it, taking the pill earlier or later each day (or skipping a day accidently) is one of the reasons that the "actual use" failure rate for the pill is around 8-9%, while the "perfect use" rate is 0.3%.
posted by iminurmefi at 8:32 AM on March 2, 2012

If they're progestin-only pills, it's a big deal. If they're combined pills, it's not.

(there may be exceptions to this rule, but that's my understanding)
posted by randomnity at 8:33 AM on March 2, 2012

The type of pill matters here: progestin-only pills are WAY less forgiving than combined pills.

Is there a possibility of switching to a non-pill hormonal contraceptive so you can avoid this altogether? I hear all sorts of good stuff about NuvaRing.
posted by Metroid Baby at 8:33 AM on March 2, 2012 [1 favorite]

I was pretty consistently late one weekends (I had the same though -- take it at 8 when I wake up. Except on weekends, when I forget or am not at home or or or...). We're talking upwards of 5 hours late at least once a weekend (this was progesterone-only. I know, I know, risky and dumb).

On the one hand, I never got pregnant.

On the other, there are effective methods of birth control that do not require super-human memory and dedication. I am using one of those now. Less stressful. And let me tell you, the first few weeks of "OH MY GOD I FORGOT MY PI-- oh wait! heee!" were awesome.
posted by AmandaA at 8:34 AM on March 2, 2012

If you truly don't want to get pregnant right now, I'd try to be more consistent. I used to be kind of like this-plus or minus three or four hours maybe and I did get pregnant. Twice in fact. I guess I'm just a fertile myrtle but now that I really really don't want another baby, I have an IUD.

Long story short, the type of pill matters and the individual person matters so this isn't something anyone can give you a definite answer on.
posted by supercapitalist at 8:35 AM on March 2, 2012 [1 favorite]

Just FWIW there is a progestin-only pill that gives you a 12 hour window (Cerazette) the leaflet that comes with the pills should tell you what sort of window you have.
posted by missmagenta at 8:41 AM on March 2, 2012

If this is important to you, why not an IUD?
posted by k8t at 8:44 AM on March 2, 2012

Or the patch or the ring. Why mess around when there are other non-daily options?
posted by amodelcitizen at 8:45 AM on March 2, 2012

I have a 9:30 every day medicine alarm on my iphone. I hit snooze until I actually take the medicine if i can't take it immediately. Being reminded every 7 minutes makes you get around to finding water pretty quickly. The medicine also lives in my purse in case I leave the house before 9:30.

I have a friend with a nine year old who would recommend that you take it at the same time every day.
posted by artychoke at 8:50 AM on March 2, 2012 [5 favorites]

Basically, there are three main factors that play into the level of risk you're assuming with birth control pills:

1. Which kind of pill you're on, which you can control by changing your prescription
2. How precise you are in what time you take it each day, which you can control, but realistically you'll never be 100% perfect, and you know better than us what kind of accuracy you're personally capable of
3. Your body's own level of sensitivity, which you can't control and can't really know

And so the combination of the above yields your overall risk.

I was lousy at #2 and concerned about #3, so I did Ortho Evra for a couple years (worked great, but new patches tended to make me barfy), Nuva Ring for a couple more years (wonderful, no complaints) and eventually went with a Mirena IUD because it would save me money in the long run not having to pay increasingly high copays every month.

But if pills are your best option for reasons you haven't shared, I like artychoke's suggestion of a cell phone alarm. Sounds like the best way to make it easy to never screw up.
posted by katieinshoes at 9:01 AM on March 2, 2012

At risk, yes. How much risk depends on the factors others have outlined above. It also means that you are more likely to have breakthough bleeding.

If getting pregnant right now would be a disaster, I strongly suggest considering three options:

1) setting a daily alarm

2) backup protection when you have sex

3) switching to either a more effective birth control (IUD, Implanon) or to one that doesn't require daily attention (NuvaRing, OrthoEvra patch).
posted by sm1tten at 9:08 AM on March 2, 2012

I read somewhere that your body weight matters, too. Bigger = you need to be more accurate. I'll try to find the article again.
posted by the young rope-rider at 9:36 AM on March 2, 2012

Do you have to take it in the morning? I used to take mine at 5.30-6 p.m. because I was almost always awake and/or conscious at that point.

I would be getting ready to leave work and would grab a glass of water and swill it down before I left the office. That might help you have a more regular schedule.
posted by vickyverky at 10:23 AM on March 2, 2012

Figure out what's the best time of day to take it, and set an alarm of a baby crying.
posted by inertia at 10:44 AM on March 2, 2012 [6 favorites]

Is there a time of day you will always be in the same palce? Like vickyverky I take mine later in the day, at a time that (at least on weekdays) I am confident I will always be at my desk.
posted by mlle valentine at 11:23 AM on March 2, 2012

I'll Nth the recommendations to switch to a method that doesn't require any timing! Nuvaring is outstanding.
posted by kalapierson at 11:43 AM on March 2, 2012

"Getting pregnant right now would be categorized as a disaster ..."

Yeah, um, not to harp on what TinWhistle said, but you're ALREADY at risk by having sex. PERIOD. And if getting pregnant right now would be a disaster, I'm assuming it would mean a disaster for guy as well. And, IMHO, (and this is one of those things I HATE about being a woman) it sucks that it's socially-acceptable etiquette for the responsibility of that to fall on the female if BCP is an option/in use.

I say: be as careful as you can. And I think you should inform your partner(s) of it as well. I think a lot of guys JUST DON'T KNOW, you know? "Babe, I'm doing the best I can, but JUST SO YOU KNOW, I'm supposed to take this at the same time every day ... and sometimes I'm miss it by a few hours. We can use condoms, we can abstain, but I THINK YOU HAVE A RIGHT TO KNOW."

That can also open the gateway to a potential baby-conversation, if you'd like to/be open to having that. [the conversation, I mean, not the baby.]
posted by athena2255 at 1:06 PM on March 2, 2012 [1 favorite]

I take a combination pill.

I've set a daily alarm now -- I like the idea of only pressing "snooze" until I've actually taken the pill. 10:30 actually is the best time because I'm up but not out yet -- my days from 11am to midnight can vary drastically because of school and 2 jobs; normally at 10:30 I'm at least not running around like crazy yet.

I didn't like the side effects I had on the Nuvaring, though I did like the convenience. I've talked to my GYN about the IUD, but was a bit scared of it... I think I'll check it out again, though. 5 years is somewhere about the time I'll probably be ready to start a family.
posted by DoubleLune at 4:07 PM on March 2, 2012

just to chime in on the IUD bandwagon, i LOVE my mirena. i was a "just take it at some point during the day" combination pill user, and i have a sixteen month old who i wouldn't trade for any thing or person in the world, but who was definitely a surprise.
posted by woodvine at 4:26 PM on March 3, 2012

Oh hey and just as an update, I opted for an IUD. I'm kind of loving the whole thing where I don't freak out once a day that I forgot to take my pill...
posted by DoubleLune at 8:32 PM on March 20, 2012