How can I safely change the start day of my birth control pack?

December 2, 2009 12:19 PM

How can I safely change the start day of my birth control pack?

I'm looking to change the start date of my birth control pill. Because of circumstances when it was first prescribed for me, I became a Tuesday starter and have been for a few years. I really like this birth control, but the timing works out so that I always end up getting my period on Friday night or Saturday morning, during the last weekend of every month. This sucks. Quite often we are at the lake, visiting family somewhere or finding ourselves with rare free time at home when my period is the most heavy and uncomfortable.

I want to change my start date so that my period starts when it is most convenient for me. Ideally, I would get it on Sunday night or Monday morning - two days later than I would normally get it. So if I usually take my first pill on Tuesday night, then I should start taking my first pill on Thursday night for this to happen, right? My prescription is for Ogestrel, which is a generic of one of the Ortho Tri Cyclens (not sure which).

I know I have read discussions here about moving your start date up or skipping periods by not taking the sugar pills, but I can't find any specific info that has been able to help me. I asked my pharmacist and found myself going around and round with her in a discussion that only proved to me that I knew more about birth control than she did. I called my doctor's office, who more or less replied saying, "We're not sure, but go ahead and try it!"

I'm not comfortable with either of those answers, so I'm turning to the hive mind. AskMetafilter knows more about birth control than anyone I know!

What I want to know is:

- Is my plan sound? If I take all of the normal pills, take Tuesday and Wednesday's sugar pills and then start the new pack on Thursday night, will it effectively move my period back the required two days at the end of this new pack? Here is an illustration I made of my pill pack to help those who need a visualization.
- With this specific brand of birth control and using this method, can I safely skip all those extra sugar pills and start the new pack on Thursday without having to use alternative protection for the following month of sexual activity?
- What can I expect? Will I skip my period by moving to the new pack so fast? Can I expect the following month to be normal, save for the new schedule?

Thanks in advance, and I'll watch this to clarify things if needed - I know I seem to confuse whomever I ask about this!

posted by bristolcat to Health & Fitness (19 answers total)

I'm not a doctor, and I don't use ortho-tri-cyclen.

I would be VERY hesitant to only take 2 sugar pills and then re-start the next pack. In my experience and the experience of other women I know, starting the sugar pills and then not completing the cycle leads to thinks like breakthrough bleeding for the entire month and other unpleasantness

I'd recommend that you either skip the sugar pills entirely (and just open your new pack on the Thursday of the third week of your current pack), or finish out your current pack, suffer the whole period, and then wait 2 more days to start the next pack. After all, that's essentially what I did to get a Sunday-start when I first started my BCP - my period started on Monday and ended on Thursday, and I waited 3 extra days to start the first pack.

With the first method you won't have to worry about secondary birth control. With the second method I'd follow whatever your BCP instructions recommend for if you accidentally skip a pill - in my case the recommendation is 1 week of backup.
posted by muddgirl at 12:29 PM on December 2, 2009

in my case the recommendation is 1 week of backup.

And by that I mean my method - Loestrin - recommends 1 week of using a back-up method.
posted by muddgirl at 12:30 PM on December 2, 2009

Finish out this month of pills. Your last pill will be taken on a Monday. Then, on Thursday, 3 days later, start the new pack. Your period will be messed up for a month (may be on the wrong day, may not come at all, may be heavier or lighter than usual), but then you'll get exactly the effect you want. If you take a multi-phasic pill (your active pills are not all the same color), your periods may be messed up for a couple of months, but then they'll go back to normal. If you want to be super-paranoid about it, use condoms for the first month of your next cycle. But with monophasic pills, people skip the inactive week all the time, so having 3 inactive says instead of 7 won't be a problem.
posted by decathecting at 12:32 PM on December 2, 2009

Oh, I see you're taking a tri-phasic pill, which makes this more complicated. With the tri-phasic pills, you can't skip the inactive week. I'd recommend finishing your current pack, waiting 10 days to start the new one, and using condoms/backup just as you would if you were beginning to take the pill for the first time. That's the only way I know of to avoid months of messed up periods.
posted by decathecting at 12:34 PM on December 2, 2009

I agree with muddgirl. I think you're overly complicating this, and going off for only two days and then starting the new pack will just mess with your body. (Speaking from experience.) You won't skip your period, you'll probably just be starting it and then confuse your body into weirdness.

The easiest, best way to do this is to finish your period. And then start the pills on the next Tuesday afterward (2 days later than usual?) You'll have to use backup, but not for the whole month.
posted by Solon and Thanks at 12:35 PM on December 2, 2009

Ah, yeah, forgot to consider multi-phasic pills! I agree with decathecting's second post, which agrees with my Option #2.
posted by muddgirl at 12:36 PM on December 2, 2009

I take Ortho Tri Cyclen Lo. I would recommend that you actually switch to a Sunday start, as this will almost certainly leave you with period free weekends.

I would take you whole current pack, including all sugar pills, then take nothing until Sunday and start a new pack. Ortho recommends backup birth control for a week, when I did this, I did backup for 2 weeks just to be safe. Your period may take a few cycles to adjust to this, maybe 2 or three. I've had really bad experiences with trying to skip sugar pills - i ended up with a month long light period when I would have rather just had a few regular days.

This pill works in 3 ways to prevent pregnancy:
1. stops ovulation so that you dont release eggs that can be fertilized
2. increases cervical mucus to block sperm entry into the uterus
3. makes it more difficult for implantation of a fertilized egg (in the extreme rare case that would happen)

If you've been using the pills for some time, theis three prong effect gives you a nice "cushion" against pregnancy even if you skip the pill for 2 days, but still do teh backup.
posted by WeekendJen at 12:39 PM on December 2, 2009

Nthing finishing out the cycle and then starting the new cycle two days later. I've been on birth control for a long time, and I've had the "my body is confused; now I'll have my period for 28 days straight" reaction to birth control craziness a number of times. I do not recommend it.

Start your next cycle two days later than usual, and use a back-up bc method (condoms or wevs) for however long your birth control recommends. All of the kinds of birth control I've tried had you use a back-up for the first seven days of a new cycle after stopping bc or missing a start date, and I bet yours does too. But I would recommend checking their website or the materials that come with your pills to be sure.
posted by audacity at 12:41 PM on December 2, 2009

Response by poster: How can I confirm that Ogestrel is multi-phasic? It's three weeks of white pills and then one week of peach-colored pills. Every multi-phasic I've ever seen had different colors for each week.
posted by bristolcat at 12:45 PM on December 2, 2009

Response by poster: I would recommend that you actually switch to a Sunday start, as this will almost certainly leave you with period free weekends.

I have reasons to want my period to start two days later, so I'd prefer that we stay with the "Thursday" terminology. Thanks.
posted by bristolcat at 12:47 PM on December 2, 2009

I used The Google to look up Ogestrel. It's not a generic of Ortho Tri Cyclen. It's a generic of Ovral, which is monophasic. So you're good to go.
posted by decathecting at 12:50 PM on December 2, 2009

This page says it's monophasic.

Regarding changing the start date for a monophasic pill, I have had good luck by starting the pack a day at a time later than usual, and BAD LUCK (a stupidly long period) by starting the pack earlier than usual.
posted by amethysts at 12:56 PM on December 2, 2009

Response by poster: I used The Google to look up Ogestrel. It's not a generic of Ortho Tri Cyclen. It's a generic of Ovral, which is monophasic. So you're good to go.

Thank you, decathecting. I just found it on the list of monophastic bc on Wikipedia, too, as a confirmation. I do find this kind of odd as I saw the prescription note myself that said "Generic of Ortho Tri Cyclen" (possibly with or without "Lo" - can't remember). As long as it works, though, I don't care!

So, to be perfectly clear, I should:

1.) Take the entire pack (including the sugar pills)
2.) Go a Tuesday and Wednesday without any pills
3.) Start the new pack the next day, Thursday
4.) Be careful the first month (or whatever the prescription literature says)

Is this correct?
posted by bristolcat at 12:59 PM on December 2, 2009

Your plan seems reasonable to me! I'd be particularly careful about taking the pills regularly, at the same time etc. this month, as that will generally reduce your chances of being able to get pregnant in your slightly-longer-than-usual hormone-free week.
posted by wyzewoman at 1:14 PM on December 2, 2009

You could choose to do whatever strategy over several months, as in move it one day back one pack/month, and again another day back the next pack/month. It would take longer but then you might have less "weirdness".

You could also try calling the pharmacist (I assume there's a reason you're not calling your doctor).
posted by kch at 2:28 PM on December 2, 2009

Re Sunday start vs Thursday start, I agree you have the right idea with Thursday start if you already know how your body responds to the pill. The Sunday start timing never worked for me either, and I think everyone's body tends to be different in that regard.
posted by pitseleh at 6:26 PM on December 2, 2009

"- Is my plan sound? If I take all of the normal pills, take Tuesday and Wednesday's sugar pills and then start the new pack on Thursday night, will it effectively move my period back the required two days at the end of this new pack? Here is an illustration I made of my pill pack to help those who need a visualization.
- With this specific brand of birth control and using this method, can I safely skip all those extra sugar pills and start the new pack on Thursday without having to use alternative protection for the following month of sexual activity?"

To the best of my knowledge, yes.

If it's monophasic, you can basically follow the standard instructions for delaying your period/sugar-pills, as described here regarding Ogestrel specifically. Option (a), below, is kind of based on this.

Anyway, you have two options:
(a) take non-sugar-pills (pilfered from a different pack that you'd then throw out or keep for further pilfering purposes if they should arise) for 2 or 9 or 16 extra days before starting the sugar pills. after you finish all the sugar pills, move on to a fresh pack. proceed normally.
(b) stop taking the sugar pills (and start a new pack) 5 days early. (discard 5 unused sugar pills). proceed normally.

Your proposal was (b), right?

I believe you'll be safe and not need any unusual backup contraception using (a) or (b). I'm not positive, though, so I'd call the doctor again and say exactly what you plan to do, and ask about backup. For example, for (b), call and say, "I'm going to only take two days of sugar pills, and then I'm going to immediately start a new pack and proceed normally. Do I need backup?"
posted by sentient at 6:48 PM on December 2, 2009

If you don't want to use backup birth control, try to skip one (or maybe two) of the sugar pills for several cycles, thereby effectively shortening your cycle by a day (or two), until you get to the desired weekday. This normally doesn't lead to any side-effects like break-through bleeding and is still safe since you don't increase the hormone-free days.

You could also take one (or two) extra hormone pills for several cycles, making your cycle longer, to achieve the same effect. You wouldn't need any backup birth control for that as well, I think.

I am not a doctor.
posted by amf at 1:17 AM on December 3, 2009

Can you gradually expand or shrink your active pill period by taking each pill one hour earlier/later every day?
posted by Nameless at 1:32 AM on December 28, 2009