Took pills out of order....

[seishukuhime.livejournal.com]

I'm on Ortho Tri-Cyclen and start a new pack today, but I accidentally took the last pill in the pack instead of the first one.  I haven't been able to find much information about what this means and I'm honestly at a loss.  From what I already know, it could cause breakthrough bleeding...but will it compromise my protection?

Thanks in advance.

Comments

[archangelbeth]

By last pill, do you mean the last active pill, or the last placebo pill?

If you took the last placebo pill, take the first active pill immediately, or your protection will be considered compromised to some extent until you've taken 7 days of active pills.

If you took the last active pill, then yeah, taking the proper week one pills may cause enough of a rise-and-fall to provoke breakthrough bleeding. Hopefully the rise in hormones at week two will make that stop, if you get it. But other than that risk, you'll still have 21 days of active pills before your no-hormone week, so your protection will not be compromised.

Luck!

[seishukuhime.livejournal.com]

It was the last active pill. Breakthrough bleeding is annoying, but not as bad as compromised protection...

Thanks for your help. :)

[gryphonwing.livejournal.com]

On some pills (triphasics) there are different levels of hormones to mimic the natural rise and fall of hormones during a natural cycle.

edited to fix a crucial numeral!

[archangelbeth]

As gryphonwing said, triphasics have varying amount of hormones in the pills for each week. (One US brand, Natazia, is a quad phasic, having active pills with four different levels of hormones!)

The reason that taking the pills out of order can spark breakthrough bleeding is how your uterus perceives hormone levels -- it responds to a hormone drop (or rise-and-fall) by bleeding. Since a triphasic pill starts with a low dose of hormones in week 1, moves to a higher dose in week 2, and has its highest dose in week 3... Well, that means taking week 3 pills, then week 1 pills, causes a hormone drop. A sensitive uterus will go, "BLEED TIEMS NAO!"

This is why, if one is on a triphasic, the best way to stack (skip a withdrawal bleed) is to take week 1 from pack A, week 1 from pack B, week 2 from pack A, week 2 from pack B, week 3 from pack A, week 3 from pack B, and then have no more than 7 days of bleed. The second best way is to take the second pack backwards -- week 3, 2, 1, hoping that the drops from week 3 to week 2 and week 2 to week 1 will be small enough not to trigger the uterus to bleed.

(That's actually a potential in a case like this -- take the pack backwards. Though that still might be enough of a drop to trigger bleeding, and without the hope that going to week 2 -- raising the hormones -- would stop the bleed.)