Answers
to frequently asked questions
Got a burning question about sexual health and can't find the answer? Our contact form.
Questions
- What Do I Do if I Missed A Pill (or 2 or more)?
- The condom broke while we were having sex. What should I do?
- Can I get pregnant while taking the pill?
- When should I have a Pap test?
The answers
1. What Do I Do if I Missed A Pill (or 2 or more)?
NOTE: There are many different professional groups and organizations that provide guidelines for missed pills, and they are all a little bit different. The directions for missing pills can be confusing, and it doesn’t just depend on the pills you missed. What also matters is when in your cycle you missed them and the kind of pill you take.
We recommend that you check your own pill information (that came with your pill pack) and always keep it close at hand. The instructions for missed pills are usually included with your pill pack. FOLLOW THOSE. If you’ve lost them, the company may have a website with the information on it. If you can’t find any information, follow these general guidelines:
Combined Oral Contraceptives (pills with 2 hormones)
If you have lost your information and can’t find information about your pills elsewhere, here are some general guidelines for Combined Oral Contraceptives (pills that have 2 hormones in them).
One (Active/Hormone) Pill Late:
If you miss 1 pill and you discover it during the same day (within 24 hours), take that pill as soon as you remember it. Take your next pill at the regular time. It is not necessary to use a back up method.
One or More (Active/Hormone) Pills Missed in the First Week:
If you missed one or more pills in the first week and it is 24 hours
or more after the time you were supposed to take them, take one pill
right away, and then continue taking one pill each day until the
end of the pack. Use a back up method (such as a condom) for
7 days.
*If you’ve had unprotected intercourse within the last 5 days,
consider using Emergency Contraception (Plan B®).
One or Two (Active/Hormone) Pills Missed in the 2nd or 3rd
Week:
If you missed one or two pills in the 2nd or 3rd week of your pill cycle and
it is 24 hours or more after the time you were supposed to take them, take one
pill right away and then continue taking one pill each day until the end of the
pack. Throw away any placebo pills (sugar pills/fake pills/inactive/non-hormonal)
pills and start a new cycle of your pills. This means that you will not
have a hormone-free week like you normally do.
Three or More (Active/Hormone) Pills Missed in the 2nd or
3rd Week:
If you missed three or more pills in the 2nd or 3rd week of your pill
cycle, take one pill right away and then continue taking one pill each
day until the end of the pack. Throw away any placebo pills (sugar
pills/fake pills/inactive/non-hormonal) pills and start a new cycle
of your pills. This means that you will not have a hormone-free
week like you normally do. Use a back up method of contraception
(such as a condom) for 7 days. Consider using Emergency Contraception
(Plan B®).
Progestin-Only Contraceptives
If you have lost your information and can’t find information about your pills elsewhere, here are some general guidelines for Progestin-Only Contraceptives (pills that have 1 hormone in them).
Missed a pill by more than 3 hours, OR missing 1 or more pills
that are over 24 hours late:
Take one pill the next day and continue taking one pill daily at the same hour. Use
Back up contraception for 2 full days. If you’ve had unprotected
sex in the past 5 days, Emergency Contraception (Plan B®) is recommended.
Missed a pill by more than 3 hours, OR missing 1 or more pills
that are over 24 hours late (and have had not had unprotected
intercourse in the past 5 days):
Take one pill right away and continue taking one pill daily at the
same hour. Use back up contraception for 2 full days.
Tips and Information:
- When you are prescribed birth control pills, you should also get a leaflet from the manufacturer containing instructions. Make sure you read this information and keep these instructions in a safe place. Refer to this sheet whenever you have questions about the birth control you are taking. In addition to advising you on what to do if you miss pills, this sheet should also inform you of possible side effects or other important warnings to be aware of when using oral contraceptives.
- The use of the birth control pill does not prevent HIV or other STIs (Sexually Transmitted Infections). It is important to use a condom to help protect yourself from these infections.
- The inconsistent or incorrect use of pills is a major reason for unintended pregnancy.
- Women who frequently miss pills should consider an alternative contraceptive method.
- The risk of pregnancy is greatest when active (hormonal) pills are missed at the beginning or at the end of the active pills, i.e. when the hormone-free interval is extended.
2. What to do if your condom breaks:
To prevent unwanted pregnancy, you should consider the Emergency Contraceptive Pill (ECP). It is effective in preventing pregnancy if it is taken within 72 hours (3 days) of unprotected sex. It may also work up to 2 days later.
ECP - 'PLAN B' is now available through your local pharmacist without a prescription. Prices will range from $30 to 50 depending on the drugstore. If in the metro area, call 902-455-9656 to reach to the Halifax Sexual Health Clinic (formerly Planned Parenthood Metro Clinic). They dispense ECP for a lot less money.
You can also buy Plan B ahead of time, as a preventative measure, “just in case”.
If you don’t have the money, you can go to the emergency department at the South Shore Regional Hospital in Bridgewater, and they may give you some at no charge. However, if there are other people there, even if they came in behind you, you may have to wait a long time before you get to see the doctor. The emergency department receives patients by priority of need/injury, not by first-come first-served.
Some women feel sick taking ECP and may even vomit, so you might want to take an anti-nausea pill like Gravol® about an hour before taking ECP.
After taking ECP your period may come a week early or a week late. See your doctor or get a pregnancy test if your period is more than a week late. You can get a free pregnancy test at the Sexual Health Centre in Bridgewater (527-2868) or buy one at your local pharmacy.
If you have missed the 72 hour deadline for the ECP you might consider an IUD which can also be used as an emergency birth control method up to 7 days after unprotected sex.
You should also be tested for Sexually Transmitted Infections.
3. Can I get pregnant while taking the pill?
Yes, but if you read the directions on your pill package and take them as directed, the risk of pregnancy is low. The pill (or any single contraceptive method) is not 100% effective in preventing pregnancy.
Some medications, including antacids, can cause the pill to be ineffective. Taking the pill at the same time each day is also very important. Always use a second method of birth control, in addition to the pill, to reduce the risk of pregnancy and sexually tranmitted infections.
For more information, call us.
4. When should I have a Pap test?
Pap tests are swabs of your cervix, which can detect abnormal cells or dysplasia. Abnormal and dysplasic cells can develop into cancer cells. Abnormal cells or dysplasic cells might go away on their own or you may need treatment to help them go away. “Abnormal” cells are “normal” at certain times in your cycle. They show up when you are on your period, so your doctor may want you to get a Pap test as close to the middle of your cycle as possible (as far away from your period as possible). If you have dysplasia, it can be mild, moderate or severe. Depending on the test results, you may need further testing, and you may need treatments. Regular Pap tests prevent about 95% of all cervical cancers.
You can reduce your chances of cervical cancer by:
- not smoking
- not having multiple sex partners
- not having sex before age 18
- Having regular Pap tests done.
The Cervical Cancer Prevention Program in Nova Scotia recommends that you get your first Pap test within 3 years of first vaginal contact. That means within 3 years of anyone else besides yourself touching or inserting anything into your vagina. This does not just mean penile-vaginal intercourse. This also includes fingers (of another person), oral sex, or the use of sex toys (if sex toy is touched by someone else’s hands).
If you have had no vaginal contact (as mentioned above) your first Pap should be done at age 21.
Screening (a Pap test) should be done every year until there are 3 consecutive negative tests (a negative test in this case is good because it shows no abnormal cells, dysplasia or cancer cells).
After having 3 negative tests in a row, your Pap tests can be done every 2 years.
Screening is finished at age 75 if there have been negative results in all tests in the previous 10 years.
- Women with minor abnormalities that went away by itself, or those who have had colposcopies showing no dysplasia or cancer, can continue as if they tested negative, and can follow the regular regimen (every 2 years after 3 consecutive negative tests).
- Women who have sex with women follow the same regimen as women who have sex with men.
- Women who have received a total hysterectomy (with removal of cervix) and who had no signs of, or treatment for, dysplasia or cancer do not need pap tests.
- Men who are undergoing or have undergone gender reassignment surgery (and are genetically female) and who still have an intact cervix need to follow the regular regimen.
Women who must receive Annual Pap tests include those who:
- have ever been treated for dysplasia or cervical cancer
- are Immuno-compromised
- are HIV positive
*Note: STI testing is DIFFERENT from a Pap test. If you have had unprotected sex, you must request an STI test IN ADDITION to your Pap test. STI testing should be done more often than Paps if you are having unprotected sex, and with the change of every sex partner.
For an annual Pap test reminder email, go to: www.myhealthtestreminder.com
