If I had unprotected sex after missing birth control pill, could I be pregnant?

Question

Hello doctor,

I accidentally missed one birth control pill. I have been on Levlen for many years, and this has never happened before. I did not realize until the next night the one from the day before was there, so I took both pills together. I had unprotected sex with my partner a day later, I have continued pills as normal. Is there a chance I could be pregnant? I was due for my period yesterday, and it still has not come.

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

Levlen is a combined oral contraceptive pill that contains Ethinylestradiol/Levonorgestrel. It acts by inhibition of ovulation. It increases the risk of heart attack, stroke and blood clot so better to avoid for years and years. It is also contraindicated in few conditions like a migraine with aura, systemic lupus erythematosus, etc. You can have other choices of contraception as well that could be more convenient and easy like mini-pills containing Progestogen-only safe and same method of usage as you are up to now if, it is more convenient or preferable to you. Other choices of contraception like injectables Medroxyprogesterone for 12 weeks, you cannot have any stress of taking pills and can have again after 12 weeks. The better choice is Mirena (Levonorgesterone) that is an intrauterine device for contraception for around three years, but if you want to discontinue it before that, you can ask your doctor to remove it even after one year.

You missed Levlen and took two pills next day. Rule of missed pill for oral contraceptive pills is if less than three pills missed or low dose estrogen one pill, take next pills as per schedule, no need extra precautions. If missed pills three or greater or low dose estrogen two pills then take a missed pill and extra precautions for seven days. If in the third week of the cycle, you missed pill then omit pill-free interval. And if missed in the first week, use emergency contraception. You can check which time cycle you missed the pill and also follow regular menses coming on time.

I hope this helps.

Thank you.