do i need to use back-up?

iVillage Member
Registered: 09-27-2004
do i need to use back-up?
4
Fri, 10-22-2004 - 3:54pm

i was 4 hours late taking the pill today (ortho-tricyclen). do you think i need to use back-up protection? i called my doctor, and he said i don't need to use back-up unless i miss 2 whole days in a row! that's what the pill instructions say too.

but i thought the rule was to use back-up if you're more than 2 hours late... am i wrong? is my doctor wrong?

iVillage Member
Registered: 01-15-2003
Fri, 10-22-2004 - 4:14pm

At four hours, your pill was 'late', not missed (by the definitions used on this board). About 8 hours is what this board considers missed.

Up until recently, pill manufacturers did not recommend backup for only one missed pill, they didn't feel it was necessary until you missed two. This is obviously the information your doctor & your current pill pack are using. Recently, pill manufacturers have (apparently, it is since I stopped using BCP) decided that there have been enough cases of pregnancy attributed to missing only ONE pill to recommend backup after just one miss. I missed one pill about three times in the 10 years I took BCP.... I didn't use backup & I didn't get pregnant...... but your mileage may vary!!!

+/- 2 hours is considered "on time" the time between 2 & 8 hours would be more of a grey area - there should be enough hormones in your system to prevent ovulation, but for some very sensitive women there could be enough of a hormone level swing to cause irregular bleeding.

Your four hours late would be a bad thing to make a habit of, but I wouldn't worry about it, make sure you keep taking your pills on time & you should be fine.

iVillage Member
Registered: 09-27-2004
Fri, 10-22-2004 - 5:32pm

thanks. that is reassuring.

i'm not too happy with my doctor though. i think he's a little too cavalier about the advice he gives me. last month i had a yeast infection and he gave me diflucan. i specifically asked him if it could interact with the birth control, and he said no. well, now i've been reading back posts on this board and it sounds like diflucan *can* lessen the pill. luckily nothing happened, and i got my period on schedule. but geesh! i can't believe i have to double-check on a message board everything he tells me (not that you guys aren't great... but ya know, i'm paying my doctor big bucks to be right about this stuff!)

anyway. just venting.

you guys really are great. thanks so much for the advice :)

iVillage Member
Registered: 01-15-2003
Fri, 10-22-2004 - 6:33pm

No problem!

I think a part of it all is that no one REALLY knows what will interact with the pill & what won't. I believe there have been one or two proven cases, but more of it is just hearsay. Some people choose to be super-careful, others choose to roll with things.

I can tell you that I *never* used back-up for an antibiotic.... not that I was on many over the years I was on the pill, but I was on a few. I remember a doctor telling me that some antibiotics could make my BCP not work, but that "this one is OK". I believed him, I didn't get pregnant. Now I read here that many people consider *any* antibiotic requires back-up to be certain you're safe. I don't know how I would deal with this info, but I don't have to, as my husband has had a vasectomy. I'm not telling you that you don't need to use back-up when indicated, I just wanted to point out that I don't think you should stress about it too much!

iVillage Member
Registered: 03-19-2003
Sat, 10-23-2004 - 9:58am
Funny how some doctors are cavalier about very serious things! The FDA actually requested the labeling change from the pill manufacturers to reflect backup after missing one pill, not two anymore. I think they did that last spring?

The deal with drug interactions....it's complicated! With the antibiotics in particular, there haven't been any studies that have proven that "yes this antibiotic will render your pill ineffective and allow you to become pregnant." But over the last 30 years, people's experiences have shown differently. Apparently there is a certain subset of women, and there's no way to tell who they are, who will have a significant interaction with antibiotics and become pregnant. The antibiotics that have been seen more commonly in these cases are -cillins and -cyclines, but considering that we don't know who it will affect and whether or not more antibiotics may be involved (because it hasn't been successfully replicated in a study), the safest course is usually to use backup with any antibiotic.

What I've heard (from another member's doctor) about Diflucan and the other antifungals is that if you're taking them for a period of time, say for a fungal infection somewhere in the body or a nail fungus, then you'd want to use backup because there is an effect on one of the liver enzymes that also metabolizes the pill hormones. Supposedly a dose or two is okay? I don't think I'd chance it though, but Diflucan hasn't ever worked for me for a yeast infection and other antifungals haven't worked on my toenail either, so I don't take them!

If you're comfortable not using backup and accepting that the research is a little fuzzy, that's totally fine! But if you just don't want to worry about it, backup never hurt anybody.

Good luck! (Oh yeah--for four hours I personally wouldn't worry, but more than 8 I would)

Judie
Co-cl for Birth Control
Judie Cl for Birth Control