How To Change Birth Control Timing
Our pharmacist answers the latest question regarding possible ways to change the time you take your birth control.
Right now I take my birth control at the same time everyday late at night. I would like to start taking them earlier in the day. How do I make that transition with minimum risk to it's overall effectiveness. Could I gradually start taking them earlier and earlier? Would that work? If so how gradual should I make it? Thank you for your time and help in this! I really appreciate it.
It can certainly be concerning if you are looking to change the time you take your birth control pill (also known as an oral hormonal contraceptive) knowing how important it is to take them consistently for optimal effectiveness.
Fortunately, there are many different ways you can safely and effectively change the time of day that you normally take your birth control pill without altering the effectiveness of the pill.
Below, we discuss several methods.
Change Time With A New Pack
The easiest and simplest way to change the time of day you take your birth control pill is to:
- Start taking your pill at your new time when you start a new pack.
If you are not taking birth control continuously (i.e. no placebo or pill-free period), this is the best method.
Again, once you are finished with your pill-free period, simply start the new pack at your new time.
With this method, there will be no decrease in effectiveness.
However, since you are altering your normal schedule, it is possible for you to experience slight spotting or breakthrough bleeding for one or two cycles until your body gets used to the new time.
This can happen anytime you switch how you normally take your pills.
It should be noted the above only applies for 'combined hormone' birth control pills (i.e. ones that contain both an estrogen and a progestin).
If you are taking a 'mini-pill', you may need to use back-up birth control for at least 48 hours anytime you change your usual time as the effectiveness of the pill may be decreased. This is according to the prescribing information for Ortho-Micronor, a popular progestin-only pill.
The simple and effective way to change the time you take your birth control pills is to do so when starting a new pack. If you are taking a 'mini-pill', it is recommended to use back-up contraception for at least 48 hours when any change is made.
Earlier In The Day
If you want to change the time you take your pills to an earlier time, this is easy as well.
- Simply take your pill at the desired earlier time in the day.
- Since you are not missing a dose and are not taking a dose later in the day (i.e. letting more than 24 hours elapse between doses), there is no decrease in efficacy.
Concerns with a loss in birth control efficacy arise only when you want to move your dosing time to later in the day as opposed to earlier.
Moving it earlier in the day as you stated in your question, is much safer and should have minimal to no side effects. If anything, you may feel slightly nauseous but aside from that, there will be no decrease in effectiveness and there should be no issues with spotting.
This recommendation applies to both combined hormone pills and 'mini-pills'. Again, as you are not missing a dose or waiting too long in-between doses, your birth control pills will be just as effective.
If you want to change your birth control pill administration time to earlier in the day, you can simply start right away at your new time with no decrease in effectiveness.
Later In The Day
If you want to take your pills later in the day, it gets a little more complicated. Below are recommendations only for combined hormone pills.
Less Than 12 Hours Difference In Administration Time:
If the time you want to change is less than 12 hours after your normally scheduled time (e.g. you want to change from 7 in the morning to 2 in the afternoon), you can safely do this, and there should be no decrease in how effective your pills are.
More Than 12 Hours Difference In Administration Time:
If the time you want to change is more than 12 hours (some sources say 24 hours) after your normally scheduled time (e.g. you want to change from 7 in the morning to 8 at night), your birth control pills may not be as effective. It would be recommended to use back-up contraception for at least 7 days if you wait more than 12 hours between doses.
If you do want to switch to a time that is more than 12 hours later than your usual time, it is best to just start the new time with a new pack.
It should be noted that most sources, such as the CDC, state that back-up contraception (e.g. condoms) need not be used, even if you are more than 24 hours late taking a dose!
However, multiple studies have shown that inconsistent pill usage decreases effectiveness. As the consequences of unintended pregnancy are great, it is important to be careful.
If you are changing to a time less than 12 hours from your usual administration time, there should be no decrease in effectiveness (combined hormone pills only). There can be issues if you are changing to a time more than 12 hours from your usual time.
It is not recommended to slowly change to time you take your pill on a daily basis (e.g. by 30 minutes every day).
There are no published studies that can verify whether or not your pills will be as effective using this method to change the time of day you take your pill.
In addition, there is a good chance you are increasing the risk of side effects occurring, like spotting and bleeding, while you are doing this. It is ideal to pick a time and stick to it to allow your body to adjust appropriately. Consistently changing the time you take your pills will only increase side effects.
- The easiest and safest way to change the time you take your birth control pills is by starting at the new time when you start a new pack.
- If changing to an earlier time, you can simply start taking the pills earlier with no decrease in effectiveness.
- If changing to a later time, you may want to use back-up contraception, just to be safe.
- ^ Studying the Use of Oral Contraception: A Review of Measurement Approaches. PubMed
- AccessFDA Ortho Micronor Prescribing Information.
- PubMed Effect of missed combined hormonal contraceptives on contraceptive effectiveness: a systematic review.
- CDC Recommended Actions After Late or Missed Combined Oral Contraceptives.
- PubMed Use and misuse of oral contraceptives: risk indicators for poor pill taking and discontinuation.