What To Do If You Start Birth Control Two Days Early

The pharmacist discusses what to do if you accidentally start your birth control pills two days early.

Jul 29, 2018

Mtaylor asked

I have accidentally taken my first pill in a new pack of Millinette 2 days early. I am meant to start on a Tuesday but took it on a Sunday. I’ve been on Millinette for over 2 years and had no problems. Will this affect pregnancy risks?

Answer

Starting your birth control pills two days early will not decrease their effectiveness. Besides your new schedule (starting on Sunday instead of Tuesday), you shouldn't notice any differences.

Starting your birth control pills early is the best way to change your starting date as it will not affect how well they work. Problems arise if you start your pills late, which can certainly reduce their efficacy and increase the risk of pregnancy.

There is no medical reason that you need a 'pill-free' or 'placebo' week after finishing your active pills. In fact, several birth control products are available that are known as 'extended-cycle' regimens. These extended-cycle pills contain either a reduced pill free week, or omit it altogether. 

In your case, having accidentally started two days early, it is important to continue to take your pills on a daily basis and do not "skip" or miss doses in an attempt to get back on your normal schedule.

If you do want change your starting day in the future and "fix" the mistake of starting early, simply do it when you start a new pack (like you did this time). For example:

  • You usually start your pack on Tuesday.
  • You accidentally started on Sunday.
  • Take your pills once daily.
  • Since you have 21 active pills, you will run out on a Saturday, and be scheduled to start the inactive, or placebo week, on Sunday.
  • Simply start your next pack on Tuesday, even though you will only have had two hormone free days (Sunday and Monday). This is safe and will not increase your risk of pregnancy.

It is important to note that when starting early (2 days in your case), you may have some minor spotting and bleeding. This should resolve soon and should not continue into your next cycle if you decide to stay on this new schedule.

Additional Information

The vast majority of birth control pills products contain:

  • 21 active pills
  • 7 inactive pills (these are placeholders and do not contain hormones, and do not need to be taken).

These pills were designed to mimic the natural menstrual cycle. After the 21 active pills are done, you begin a 7 day hormone free interval. Typically, 1-3 days after you finish the active pills, you will get your period.

As mentioned above, there is no medical reason that you need a 7 day hormone free interval. In fact, studies show that there is no medical reason that you need to get your period on a monthly basis. There are extended cycle products available, like Amethyst, that contain no hormone free interval, and you take active pills all year.

With your birth control pill (Millinette), which contains 21 active pills, the risk of pregnancy only increases if you miss doses during your pack or you go longer than the 7 day hormone free interval. Starting early should have no consequence (aside from minor spotting).

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