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Could my girlfriend become pregnant if her mini-pill was taken a few hours late? #1117/9
I have just split with my girlfriend and she was using the mini-pill .I don't know which one and can't ask. We last had sex on Saturday the first of July. She normally took her pill at 7:00 PM, but remembered she had not taken one that night, and took one straight away. I'm not sure how late this was.

How likely is it that she could get pregnant?

Please reply as soon as you can Im really worried! Thanks

1.     The contraceptive effect of mini-pills on cervical mucus (thickening of the cervical mucus making it stop ascent of sperm into the uterine cavity) is lost in about 24 hours. 

2.     The prevention of ovulation by mini-pills is a contraceptive effect of mini-pills that is NOT lost if a woman is late for a mini-pill.  But this contraceptive effect, anovulation, is only occurring in about 50% of mini-pill cycles.

3.     The contraceptive effects of mini-pills on the lining of the uterus occurs in all women on mini-pills and would not be lost by taking a mini-pill several hours late.

4.     So there you have it: mini-pill's contraceptive effects are three-fold and being late affects one of them the most, the effect on cervical mucus.

5.     I have absolutely no idea what the risk of pregnancy from a single late mini-pill would be. I would imagine the risk of pregnancy from just one act of intercourse would be low.  

     Is your former girlfriend pregnant now?



If you could please convey to her that emergency contraception is the form of pills or an IUD (copper T) would be desirable if this happens again.  She is at some risk for pregnancy.

 

His email reply on 11-14: “Thank you for you clear and concise first email and thank you so much for your time and for coming back to me so soon.  Sorry for the delay in my reply, I have been at work.”

 

“My girlfriend will not be pregnant yet, I gave you the wrong dates in my first message - sorry!  We only had intercourse a few days ago Sat (07/11/09) not 07/01/09. She has been taking the mini-pill for a couple of months at 7PM each day, and as far as I'm aware, never missed one. She was supposed to take her pill at 7pm on 07/11/09. We had intercourse I think somewhere between, 10PM – 12:00AM that night. As soon as we had intercourse, she realized she had not taken her pill at 7PM that night as planned, and took a pill straight away after intercourse (somewhere between 10pm - 12.00am that night).”

 

“We split up the following day and my suggestion by text that she may not have been protected and she might take the morning after pill, was met with some hostility! I'm hoping this is because she has it hand, but I am obviously very worried and have no control, and she won’t talk to me.”  

 

“I don’t know the brand of pill, but I do know it was a mini-pill .Obviously, all of the manufacturer’s guidelines say that there is only a 3-hour window in which she should be late, but surely the protection after 3 hours does not just drop to zero. I know you cannot give me any concrete answers, but in your opinion, given the times as above, would she still have had a very high level of protection? Maybe even the same level as if she had taken it on time. If she did NOT take another pill the following day, would this affect the protection she may have had when we had intercourse the previous night? (07/11/09).”

 

“I don’t know if this makes any difference but I am 35 and she is 33 years old. What is the likelihood of her getting pregnant given all this information, would you say it’s very unlikely?  I'm sorry for all the questions and the long email, and if I may have repeated myself a little, but as I’m sure you can tell, I am very anxious, and very much hope you can put my mind at ease, at least a little!”
  
Again, I would suggest that the risk of pregnancy is low, but not zero.

 

It might have been better if she had continued mini-pills for the next week.  At this point it is a waiting game.  Unfortunately, you and she are not communicating.  Perhaps she would communicate with me.
 
 


Now February 9th, please give us a follow-up.  Have you heard that she is or is not pregnat?

Key Words: 
mini-pills, sex, pregnant, contraceptive effect, cervical mucus, sperm, uterine cavity, ovulation, cycles, uterus lining, risk, intercourse


Posted 11-19-09, Updated 12-5-2009, Updated 12-9, 2009, Updated 2-9-2010 

Robert A. Hatcher MD, MPH
Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA
---2010-02-9


A Pocket Guide to Managing Contraception ISBN 978-0-9794395-0-6 #8005
  


Contraceptive Technology 19th Edition ISBN 9781597080019 #7019
  

The directors and owners of this website and any publications and information concerning health matters offered here advise a person with a particular problem to consult a primary-care clinician or a specialist in obstetrics, gynecology, or urology (depending on the problem or the contraceptive) as well as the product package insert and other references before diagnosing, managing, or treating the problem.
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