What is the risk of pregnancy if a dose of the progesterone-only pill (POP) is taken late, and what is the recommended timing for the next dose after taking it at 9:40pm, given unprotected sex occurred 2 days prior?

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From the Guidelines

You should continue taking your progesterone-only pill tomorrow at your regular 7 PM time. Given that you forgot to take your pill at 7 PM and took it at 9:40 PM instead, which is less than 3 hours past the recommended dose, you are still considered protected against pregnancy [ 1 ]. The key factor here is that the delay was less than 3 hours past the recommended dose, and according to the guidelines, if the delay is more than 3 hours, you would need to take the missed pill as soon as possible and use backup contraception for 2 consecutive days [ 1 ]. However, in your case, since the delay was less than 3 hours, you can continue with your regular schedule. It's also important to note that the sex you had 2 days ago would still be covered by your previous pills, assuming you've been taking them regularly before this minor delay. Going forward, try to take your pill at the same time each day, as the progesterone-only pill has a narrower timing window than combined hormonal contraceptives. Some key points to consider when taking the progesterone-only pill include:

  • Taking the pill within 3 hours of the usual time to maintain contraceptive protection [ 1 ]
  • Using backup contraception for 2 consecutive days if the pill is taken more than 3 hours late [ 1 ]
  • Continuing the regular pill schedule even if a dose is missed or delayed [ 1 ]

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Progestogen-Only Pill (POP) Effectiveness and Efficacy

  • The progestogen-only pill is an effective form of contraception, with studies showing varying efficacy rates 2, 3, 4.
  • A review of 54 studies found that the median Pearl Index rate (failure rate during typical use) was 1.63, and the median method failure Pearl Index rate (failure rate during perfect use) was 0.97 4.

Missed Pill and Pregnancy Risk

  • If a pill is missed, the risk of pregnancy increases, but the exact risk depends on various factors, including the type of pill and the timing of the missed dose 3, 5.
  • In this scenario, where the pill was taken at 9:40pm instead of 7pm, and sex occurred 2 days ago, the risk of pregnancy is difficult to determine without more specific information about the pill and individual factors.

Taking the Next Pill

  • If a pill is missed or taken late, it is generally recommended to take the next pill at the usual time, which in this case would be 7pm the next day 5.
  • However, it is essential to consult the specific instructions provided with the pill or consult a healthcare provider for personalized advice.

General Guidance on Progestogen-Only Pills

  • Progestogen-only pills are a valuable option for women who are ineligible to take combined hormonal contraceptives due to increased risk of thromboembolism 6.
  • The choice of progestogen-only pill may depend on individual factors, such as the presence of androgenic activity or anti-mineralocorticoid effects 6.

References

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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