What are the recommendations for an 18-year-old female (F) who is switching birth control (BC) methods, is one week from her menstrual period, and accidentally disposed of her current pack of birth control pills?

From the Guidelines

The 18-year-old female should start her new birth control method immediately, without waiting for her next period, and use a backup method like condoms for the first 7 days, as recommended by the most recent guidelines 1. To minimize the risk of unintended pregnancy, it's crucial to avoid gaps in contraceptive coverage. Since she accidentally disposed of her current pack of birth control pills and is one week away from her period, she should contact her healthcare provider for guidance on the best course of action. Some key considerations for her situation include:

• If she's switching from combined hormonal pills to another hormonal method, she can typically start the new method the day after taking the last active pill of her previous pack, if she had any left, or immediately if she has none left 1.
• For switching to non-hormonal methods like copper IUD, she can have it inserted anytime, but she should use a backup method for 7 days after insertion if she has had unprotected sex since her last period 1.
• If she cannot reach her provider quickly and has had unprotected sex in the last 5 days, she should consider using emergency contraception like levonorgestrel (Plan B) to prevent pregnancy, in addition to using condoms until she can start her new method 1. The specific recommendation will depend on her new chosen method, how many pills she missed from her current pack, and whether she has had unprotected sex since her last period. Given the potential for fertility to return quickly after stopping hormonal contraception, immediate action is necessary to prevent unintended pregnancy, and the guidance from the most recent study 1 should be followed to ensure the best outcome in terms of morbidity, mortality, and quality of life.

From the Research

Recommendations for Switching Birth Control Methods

The user is switching birth control methods and is one week from her menstrual period, but accidentally disposed of her current pack of birth control pills.

• To prevent unintended pregnancy, emergency contraception options can be considered, as the user is close to her menstrual period and does not have her current birth control pack 2, 3, 4.
• The most effective method of emergency contraception is the copper intrauterine device, which can be left in place for up to 10 years for efficacious, cost-effective, hormone-free, and convenient long-term primary contraception 3.
• Oral levonorgestrel (LNG) is available over the counter for women of all ages and can be used as emergency contraception, but it may be less effective for women who weigh more than 75 kg or have a body mass index greater than 25 kg/m(2) 3.
• If the user decides to start her new birth control method after her period, she should use a backup method of contraception, such as condoms, for the first week to ensure effectiveness 5, 6.

Considerations for Choosing a New Birth Control Method

When selecting a new birth control method, the user should consider factors such as effectiveness, potential side effects, and personal preferences 5, 6.

• Long-acting reversible contraceptives, such as intrauterine devices and subdermal implants, have the highest effectiveness and can be a good option for women who want a low-maintenance birth control method 5.
• Oral contraceptive pills are the most commonly used reversible method of contraception, but they may have a higher risk of venous thrombosis and other side effects 5.
• The user should discuss her options with a healthcare provider to determine the best birth control method for her individual needs and preferences 5, 6.