Combination pill, first pack effectivity


How soon will a combined emergency pill start working if i have taken it on the first day of my most recent period. I was on marvelon about 6 months ago and just resumed january 19.

Dec 28 2019 last period
Jan 19 first day of next period in 2020
Jan 30 withdrawal method sex at 2pm
Jan 30 12th day of cycle took, emergency pills 7hrs taken after withdrawl sex. 150mg levonorgestrel
Ave of 26 day cycle
44 yers old

What are my risk of pregnancy? Low?



Hello @Tsq

On the one hand you had sex at mid cycle and on the other hand you took emergency contraception very quickly and will have some protection from using withdrawal.

It is so hard to predict.

The best that I can recommend is a pregnancy test 3 weeks after the risk, although you could do one initially at the time that your period is due which is probably the 16th Feb and obviously if you have a normal period then that is hugely reassuring.

Many thanks



Hi @Dr_Paula ,

I was on the birth control pills for 12days already when I had withdrawal sex at mid cycle on the 12th day.

I was not sure if the combimed pills had taken effect after 12days that was why I took emergency pills 7hrs after withdrawal sex.

Question also is, do birth control pills take effect already at 12th day when I had taken the first pill on the first day of my period.

Many thanks again :slight_smile:


Hello @Tsq

If you start the combined pill on any one of the first five days of your period the it should be effective from that day. If you start the combined pill on any other day of your cycle it takes 7 days to become effective.

So, I agree with you - your risk of pregnancy should be very low indeed.

Many thanks



Dear @Dr_Paula

Thank you once again for your reply. I have kept on taking the rest of the combined birth control pills the following day at their usual time without gap after I have taken the emergency pills. The 21st day of the pill is on 8th of Feb from 19th Jan. Since I have taken the emergency pills mid cycle, can I expect the break through bleeding from the birth control pills to occur 2 to 4 days after active pills, or will the ecp make it earlier or delayed?

Secondly, just to mention here… I got paranoid on the effectivity of birth control combined pills since I read that some doctors recommend one full pack before having unprotected sex despite what the leaflet of the pill manufacturer indicates that pills are effective immediately if taken on first day of period… Why do you think some doctors say 30 days before effectivity kicks in?

Thank you and God bless :slight_smile:)


Hello @Tsq

The ecp can change when you next have a period - but this is usually because it delays ovulation. Because you were already taking the pill and would not have ovulated anyway I expect it will have no efffect.

The manufacturers leaflets are often over cautious.

The standard guidance is that the pill is effective immediately if taken within the first 5 days of the cycle or after 7 days if taken at any other time.

Hope helpful



Dear @Dr_Paula,

Appreciate your patience in answering all my questions. They clarified and pacified me.

Bless you :slight_smile:


Dear @Dr_Paula,

Would just like to update you that I had withdrawal bleeding on the 4th day after my active pills.

You are right that the ecp did not change the expected date of break through bleeding from bcp.

Thank you.


Hello @Tsq
Good to hear.
Many thanks!