Missed 1 pill 13 days ago, now bleeding 6 days prior to period



Hi @Dr_Paula

I missed 1 Microgynon 30 pill 13 days ago (day 8 of 21 pills). I took it 24 hours late, so I took it with that day’s pill as well (so 2 pills at the same time). I’d had sex 6 days before I missed the pill, so it was too late to take emergency contraception.

3 days ago, 6 days before my withdrawal bleed is due, I started bleeding lightly. This is still going on now. Is this an early withdrawal bleed? Or breakthrough bleeding? Or implantation bleeding? I’m concerned that I’m pregnant after missing that 1 pill and having had sex 6 days before. I took a pregnancy test on the day I started bleeding unexpectedly, but admittedly this is probably too early anyway as my withdrawal bleed is still not due until next week.

What’s going on? And should I not take my pill-free break? (my last pill of the pack is today).

Thank you


Hello @magic

Many thanks for your question.

Missing one combined pill should not put you at risk of pregnancy - it is only when you miss 2 or more pills that you need to use extra precautions.

Missing pills can cause break through bleeding - but there is quite a long gap between your missed pill and the subsequent bleeding.

It would make sense to check other causes of bleeding - pregnancy, infection, make sure that you are up to date with your smear tests.

The normal advice is to take the pill free week as usual as you only missed one pill and you have taken more than 7 pills since then.

Many thanks



Hi @Dr_Paula, thanks so much for getting back to me.

I had my smear test last month, but still awaiting the results (the nurse said there was a 5 week wait for results to come back).

What would you suggest I do next?



Hello @magic

If I saw you in clinic with this history I would normally do a pregnancy test and a screen for chlamydia and gonorrhoea and suggest that you keep taking the pill a usual and to see your clinician if the bleeding continues into the next packet.

Does that make sense?



Hi @Dr_Paula I’m with the same partner though so I’m not expecting it to be an STI?



Hello @magic

Thats fine - its just standard practice to offer testing to everyone with irregular bleeding.

Many thanks