Expert: Mia - 11/18/2008

Question
My fiancée is taking the pill and we decided to manipulate the dates slightly by having 2 9day breaks instead of 7day breaks to make her period more convenient for other events.
She stopped taking her pills on thursday or friday last week(we can't remember) but it's tuesday now and she still hasn't come on yet. Normally she takes 2-3 days(occasionally 4) after her last pill to come on. We use condoms anyway because she doesn't trust the contraceptive ability of the pill but she's getting a bit worried that she's pregnant. Recently she has become very hormonal, stressed and paranoid (which is very abnormal for her).
If she doesn't come on soon I'll get her a test but I dont know how to reassure her.

Answer
Hi Conor,

There is a possibility that she ovulated because she has had 9 day break without the pill. She should never go more than 7 days without being on the pill as that increases the chance of ovulation and of pregnancy. If she wants to switch the timing of her period, she should do so by reducing the number of days in her break or skipping the break entirely and starting a new pack.

However, this does not mean she is definitely pregnant, for several reasons. If you always use condoms then her chances of being pregnant are greatly reduced, even if she happened to ovulate. Plus, since having 9 days without a pill is like having 2 days of missed pills, this can affect her hormones and when her period arrives. Her stress of possibly being pregnant can also affect it. Finally, even though normally she may get her period 2-4 days after her last pill, this does not mean she always will. It can come at any time during those 7 days, can be very light (like spotting) or even skip a month.

So I would say that if you have been using condoms during sex and they had no rips or breaks, then the lack of period is more likely due to the manipulation of the pill then to pregnancy. If she does not get her period by the time she starts her next pill pack, she should take a pregnancy test to be sure and to ease her mind. In the future, stick to a maximum of 7 days of inactive pills/break between pills so that the pill stays at its maximum effectiveness.

I hope this helps. If you have further questions let me know.

-Mia