Birth Control/Missed Pill


Hi there,
I have a very common situation, with specific questions. I am on Mononessa Tablets, have been for about a year since the birth of my 2nd child. I have never missed a pill until recently. However, the time I take the pill varies by a couple hours every night.
My question is this, I missed my pill (36 hours late) on my Anniversary. As you can imagine, there was a lot of "activity" surrounding this occurrence. When I remembered the forgotten pill, I took it immediately, then took my regular scheduled pill that evening. It is now 8 days later, and I am having light cramping and spotting, including tender breasts, mood swings, and mild acne, Etc. Does this sound like "breakthrough bleeding" from the fluctuation in hormones? Or is there a good chance I rendered the birth control ineffective, and could be experiencing "implantation bleeding"? I do not expect my period for another 7 days, so obviously I don't want to waste a pregnancy test. Clearly we aren't "trying" to conceive, but would welcome another little addition if this happened. If there is a possibility of pregnancy, I would like to know, that way I take necessary precautions (no alcohol) until I can take a test.

Thanks in advance,

Hi Brittany,

Thank you for your question. You say you took one of your pills 36 hours late and took the next one at your regular schedule. You are having some side effects and are wondering if it's because you missed the pill.

Normally if you miss a pill but remember to take it within a day then continue as usual the pills will still be effective (read here:

It is possible that because of the change in when the pills were taken your body is adjusting. However there is no way to know for sure without talking with a doctor.

As I said, the pills should still be effective and it's quite likely you are not pregnant. However if you are concerned you can always get a pregnancy test to be sure or see your doctor.

I hope this helps,

Birth Control

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Allison Macbeth


I can answer questions about how to choose which method of contraception is right for you, how to deal with mistakes, effectiveness, and emergency contraception. I also have training in HIV, STIs, and sexual health education. I cannot tell you what is the right choice, but I can tell you the pros and cons of each method to help you make an informed decision for your circumstances. If you have had a condom break or had unprotected sex and need emergency contraception please call you local Planned Parenthood or check out


I have been working in the field of sexual health for a decade with specific training in contraception, STIs, HIV, and sexual problems. I have worked in several Planned Parenthood-affiliated charities, telephone helplines, research, education, and currently work for a local health authority evaluating HIV programs in the city.

Macbeth, A., Weerakoon, P., Sitharthan, G. (2009). Australian Parentsí Opinions about School-based Sexual Health Education. Sexual Health. 6, 328-333. I write a weekly advice column for Morning Quickie website which can be found here:

I have a Masters in Applied Science (Sexual Health) where I did research on sex education in schools and at home with parents and young people, as well as many counselling skills courses.

Past/Present Clients
I have worked extensively with young people under 25, people living with or affected by HIV, and parents.

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