Delayed Period After Starting Ortho Tri-Cyclen: What to Do?

Question
Hello.

I have recently finished my first pack of Ortho Tri-Cyclen Lo. I am a bit worried because I am on my 3rd (going on 4th) green pill and I still have had no bleeding.

I had sex on Nov. 3rd, 6th, and 10th, and I was also prescribed Batrcim, so on the 6th and the 10th, my boyfriend and I used condoms and spermicide.

Lately, I have been feeling a little different. I have been constipated, gassy, nauseous, and I find that foods I used to like, I don't even want to think about because it makes me queasy. Also, food I normally don't like, I find myself eating twice or three times a week. (Like pancakes)

Should I be worried that I might be pregnant? would it be worth it to take a pregnancy test?

Thanks in advance.

Answer
Dear Rachel,

It isn't terribly uncommon that women have a scant, very short, or even missed period when they first start taking the BCP. If you started taking the pills on Day 1 of your cycle (first day of your period) then the standard rule of thumb is that you are protected and do not need to use a back-up method. If you started them on the Sunday after your period started, the standard is that you would have to use a back-up for one week. (I, personally, always recommend using a back-up for the first month anyway - for those who want to be absolutely sure.)

It was very "heads up" of you to make sure you covered your bases since you were prescribed Bactrim! That was great!

So...here's the deal - the symptoms you are having could simply be related to hormonal changes due to starting the pill OR they could be related to pregnancy. However, you have protected yourself well. My guess is that it's hormone-related. The suggestion of the manufacturer of Ortho Tri-Cyclen Lo is: "As long as you've taken your pills exactly as instructed, a missed period is probably not a problem. Continue as usual with the next cycle of pills, but inform your doctor or healthcare professional. If you miss 2 consecutive periods, you may be pregnant. Stop taking your pills and check with your doctor or healthcare professional immediately. Until you know whether you are pregnant it is very important to use another form of birth control, such as condoms."

My suggestion is - if, over the next week or so, the symptoms you describe continue or worsen, go ahead and take a HPT to know for sure. Make sure to use 1st morning urine to get a concentrated sample that has been in the bladder at least 4 hours for the most accurate results. Until then, go ahead with your pills and if you are worried about their effectiveness, use a condom as a back-up. If the test is negative, more than likely the symptoms are due to hormones. If positive, stop taking your pills.

I hope I've helped and I wish you good luck! Please write again with any further questions.

Brenda