What am I supposed to do if I lost my package of Birth Control Pills?

Start a new package today. Then, in a week or 11 days or whenever you were supposed to get your period, stop taking it for 7 days. Then start taking it again. In the meantime, call your doctor and have her/him call in an extra refill for you at your pharmacy and pick that up. If you get the refill in time, when you end your period, start that package and just keep partially used package for another emergency such as this.

**Tonight, take both last nights pill AND this nights pill.

@papayalily Gave you exactly the right answer.

@papayalily thank you!

@papayalily Umm one more question. I don’t really remember when exactly I was supposed to get my period. I think I was on the second week of the lost package, so I must have had at least 10 more pills to go until I reached the reminder pills. So, when do I stop taking the pills? Would it be harmful to just keep taking the whole package instead of stopping for 7 days? I have skipped the reminder pills before and just kept taking the real pills so I wouldnt have to have a period. I only did that once, but would it be okay to not stop for 7 days and just take the package as usual?

You don’t have to do it exactly like you did before, but if you had 10ish days more, I’d do 13 to make sure there’s no lapse in the effectiveness. It’s sort of harmful to just keep taking the package. What happens in that once you start PMSing, you won’t stop until you have your period, and it will get worse and worse. It’s really up to you as to if this is a consequence you can stand or not. You might get spotting anyway (which will let you know when you were going to get it).

Also, there are only 4 inactive pills in a Yaz pack, not 7.

You don’t know what day of the week you started your pills? Usually it is suggested to start on a Sunday so you don’t have your period on a weeked. Does that sound familiar? It might be different with Yaz since it is only 4 inactive days.

You should call your doctor and ask if you can just start the new pack and take the whole pack and have your period whenever the new pack lines up for it. Most healthy women have no need for a monthly period. Then you don’t waste half a pack.

@Seaofclouds Why? Why not just estimate when she would have been done with her pills anyway?

@desiree333 Also, this is your chance to line up your period to the days you want it. If you usually start your period on the second day of your inactive pills and you want to get your period Tuesday through Friday, you can make that adjustment now, while you are going to have a little bit of a screwed up month anyway. Also, you might want to use some back up protection this month.

@JLeslie She can do that if she wants, I was just coming up with a way for her to avoid that headache and avoid wasting her pills.

@Seaofclouds That’s not really true. Because the effects of PMS continuing for a few more days can be looked at as a psychological issue (because it’s mostly the “crazy” that people mind more than anything else) they can say it doesn’t have any medical effects but it’s really a half-truth.

@papayalily That’s why I said for her to talk to her doctor about it and that most, not all, healthy women don’t need a period every month.

@Seaofclouds I disagree with that whole idea of not getting your period every month. Bad enough we screw around with nature, let’s at least get as close as we can to the real thing I think. Just my opinion.

@JLeslie It just depend on the birth control you use. Some women on depo and with some IUDs stop having periods all together. I’ve been on the pills that allowed me to have only 4 periods a year and it was really nice. They worked well for me. I respect your opinion though. I was just giving the OP another idea.

@Seaofclouds Sure, I respect your opinion. That’s what fluther is for.

Abstain. ;)

@mowens Assuming she’s taking it for birth control and not for polycystic ovary syndrome. :-)

@Dr_Dredd Why do doctors prescribe the pill for PCOS, when that seems to me to be treating the symptoms rather than the underlying cause? Why do doctors not address the sugar problem? Or, I should say why don’t GP’s and GYN’s not address it, the RE’s do treat with diabetic drugs.

@JLeslie Because the pill is treating the underlying cause. Hormones are the best way to keep more cysts from developing. It’s also the best way to keep endometriosis at bay, as well has helping reduced the severity of cramps, acne, hormonal mood swings, and reduces your risk of endometrial or ovarian cancer, or becoming anemic.

@papayalily But the pill does not cure a sugar problem if there is one, and I have always wondered if the minor sugar problem is affecting that person negatively besides the obvious ovarian and reproductive track problems. RE’s give glucophage and ovulation comes back. The pill works for PCOS because it quiets the ovary, but that does not really help the patient have a normal cycle, it just masks that the person does not have a normal cycle.

@JLeslie Sugar problem as in they can’t stop pounding down the devil’s food cake? PCOS is often genetic, so they may have a problem with sugar (which should be looked at) or they may not, but it’s a different problem.

“does not really help the patient have a normal cycle, it just masks that the person does not have a normal cycle.”
Huh? Restate please?

@JLeslie Because taking metformin (or spironolactone) doesn’t always help regulate periods and reduce hirsutism. Insulin resistance is one aspect of PCOS, but not everyone has it to equal degrees. Sometimes the only thing that will work is the OCP.

@Dr_Dredd But, my impression is that GP’s and GYN’s go straight to BC pills, that they don’t even bother with the insulin resistance testing unless maybe there are other indicators like obesity, especially if the patient is a young woman. I assume partly because it is teenagers coming in initially for having irregular are non-existant periods, and everyone probably figures good idea to getthem on the pill anyway, just in case they are sexually active.

@papayalily No, well not exactly. Certainly eating a diabetic type diet would probably help these people who are PCOS who have indicators for sugar/insulin problems. It many times does not show up in a fasting sugar test, the doctor needs to do further glucose and isulin testing and look at some ratios or something, not just normal ranges.

http://en.wikipedia.org/wiki/PCOS

See under diagnosis just how high the percentages are:

2-hour oral glucose tolerance test (GTT) in patients with risk factors (obesity, family history, history of gestational diabetes) and may indicate impaired glucose tolerance (insulin resistance) in 15–30% of women with PCOS. Frank diabetes can be seen in 65–68% of women with this condition. Insulin resistance can be observed in both normal weight and overweight patients.

And under Management:

General interventions that help to reduce weight or insulin resistance can be beneficial for all these aims, because they address what is believed to be the underlying cause of the syndrome. Regular exercise and maintaining a healthy weight will help reduce the hormonal imbalance, restore ovulation and fertility, and improve acne and hirsutism.[23]

You asked me to restate what I said about a normal cycle. I do not mean a normal cycle is regular or 28 days. I mean a normal cycle is one where the proper hormones allow for ovulation and mentruation and basically fertility. A woman with a healthy cycle who is on the pill, still is a woman with a normal cycle naturally, just the BC pill is inhibiting the release of the egg, if she stops her pills she goes back to a normal cycle. The PCOS person on the pill is not naturally cycling normally, and so her reproductive system is not “healthy.” The BC pill only hides the fact that things are not working right, it is not “curing” the problem. The endometriosis and other things mentioned are not what I am talking about here, but certainly the pill can help treat that problem as well.

My experience with friends is that women who dont ovulate, when they go to their GYN, they are prescribed the pill. When they go to a fertility doctor because they can’t get pregnant, which is an RE, they are given insulin resistence tests and diabetic drugs. The RE is trying to fix the underlying causes. This may have changed in the last 10 years as other specialties are becoming more and more aware of PCOS, and in fact PCOS is still kind of misunderstood, medical science is still trying to understand the condition better.

@JLeslie Part of the problem is that there is no one definition of PCOS. Different professional groups have different criteria. But all include the following: Menstrual irregularity due to decreased ovulation or total lack of ovulation; evidence of hyperandrogenism, whether clinical (hirsutism, acne, or male pattern balding) or biochemical (high serum testosterone concentrations); and no other etiology for the problem. Technically, one doesn’t even need to have visible ovarian cysts. Abnormal glucose tolerance is often (~40%), but not universally, present.

Because there is no standardized definition of PCOS, there isn’t one standard treatment, either. The different parts of the syndrome are treated separately. For some, the associated hirsutism is the most worrisome factor, which can be controlled with oral contraceptives. For others, the most bothersome problem is the irregular menses, which is also best controlled with OCPs. Metformin doesn’t really help either of those symptoms, even though it may help correct glucose intolerance.

I think the reason that most clinicians don’t routinely test for insulin resistance/glucose intolerance is that simply treating it won’t get rid of the other parts of the syndrome. Therefore, no need to test for it unless something else would suggest its presence (e.g. obesity)

@Dr_Dredd Thanks for your explanation. But, then if the person starts to ovulate they will likely not get cysts, because the egg is popping out, and they will have a cycle, although I guess maybe those patients are still unlikely to be perfectly regular? Not sure. I do have a friend who got pregnant taking Glucophage, after being infertile for years and not menstruating. I did know that you don’t have to have cysts to be PCOS. 40% seems like a very high number to me.

I understand better, now that you pointed out that doctors are treating the most worrisome factor. I guess, I always want to treat the underlying cause if it is identifiable. This is a personal thing for me, and certainly not everyone looks at as I do. After having had suffered a long time in chronic pain and doctors wanting to throw pain meds, and psych meds at me, it turned out I was right and I had an infection the whole time, which I finally proved with surgery showing a tremendous amount of scar tissue typical of infection. If I had covered up my symptoms with pain meds and cortizone, and other such drugs, my insides would have continued to be distroyed. As it is I am not 100%, but I have significant improvement, things have healed more than any doctor ever predicted. Supposedly I had irreversable tissue damage. My situation is not perfectly anagolous to the PCOS discussion, I just get a little nervous that doctors aren’t thinking of all possibilities and going for what will satisfy the patient at the moment or what is simply standard of practice, and the patient typically doesn’t know any better to ask further questions. Standard of practice is of course helpful for protecting patients, but it is also a catch 22, because the standard sometimes have not been proven to work, it’s just what is being done at the time. I just went through that with my husband, a doctor had suggested a treatment that we refused at the time. When we went back about a year later and asked about trying the suggested treatment, the doctor said he stopped doing it because he had not seen any real positive results. Bbbbut, he had given it to many other patients, and it wasn’t like he was conducting a formal drug study.

Well, like I said, thanks for the explanation. I understand it better now from the doctor’s point of view, that helps.

@JLeslie The 40% is how many have insulin issues, not how many don’t have cysts.

Your ovaries normally grow cystic structures called follicles each month. Typically, these resolve back to normal ovarian tissue after ovulation. But with PCOS, something goes wrong and they don’t develop fully, and then don’t decend when you ovulate, and then just stick around. When you’re on the pill, you’re ovaries will stop trying to mature the egg in the follicles, so the underdeveloped follicle won’t become a cyst.

So, your doctor was shit, and if you are still with them, you should get another doctor. Doctors should always try to prescribe you something that isn’t pain killers to see if that works, and then if it doesn’t give you the pain killers (or move on to the next thing to try). But pain killers should be a last resort. Hell, I was in a car accident and my doctor gave me prescription strength anti-inflammatories before she wrote a script for Vicodin. You also want to have a doctor that doesn’t view seeing you as a waste of time, and is as enthusiastic as you are to find out what the core issue is. They should also know their limits, and have the ability to say “I don’t know, so let me refer you to someone who does.”

@papayalily Yes, I understood the 40%. 40% seems high to me. Worth checking probably more often than it is. Too many women have to go to an RE before they are diagnosed correctly with PCOS from people I have talked to. If they are not trying to get pregnant a GYN puts them on the pill. If they want to get pregnant they might get put on chlomid, and then when it doesn’t work on to an RE where the RE does the more extensive hormonal and sugar testing. GYN’s in my experience do not do day 3 testing to evaluate a woman’s hormones in relation to fertility, they just look for in range hormonal tests. I can’t understand why GYN’s are not a little more familiar with some of these tests. I am not talking about GP’s or internists, that I can understand.

I know how a woman’s cycle works, I know that we have 8–12 follicles more or less, and one develops to pop out mid month. I was a fertility pt, I have seen my follicles many times on the ultrasound screen. I am not a PCOS patient, I cycle perfectly, I have never had an ovarian cyst, except for a leuteal cyst during a pregnancy.

We are agreeing that the pill stops the egg from maturing and popping out. But, if you have PCOS associated with an insulin problem, taking the pill will not help your sugar problem. But, addressing the sugar problem might just help the ovulation problem. That is why in that case I consider the sugar problem the underlying problem. If you get rid of the cyst problem with the pill and stop investigating the pt might be insulin resistant for years unchecked and unknowing.

I went to over 10 doctor, lost count, over 8 years of significant daily pain. I was very symptomatic and my symptoms screamed infection, but nothing cultured, and so they assumed, I guess, that I was wrong, even though some very specific antibiotics relieved my symptoms while taking them. Your know Chlamydia back 40 years ago was thought to be normal flora, and everyone used to blame the patient for not dealing with stress well, and eventually science found that the majority of stomach ulcers are caused by a bacteria. And, all of those children in Lyme, CT were supposedly just devoloping childhood arthritis, until mothers pushed enough to insist on research and they figured out it was an infection carried by a tick. My experience is that medical science prefers to not think things are not infectious for some reason, and so I suffered. I understand that doctors are kind of in a tough spot, that they can’t treat something if it is not standard practice or if they don’t have acceptable supporting documentation for why they are treating, because they put themselves, their medical license, at risk, or risk of being sued.

@JLeslie Are you saying that PCOS is caused by insulin resistance, or insulin resistance is a symptom of PCOS? The patient may or may not be insulin resistant, the doctor probably tests based on whether or not there is any reason to think that they might be. In my case, there wasn’t, so they didn’t test for.

I’m not getting the problem with going to a reproductive endocrinologist, especially if that patient’s gyno has their plate full with annual pelvic exams or doesn’t know much about that disorder.

I get that the people you talked to weren’t diagnosed as quickly as they feel they should have been, but shouldn’t that be blamed on the doctor’s they were seeing for not being good doctor’s instead of the underlying science?

@papayalily It seems that correcting the sugar problems does correct the ovulation problems, so yes, I am saying in those cases the ovarian problems are a symptom of the sugar problem. See that is where I disagree, I think women are not being tested when they should be for possible sugar problems. From what DrDredd said PCOS is not always present along with insulin resistance, which I am willing to accept as a given, but I also think we don’t really know how often it is the cause because it is not tested for consistently. Like how so many people are vitamin D dificient now that we are finally testing people for it.

The problem with going to an RE is…if you are not trying to get pregnant you never go to one. It seems reasonable a GYN would know about the disorder they are treating it after all. It is just a blood test, it does not really take more of the doctors time.

I did a quick google and here is one article on a fertility site stating what I am saying http://www.sharedjourney.com/articles/insulin.html and this has more info go down to where is says PCOS a few paragraphs down http://responsescientific.com/insulin-resistance/

Your last sentence seems to contradict the paragraph above it. You are saying GYN’s should not have to know or do that testing, and then you are blaming a specific doctor for not being a good doctor. I don’t think it is the doctor not being a good one, I think -he/she/they are just following standard practice.

@JLeslie No, I’m saying that what your friends went through isn’t standard practice, at least not with competent doctors. I am, however, saying that sometimes a GYN is more of a basic caregiver since so many family doctor’s don’t do pelvic exams, and others are much more into reproductive disorders, so if you have the first, you should go see an RE.

@papayalily Well, I’m glad if it is true that GYN’s do test for it. But, again, no one goes to an RE unless they are infertile and trying to get pregnant. Well, at least no one I know. And, I wonder how a patient knows which type of GYN they go to according to your descriptions? My impression is most GYN’s are OB’s and what they are best at is taking care of healthy patients, pregnant patients, and delivering babies.

I have a looooonnngggg list of doctor screw ups and misses that have happened to me or family members. To keep saying a particular doctor isn’t good, I don’t know if I really can accept that explanation, because there are so many. My father being prescribed two drugs by the same doctor that are black box contraindicated. My mother being prescribed for a second time a colonoscopy prep that she told the doctor gave her uncontrollable high blood pressure for two days afterwards, which he ignored, and we figured it must be due to the electrolytes and when I looked up the drug for her it was contraindicated with her blood pressure medicine, I could go on and on, but I won’t, with misdiagnosis, all sorts of shit, it’s annoying. The only way I handle it mentally is by lowering my expectations, which is kind of the opposite of what you are saying.

I get the impression you were not aware of the theory that insulin resitance is, or might be the underlying cause for PCOS.

Are you a doctor?

@JLeslie I’ve heard it that it might be the cause for some women, which is different that the definitive cause for all cases of PCOS. I’ve also heard many other theories on what might be the cause, including genetics and pollution, and I don’t think doctor’s should necessarily cater the theory de jour to the extent of doing tests that they have no other reason to do, especially if putting the patient on insulin drugs will cause severe side effects for the patient and OCP is a milder but just as effective way to do it (and one they might already be taking).

Some RE’s do specialize in fertility, others specialize in other things. It’s a matter of finding one who specializes in things like PCOS and endometriosis.

There are a lot of shit doctors. Doesn’t make them any more crap just because they are in abundance. Just like wine – there are a lot of wines that come in boxes, but it doesn’t mean that they aren’t still crap or that Dom Perignon isn’t freaking fantastic.

You find a good doctor by asking for referrals, from a doctor you see and already like, from a friend, from online communities. You specify what you are looking for (for me, they have to be female and they have to be sensitive to trauma). Sometimes, the most knowledgeable or the one with the best surgery hand won’t have the best bedside manner, and you have to decide what’s more important to you.

I’m not a doctor, but hung out with them my whole life, so I have a pretty good feel for the community.

I’ve lost prescriptions before and I’ve had my pharmacy replace it.

@JLeslie I went to an RE and I wasn’t trying to get pregnant. I was having hirsutism and irregular periods (the latter especially was driving me crazy), so I went to a specialist at the med school I wound up attending 10 years later. :-)

@papayalily I do not disagree with what you said regarding insulin not necessarily being the cause. Like I said it is a theory so I realize it is not proven, and I also said I accepted @Dr_Dredd‘s statement that addressing insulin problems does not always fix ovulation problems, even when there is insulin resistance I realize it isn’t perfect. I just think it is overlooked a lot. And, I would not want to jump to drugs either, but learning about diabetes and that a diet change might help would be worth trying I think, just to see what happens. If nothing changes in a few months, then nothing changes.

@Dr_Dredd I realize any patient can go to a RE, but I think most women have no idea there is a specialty called Reproctuctive Endocrinology unless they have fertility problems. In fact I bet the majority of women think GYN’s treat infertility generally. You know better because you have better access to the knowledge. Your pts have the advantage that you have the condition so you would be more likely to recommend the specialty if you did not have luck treating them succesfully, and I would bet you are much more up on PCOS and related disorderd than many of your peers.

While living in Memphis I decided to seek a new RE, so when I had an appointment at my GYN’s office I asked one of the nurses if she knew what Reproductive Endocrinologist my doctor usually refers fertility patients to, and she had no idea what the specialty is. She is a nurse in a OBGYN office. I know it is not really her job to know or refer, but I still find that dissappointing.

Guess what? I did what @papayalily said to do in the very first comment and today at work I was reading my book and I noticed that my old, lost package of pills was lodged in between the pages of the book. I guess when I took my Pill and threw the package back into the inside of the purse it fell into a space between the pages. All of that for nothing.

Now that I have my old package should I just skip the pills on that one that I’ve been taking on the new package and just go back to taking the old package so I dont have to deal with all of this crap of making sure I get my period? Then can I just throw out the new package I opened and continue as normal with the old package?

Its kind of a waste but…

@desiree333 Ok, so take the old package, skip ahead however many days it’s been (3, I think?), and just continue on the old package as if you had never lost it. Then, punch out those 3 pills from the days you skipped on the old package, and put them in the new package (if it were me, instead of putting them in the new package where they might fall out, I’d just grab a plastic baggy and throw the 3 pills and the new package in there). Then, after your period, just grab the new package, and take it as you regularly would, including those 3 pills. Then you haven’t wasted anything!

I agree with @papayalily why waste the pills, but I would not punch them out, because you might lose them and they have more chance of something happening to them, because the pill will be exposed. Just hold onto both packets and use up the pills,

@Dr_Dredd I just realized you went to the RE 10 years later when you were in med school, and I am betting your doctor never had mentioned you could see an RE or you would have gone sooner. I wonder was the RE able to help you better than your GP or GYN? Or, at mininum give you better understanding or insight about what was going on with your hormones and condition? Why did it take so long for you to see that specialty? I think you might be proving my point that women don’t even know about that specialty.

@JLeslie Actually, I saw her when I was 16, ten years before I went to med school. To be honest, I never asked my pediatrician or regular ob/gyn about it. My mother had infertility issues which were probably related to PCOS, and she’d seen the same doctor. When I stopped getting periods at age 16, off I went to see this doc.

I’m not sure if the pediatrician or ob/gyn would have been better or worse at explaining the issues to me, because I never gave them the chance. :-)

@Dr_Dredd I See. So you benefitted from your moms experience. Makes sense.

@JLeslie Yeah, we had a pretty good idea of what was probably going on. It’s amazing, isn’t it? Medicine has progressed to a point where infertility is hereditary. ;-)

@Dr_Dredd Oh, I am way beyond that. I think there are rheumatological type of things at work with some types of infertility, and infectious that is not understood. But, I don’t know of any new research on those fronts.