Obstetrics & Gynecology>>>>>Human Sexuality and Contraception
Question 37#

No menses during 7 days following 21-day cycle of correct use.

For the situation involving oral contraceptives, select the most appropriate response.

a. Stop pills and resume after 7 days
b. Continue pills as usual
c. Continue pills and use an additional form of contraception
d. Take an additional pill
e. Stop pills and seek a medical examination

Correct Answer is B


Common side effects of birth control pills include nausea, breakthrough bleeding, bloating, and leg cramps. If these side effects are experienced in the first two or three cycles of pills—when they are most common—the pills may be safely continued, as these effects usually remit spontaneously. On occasion, following correct use of a full cycle of pills, withdrawal bleeding may fail to occur (silent menses). Pregnancy is a very unlikely explanation for this event; therefore, pills should be resumed as usual (after 7 days) just as if bleeding had occurred. However, if a second consecutive period has been missed, pregnancy should be more seriously considered and ruled out by a pregnancy test, medical examination, or both. Women occasionally forget to take pills; however, when only a single pill has been omitted, it can be taken immediately in addition to the usual pill at the usual time. This single-pill omission is associated with little if any loss in effectiveness. If two or more pills are omitted, the pill should be resumed as usual, but an additional contraceptive method (eg, condoms) should be used through one full cycle. Although most side effects caused by birth control pills can be considered minor, serious side effects do sometimes occur. A painful, swollen calf may signal a deep vein thrombosis.