Women's Health Community

Dear An: Yes, that can certainly happen, and it would not impact the effectiveness of your birth control pill.

For those women who have very irregular bleeding patterns (eg lots of spotting episodes) it can be difficult to know which of those episodes are your "real" period. In that instance starting your BCP at a random time would be the same as the "Quick Start" regiment for initiating BCPs. Here is some information about this:

Obstet Gynecol. 2007 Jun;109(6):1270-6. Links

Initiation of oral contraceptives using a quick start compared with a conventional start: a randomized controlled trial.

Westhoff C, Heartwell S, Edwards S, Zieman M, Cushman L, Robilotto C, Stuart G, Morroni C, Kalmuss D.
Department of Obstetrics and Gynecology, Columbia University, New York, New York, USA.

OBJECTIVE: To estimate whether young women taking the first pill on the day of prescription had higher continuation rates and lower pregnancy rates than women who waited until menses to start the oral contraceptive pill (OCP). METHODS: We recruited 1,716 women aged younger than 25 years seeking to initiate the oral contraceptive at three publicly funded family planning clinics, and randomly assigned them to conventional initiation of the pill (conventional start) or immediate, directly observed ingestion of the first pill (quick start) during the clinic visit. Women underwent follow-up interviews at 3 and 6 months. RESULTS: Sixty percent of participants discontinued the pill, and 8% became pregnant during follow-up. Women who took the first pill in the clinic were more likely to continue to the second OCP pack (odds ratio 1.5, 95% confidence interval 1.0-2.1.); however, the Quick Start approach did not improve OCP continuation rates at 3 and 6 months. Those assigned to Quick Start were slightly less likely to become pregnant within 6 months from the time they started the pill (hazard ratio 0.90, 95% confidence interval 0.64-1.25). Eighty-one percent of women rated the Quick Start approach as acceptable or preferable to waiting. Rates of serious adverse events were low and similar in the two groups. CONCLUSION: Protocols that require a woman to wait until the next menses to start hormonal contraceptives are an obstacle to contraceptive initiation. Directly observed, immediate initiation of the pill improves short-term continuation.

To do "Quick Start" one first has to be assured that they are not pregnant. The BCPs can be started at anytime but must be followed by a seven day usage of a reliable back up method. If there has been any unprotected sex one needs to do a pregnancy test two weeks after starting the "Quick Start" regimen.

Bottom line, if you started on a day when you generally expected a period to arrive, having your flow be shortened is not a problem.

Yours,
Jane