Question:medium
Female missed OCP on 4 different days in 1st 2 weeks of menstrual cycle. What will you advice?
Female missed OCP on 4 different days in 1st 2 weeks of menstrual cycle. What will you advice?
Show Hint
When multiple pills are missed in the first two weeks, the key is to continue the pack while adding backup contraception rather than stopping or taking all missed pills at once.
Updated On: Jun 23, 2026
- Continue taking pill
- Take all 4 pills at once & continue taking pills
- Adopt another method of contraception
- Continue current pack, consider additional contraceptive method for remaining days
Show Solution
The Correct Option is D
Solution and Explanation
WHO Missed Pill Protocol -- Weeks 1 and 2:
When $\geq 2$ consecutive hormonal pills are missed (i.e., $\geq 48$ hours since a pill should have been taken):
Option analysis:
- Option B (take all 4 at once): incorrect -- causes nausea/vomiting and is not recommended
- Option C (abandon OCPs): too aggressive; mid-cycle discontinuation is not advised
- Option D: matches WHO guidance -- continue the pack AND use additional contraception
\[\boxed{\text{Continue current pack + additional contraceptive method}}\]
When $\geq 2$ consecutive hormonal pills are missed (i.e., $\geq 48$ hours since a pill should have been taken):
- Take the most recent missed pill immediately (discard others).
- Continue remaining pills at the usual scheduled time.
- Use $\textbf{backup contraception}$ (condoms) for the next 7 days.
- Consider emergency contraception if unprotected intercourse occurred in the previous 5 days AND pills were missed in Week 1.
Option analysis:
- Option B (take all 4 at once): incorrect -- causes nausea/vomiting and is not recommended
- Option C (abandon OCPs): too aggressive; mid-cycle discontinuation is not advised
- Option D: matches WHO guidance -- continue the pack AND use additional contraception
\[\boxed{\text{Continue current pack + additional contraceptive method}}\]
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