I've been taking a 21 pill birth control pack continuously. Am I an idiot?

[SevereAgony]

For almost three months, I have been neglecting to take the week long break I was supposed to after each pack. I had no idea. I've never used oral contraceptives before and my Gynecologist didn't explain this to me. There are no placebos or inactive pills in my packs, just 21 actives.

Do I finish up this last pack then wait a week to start a new one? I still had a period regardless and I'm cramping terribly. Am I just wasting pills?

[AnnieBrooke]

Yes, you're (over)due to take a week's break from the pills and let yourself have a period, to clean out your uterus. Go ahead and take that break. You haven't hurt yourself, but stop the pills now for a week. Also, take Advil, it might be a crampy period.

It's unusual that you had a period even though you kept taking the pills. Because that happened, you should do a couple of things: talk to your doctor about getting a stronger pill, and take a pregnancy test. Bleeding while on the pill is an indicator that the pill doesn't give you enough of a hormone load to be effective as birth control.

The pill works by giving you enough hormones that your body is fooled into thinking you're pregnant and stops ovulating. If your body was doing its natural thing enough to have a period, you might also have ovulated during the three months. If you've been having sex in that time, since the pill seems to have been too light a dose for you, get a home pregnancy test to check if you're pregnant.  

[SevereAgony]

Thank you. It's a low-dose pill, though I read that doesn't necessarily make it more ineffective, but I'm still pretty much bleeding and ovulating at the expected times (barring the breakthrough bleeding, of course). Given those symptoms, I worry that if I do take the expected break I'm going to wind up pregnant.

I'll start the break now and see if I menstruate properly. I don't want to waste more pregnancy tests over my paranoia, but I'll keep that in the back of my mind. Again, thank you.

[AnnieBrooke]

If you don't want to talk to the doctor about this (though it's hard to see why you would avoid it), call the pill company and ask them. Being low dose wouldn't make a pill ineffective if it is doing what it is supposed to do, but if you are bleeding, the pill is not doing what it is supposed to do. This suggests it is ineffective. And if you are convinced you are also ovulating, you need to be on some other kind of birth control. (Even if you are taking the pill.) In short, if you *know* you've been ovulating  because you've taken an ovulation test and found you are, then your birth-control pill is not actually doing anything for you, and you should treat the situation as though you have no protection.