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OCP mechanisms of action and missed pillsFrom: Abbey (anonymous@obgyn.net)Wed, 10 May 2000 23:19:38 -0500 (CDT)
With combination pills, you usually get 7 pill-free or placebo pills- which is plenty of time for a follicle to develop, right? So, in theory, ovulation could occur during this period...does it usually? If so, how is there zero chance of getting pregnant during those 7 days? Is it because of the endometrial changes- shedding the lining, etc? If that's the case- then I don't understand why missing a pill- or even 2,3,4, or more- in the third week is a problem. All of the pill directions advise patients to immediately start a new pack if they miss more than one pill in the 3rd week...why? Why not just lay off the pills for 7 days, have an early period, and start a new cycle after the 7 days are up? Also, what exactly causes breakthrough bleeding in the third week? Finally, what happens to the endometrium when you take pills continuously without the placebos? Shouldn't this cause serious breakthrough bleeding?
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