Switch her to a BCP that is available.

This is frequently an issue in operational settings. Because medical resources may be limited in these situations, it is often necessary to switch the patient to a different pill.

Since most women (90%?) will tolerate any BCP without difficulty, making a switch is usually uneventful and most women will not notice any difference. It is best to make the switch at the time the old pills would have been started (after the “off” week), but they can be switched at any time during the cycle.

It is possible but not common that they will experience some of the side-effects of nausea, spotting or breast tenderness during the first month of the switch. After the first month of the switch, these symptoms generally disappear. When this occurs, it is because during the switch, the patient’s ovaries lost their suppression and started producing ovarian hormones. This would not be expected to lead to a pregnancy (because of the other things BCPs do to prevent pregnancy), but could lead to a brief episode of increased hormone levels (the patient’s own hormones plus the BCP hormones).

Anticipate that some of these women will be reluctant to change pills, particularly if they have had good success with one pill for a long time or if they had difficulty finding a pill that worked well for them.