Health Guide — Birth Control Refills (Pill • Patch • Ring)
Birth Control Refills — Fast, Safe, and MEC‑Aligned
Safe refills start with MEC screening and a recent blood pressure (for estrogen methods). Avoid combined hormonal contraception (CHC) if you have migraine with aura, uncontrolled HTN, are ≥35 and smoke ≥15 cig/day, or have VTE/stroke/ischemic heart disease. If you don’t have a recent BP, consider a progestin‑only pill (POP) bridge while you obtain one. Use quick‑start and missed‑pill rules to stay protected.
Who this guide is for
Adults (18+) on pill/patch/ring who want to renew safely and understand when estrogen is not appropriate. This guide does not cover IUD/implant placement (we can refer locally).
What to prepare before your refill
Recent BP (≤12 months; optimal <140/90 for CHC).
Medical history: migraines (aura vs none), smoking status, VTE history, hypertension, diabetes with vascular disease, liver disease, breast cancer, postpartum/breastfeeding status, meds that induce enzymes (carbamazepine, phenytoin, rifampin, St. John’s wort).
Method & goals: cycle control, dysmenorrhea, acne, or period suppression.
Adherence notes: missed doses, spotting, side effects.
MEC high‑risk situations — avoid estrogen (choose POP or non‑hormonal)
Migraine with aura (any age).
Age ≥35 + smoking ≥15 cig/day.
Uncontrolled HTN (≥160/100), or vascular disease.
VTE/PE history, known thrombophilia, or high VTE risk (consult).
Ischemic heart disease/stroke, complicated valvular disease, lupus + antiphospholipid antibodies.
Breast cancer (current).
Postpartum <21 days (all), and <6 weeks if breastfeeding with VTE risk.
POP bridge: when and how
If you lack a recent BP (or CHC is temporarily contraindicated), norethindrone 0.35 mg daily is a solid bridge. Take at the same time daily (3‑hour window). Backup contraception if >3 hours late — take ASAP, continue next dose at usual time, and use backup for 48 hours.
Missed‑pill rules (quick reference)
CHC 1 pill late (<24 h): take now; continue pack; no backup needed.
CHC ≥2 pills missed: take the most recent pill now, discard others; continue pack; backup for 7 days. If in week 3, skip the placebo week and start a new pack.
POP >3 h late: take now, continue; backup for 48 h.
Consider EC if unprotected intercourse occurred after missed pills.
Patch & ring notes
Patch: reduced efficacy cautions at BMI ≥30 or weight >90 kg (varies by brand label).
Ring: keep refrigerated until dispensed (brand‑dependent); 3‑weeks in, 1‑week out, or continuous use if desired.
Red flags — seek in‑person/urgent care
ACHES: severe Abdominal pain, Chest pain/SOB, severe Headaches, Eye/vision changes, Severe leg pain/swelling (possible VTE).
Persistent heavy bleeding, new jaundice, focal neurologic deficits, or pregnancy concern.
How TeleDirectMD supports refills
We perform MEC screen + BP check, renew CHC/POP when eligible, or provide a POP bridge and BP capture plan. We share missed‑pill/quick‑start instructions and link to urgent care if ACHES symptoms occur.
Internal links
Levothyroxine refills online → /treatments/hypothyroidism-levothyroxine-refills-online
UTI treatment guide → /health-guides/urinary-tract-infection-uti-treatment-online
Migraine triptan refills → /health-guides/migraine-triptan-refills-online
Book your $49 MD video visit to renew birth control safely and get a plan for missed pills.
