Can I take Trust pills even without menstruation?

Starting without a period

The Trust leaflet and many doctors say to start on the first day of your period, because that is the simplest way to be sure you are not already pregnant. But waiting for your period is not required. Starting on a random day is called a quick start (Starting a method on any day rather than waiting for your period, with backup for a few days.), and it is in the WHO Family Planning Handbook.^[src] It is useful when your period is irregular, when you are switching from another method, or when you simply do not want to wait weeks and risk a pregnancy in the meantime.

People also ask this when their period has stopped for months, for example after giving birth or because of PCOS. The answer is the same: the question is not "am I bleeding?" but "can I be reasonably sure I am not pregnant?"

The WHO checklist

WHO's handbook gives health workers a short list. If any one of these is true for you, and you have no signs of pregnancy, you can be reasonably sure you are not pregnant:^[src]

• You have not had sex since your last normal period.
• You have been using another reliable method correctly every time since your last period.
• You are within the first 7 days after the start of a normal period.
• You gave birth less than 4 weeks ago and are not breastfeeding.
• You gave birth less than 6 months ago, are fully or nearly fully breastfeeding, and your period has not come back.

One note on the last two: if you are breastfeeding, a combined pill like Trust is usually not the first choice in the early months. Ask about a progestin-only pill like Daphne (lynestrenol) instead.^[src] See Pwede ba sa nagpapadede ang Trust?

The 7-day backup rule

Trust needs 7 days of hormone pills in a row before it reliably stops ovulation. So if you start more than 5 days after your period began, or without a period, WHO says to use condoms or avoid sex for the next 7 days.^[src] Starting within the first 5 days of a period needs no backup. The When am I protected? tool shows your dates.

Start with pill one of the hormone row, the first light-colored tablet marked on the strip, not with a brown iron tablet. The brown tablets come last.

If you are not sure

If none of the checklist points fit you, for example you had unprotected sex in the last few weeks, take a pregnancy test first. A test costs from ₱64.75 and needs no prescription. A very recent pregnancy may not show yet, so your doctor may suggest starting now with condoms and testing again later. WHO notes that combined pills do not harm a pregnancy if one has already started.^[src]

Your health center or a doctor can do this check with you in minutes, and pills are free at public facilities, subject to supply.^[src]