Old blood on panties this morning - Was it the sex or the pill?

I've been taking the oral contraceptive pill to control my endometriosis for about 6 months now. In the first few months I skipped one pill and that was enough to start off my period (which is a problem because I'm supposed to skip the sugar pills in each packet so that I don't have one). Taking two the next day wasn't enough to fix it and in the end I gave in and took the sugar pill to reset my system.

A few weeks ago I missed a pill, took both the next morning, and was fine. A few days ago, I missed another pill and didn't realise until the next night. I took both pills, didn't notice any bleeding. Didn't notice any blood for the next few days of taking the pill either, until this morning I found some old blood on my panties, which is what happened last time I was spotting. Even though it was a few days ago that I missed the pill, I suspected it was probably missing the pill... until I thought about last night.

(Sorry to squeamish people.)

Last night my boyfriend and I used a toy that was about the size of a normal penis for once (instead of my usual one which is the size of a finger). It's the same size as his, anyway. It felt huge, and painful, and exactly like I imagined my first time to be. I wasn't expecting any bleeding because my hymen tore a while ago when I was dancing, but could it have done something anyway? I know if you're not careful with what you put in there you can tear things and I do feel pretty raw today.

What do you think, is it more likely to be tearing from what was basically like my first time, or was it missing a pill earlier in the week? I'd also appreciate if anyone knows what I should do if it's the pill, because I really don't want to go against my gyno's wishes and have a period again. (And I definitely don't want to go back to him because he has a long waiting list and a high pricetag.)