What should you do if you miss a birth control pill?
There are two types of birth control pills:
Whether or not you need to use back-up protection or the emergency contraceptive pill (also called Plan B) can depend on whether you're taking a progestin-only pill (also called the mini-pill) or the combined pill. This is because for the mini-pill, if you take it more than 3 hours late, that counts that you missed it. Essentially, you have a 3-hour grace period.
If you’ve missed 1 combined birth control pill: Doctors say that if you miss one combined pill, you should take the late or missed pill as soon as you realize. You really don't have to worry about getting pregnant. Simply continue taking your pills as normal.
If you’ve missed 1 mini-pill: Take it as soon as you remember. You should use a backup contraceptive method like condoms until you take your mini-pill correctly, on time, for 2 days in a row. The CDC has more information on mini-pills here.
What to do if you've missed 2 or more birth control pills
Here's when you want to be extra careful. The CDC says to take the most recent missed pill as soon as possible (throw away any other pills you've missed). Continue taking your pills as normal, but your chances of getting pregnant are greater now. You should use back-up contraception like condoms (or not have sexual intercourse) until after you've taken your active pills for 7 days in a row. If you've missed a pill, either the combined contraceptive pill or the mini pill, we have pretty detailed information for you below on what to do if you miss your combined contraceptive pill or mini-pill.
More detailed instructions for combined pills
After you've missed your contraceptive pill, we always advise you to follow the instructions in your pill packet and, if needed, speak to your doctor or healthcare provider.
However, we've put together a detailed guide to help you decide the right course of action if you forget to take your contraceptive pill over 1, 2, or 3 days. Here are some names of different types of combined birth control pills:
Apri™: The generic versions of Apri are Cyred EQ™, Emoquette™, Enskyce™, Isibloom™, Juleber™, and Reclipsen™.
Ortho-Cyclen™: The generic versions of Ortho-Cyclen are Estarylla™, Feonynorm Mono-Linyah™, Mononessa™, Previfem™, Sprintec™, VyLibra™.
Lutera™: The generic versions of Lutera are Vienva™, Aubra EQ™, Aviane™, Larissia™, Falmina™, Lessina™, Orsythia™, Sronyx™.
There are even more brands, but we've listed some common ones above.
1. Doctor's advice for missing 1 combined pill
If you've missed only 1 combined contraceptive pill: Take the last pill straight away and, if needed, the current pill too. It's okay to take 2 pills in one day. Continue taking the rest of the pills as usual. You should not have to worry about getting pregnant the next time you have sex.
If you're set to have a monthly period, then take your 7-day break or your inactive pills as usual. Or, if you're not planning to get your monthly period, you can skip the inactive pills and move on to the next pack. You don't need to use a condom or any other form of additional contraception if you don’t need to worry about STIs.
2. Doctor's advice for missing 2 combined pills
Missing 2 birth control pills increases the chances of ovulation, especially at the start of a new pack.
If you've forgotten to take 2 of your combined pills: Take the last missed pill, even if this means taking 2 pills in one day. Don't take any other missed pills. Then, continue taking the rest of your pill pack as directed. Remember to use back-up contraception, such as a male or female condom, for the next 7 days. Take emergency contraception if you've had unprotected sex within the first week of a new pill packet.
If your missed pills are in week 3 of your pack (week 3 is the week before you get your monthly period. Or if you're not set to get your monthly period, this would be the week before starting your new pack if skipping your period), start a new pack at the end of the 3rd week. If this isn't possible, use condoms or another form of contraception, or don't have sexual intercourse until you can begin taking the combined pill again.
3. Doctor's advice for missing 3 combined pills
Missing 3 birth control pills increases the chances of ovulation, especially at the start of a new pack.
If you've forgotten to take 3 of your combined pills: Take the last missed pill, even if this means taking 2 pills in one day. Don't take any other missed pills. Continue taking the rest of your pill pack as normal. Use back-up contraception, such as a male or female condom for the next 7 days. Take emergency contraception if you've had unprotected sex within the first week of a new pill packet.
If your missed pills are in week 3 of your pack (a week before you take a break or take your dummy pills), start a new pack at the end of the 3rd week. If this isn't possible, use condoms or another form of contraception, or don't have sex until you can begin taking the combined pill again.
Detailed instructions for Progestin-Only ("Mini Pill"):
There are two types of Mini-Pills: one which contains an ingredient known as norethindrone and another that contains desogestrel. Favor pharmacy only carries the mini-pill that contains norethindrone, which is named Ortho Micronor™ (Heather, Jolivette, Nora-Be, Sharobel, Tulana).
1. Doctor's advice if you miss 1 mini-pill
If you've missed taking 1 of your mini pills: The first thing to do is to find out whether your pill contains desogestrel, as the advice will vary depending on which type of pill you have. You can find this information on the packet that came with your pills, using our table below, by asking your pharmacist, or your doctor.
According to the National Health Service (NHS), if you forget to take a traditional mini pill within a 3-hour window period of when you'd normally take the pill, then you can simply take the pill without worrying about pregnancy.
A study highlighted that, if taking the mini pill containing desogestrel, you have a 12-hour window period to take your pill to ensure that you're protected against pregnancy.
If you're within the 3-hour or 12-hour window period, depending on which pill you're taking, then follow this advice:
If you remember to take your pill and it's over the 3-hour or 12-hour window period, you are not protected against pregnancy and should follow the advice below:
It's important to read the pill label and leaflet that came with your mini pills as it may state that you need to use condoms for 7 days after taking your last pill, as it takes the mini pill 7 days to stop ovulation.
It's also possible to experience breakthrough bleeding or spotting when you've missed a contraceptive pill; this should settle down within a few days. If the bleeding continues, then speak to your nurse or doctor.
2. Doctor's advice if you miss 2 mini-pills
If you've missed taking 2 of your mini pills: You are not protected against pregnancy and should follow this advice:
It's important to use extra protection for the next 2 days (48 hours) or not have sex. After you've taken your mini-pill correctly, on time, for 2 days in a row, you don't need to use back-up contraception like condoms or avoid having sex.
It's important to read the pill label and leaflet that came with your mini pills as it may state that you need to use condoms for 7 days after taking your last pill.
3. Doctor's advice if you miss 3 mini-pills
If you've missed taking 3 of your mini pills: You are not protected against pregnancy and should follow this advice:
It's important to have a look at the pill label and leaflet that came with your mini pills as it may state that you need to use condoms for 7 days after taking your last pill.
What side effects might you notice if you miss your hormonal pills?
When you miss an active birth control pill you might experience breakthrough bleeding or spotting. This is nothing to worry about and should settle down once you begin to take your contraceptive pill again regularly. You may also just get your period early, which could come with symptoms like nausea or period cramps.
What if you’re missing pills regularly?
If you're struggling to remember to take your contraceptive pill, you may want to consider other birth control options, such as:
What if you forget to take out or reinsert a vaginal ring?If you're late with re-inserting the ring by more than 2 days, you should insert the new ring as soon as possible.
Keep the ring in until you're scheduled to remove it. As a precaution against unintended pregnancy, you'd need to use back-up contraception like condoms, or not have sex, until your ring has been in place for 7 days in a row. For more details, read up on what to do if you forget steps with vaginal rings (Nuvaring®, Annovera™) from the Center for Young Women's Health.
Ways to stay on schedule with birth control
If you're forgetting to take your birth control pills every day, you're not alone. It happens to everyone on birth control at some point or the other.
But there are things you can do to help you remember to take your pill:
Wrapping it up
Realizing you've missed a birth control pill can be a confusing and worrying time. The guidance can vary for each type of pill, especially between the combined pill and progestin-only pill.
However, following the advice given in this post and the leaflet that accompanies your pill packet, you can take action to prevent unintended pregnancy.
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