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Missed Birth Control Pill: What Does This Mean?

Blog Birth Control

Missed Birth Control Pill: What Does This Mean?

March 26, 2018 Read Time - 9 minutes

About Author

Laurel is a linguist at heart and studying to become a Certified Spanish Interpreter and Translator. She believes in making quality healthcare accessible, and is proud of PlushCare's mission to do so.

Missed Birth Control Pill: What Does This Mean?

Birth control pills, also known as oral contraceptives, are most effective if taken at a consistent time each and every day. But life can be unpredictable – maybe you were stuck in traffic, your reminder didn’t go off, or you just plain forgot to take your birth control pill. Read on to learn what to do if you miss a birth control pill, how the risk changes with number of missed pills, as well as common questions and concerns associated with a missed birth control pill.

How does birth control work?

To understand what your body is experiencing when you forget to take a birth control pill, it is helpful to discuss the different types of hormonal birth control pills, how a birth control pill interacts with your body and how the hormones work to prevent pregnancy in the first place.

There are dozens of varieties of birth control pills available with a prescription from a healthcare provider. All birth control pills contain varying levels of the hormones estrogen and progestin, which are released into a woman’s body to prevent pregnancy. The main functions of the hormones in birth control pills are to halt ovulation, which prevents the release of an egg from the ovary, and to thicken the mucus surrounding the cervix, which keeps sperm cells from reaching the eggs. Birth control pills work by minimizing the chances of fertilization, which thus reduce the risk of pregnancy.

Hormonal birth control pills have been developed for over 50 years, and are designed to work for a variety of body types. However, many women will experience varying side effects. Dialogue with your doctor is important to ensure you are taking the best form of birth control for your body and lifestyle.

To know what to do if you miss a birth control pill, it is necessary to know which type of pill you are taking, as the responses for one or more missed pills vary depending on the type and brand of your birth control pill.

Combination Pills

Combination pills are the most common variety of birth control pills. Combination pills contain both of the hormones estrogen and progestin. This type of birth control pill is available in 28-day packs, which contain 21 “active” pills and 7 “inactive” or sugar pills, and 21-day packs, which are all “active” pills. In the 28-day packs, 21 of the pills contain hormones, and 7 of the pills do not.

Combination pills are also available in extended-cycle packs of 84 active and 7 inactive pills.

Common brands of combination pills are:

  • Yaz
  • Yasmin
  • Apri

Combination pills are the most effective in protecting against pregnancy because they simultaneously stop the process of ovulation and thicken the mucus layer surrounding the cervix. This double-action prevention makes combination pills 91% effective against pregnancy if used correctly and consistently. But what do you do when life happens, and you (oops!) forget to take a birth control pill?

So You Missed a Birth Control Pill… (Combination Pill)

Maybe you fell asleep early last night, or stayed up late to study for that final exam… and you forgot to take a birth control pill.

What you should do depends on

  • How many pills you haven’t taken on schedule (how many you’ve missed)
  • What part of your cycle you are in

If it has been 24 hours or less since you should have taken your last birth control pill (you have only missed one birth control pill), you are still most likely protected against pregnancy.

What to do if you’ve missed one pill:

  • Take the pill you missed as soon as you remember – even if this causes you to take two in the same day.
  • Continue on your daily schedule
  • Choose to begin your seven days of inactive pills (or begin your seven day break)
  • Check the packaging of your birth control pills for additional information

If it has been 48 hours or less since you should have taken your last birth control pill (you have missed two birth control pills), your protection against pregnancy may be compromised.

What to do if you’ve missed two birth control pills:

Take the pill you missed most recently
Tomorrow, take two pills (to account for the pill you missed the first day)
Continue on your daily schedule
Begin using a secondary form of birth control (such as condoms) to ensure your protection against pregnancy
Check the packaging of your birth control pills for additional information

What to do if you’ve missed three birth control pills or more:

  • Take the pill you missed most recently as soon as you realize
  • Do not take additional pills in the following days
  • Continue on your daily schedule
  • Use secondary form of birth control (condoms), and consider using emergency contraceptive if you have had unprotected sex in the past 2-3 days
  • Call your doctor to ask what action you should take

*If you have missed two or more birth control pills, and there are seven or more pills left in your monthly pack, finish the month as usual, taking your seven days of inactive pills, or a seven day break (depending on which method you are using).

*If you have missed two or more birth control pills, and there are less than seven pills left in your monthly pack, begin taking the active pills in your next month’s pack, and skip your seven day break.

Progestin-Only or “Minipills”

If you are not taking combination pills (both estrogen and progestin), you may be taking progestin-only pills, also known as “minipills.” If your body does not react well to estrogen, you are most likely taking a minipill form of oral contraceptive.

The most popular brands of progestin-only birth control pills are:

  • Micronor
  • Nor-Q-D
  • Camila

Progestin-only pills, like their combination counterparts, are designed to thicken the mucus lining of the cervix, thus preventing sperm from fertilizing an egg. However, Progestin-only contraceptive pills are less effective in stopping ovulation, which slightly increases the risk of becoming pregnant. This also means that timing is more sensitive if you miss a progestin-only pill than if you miss a combined pill. Use this guide if you are taking progestin-only birth control pills.

So You Missed a Birth Control Pill… (Progestin-Only Pills)

If it has been three hours or less since you should have taken your last birth control pill (you have only missed one birth control pill), you are still most likely protected against pregnancy.

What to do if you’ve missed one pill:

  • Take the pill you missed as soon as you remember
  • Take tomorrow’s pill at the normal time
  • Continue your regimen as usual
  • Check the packaging of your birth control pills for more information

If it has been three hours or more since you should have taken your last birth control pill, you protection against pregnancy is compromised. It takes up to 48 hours for a progestin-only pill to build up the mucus lining of your cervix, which means that you are more susceptible to pregnancy if you miss taking one of these pills.

What to do if you’ve missed 2 birth control pills or more:

  • Take the pill you missed as soon as you remember
  • Take tomorrow’s pill at the normal time
  • Continue your regimen as usual
  • Call your doctor for what action to take
  • Be sure to use a secondary form of birth control (condoms) for at least a week after you have missed two birth control pills
  • If you have had unprotected sex in the past 2-3 days, consider using emergency contraceptive to ensure your protection against pregnancy.

*In the case of missed birth control pills (either combination or progestin-only) contact your doctor if you experience excessive bleeding or abdominal discomfort.
*

Risk of Pregnancy

One of the most common questions that arises is If I missed one birth control pill, can I get pregnant?

The simple answer is that your risk of pregnancy increases when you forget to take a birth control pill. As described above, the timing is more sensitive if you take a progestin-only pill than if you take a combination birth control pill. In either case, your risk of pregnancy increases as the time from your last scheduled pill increases. That is to say, the more pills you forget, the higher your risk of pregnancy. If you miss a birth control pill, it is a wise precaution to use secondary birth control, such as a diaphragm or condom, for up to a week after your missed pill(s) to reduce your risk of pregnancy.

Missed Period on Birth Control Pill

Other common questions related to birth control pills are concerns about missed periods. When a woman takes hormonal birth control pills, it is not uncommon to experience a missed or very light period. You are most likely not pregnant if you are consistent in taking your pills and have missed only one or two periods.

However, if you miss periods for more than three months, you should contact your doctor to discuss expectations of your birth control pills and which brand is best for your body. Many women try several brands of birth control pills before they find the best fit. Many doctors recommend allowing at least three months for your body to adapt to a new brand of birth control pills before you change your regimen.

Solutions for Consistently Missed Birth Control Pills

Some people have difficulty purchasing refills for their birth control. Perhaps you work late and the pharmacy closes early, or your pharmacy has limited hours. Increasingly, birth control prescriptions and refills are available online, and can be sent either to your pharmacy or home at your convenience. If you miss birth control pills for these reasons, you may consider purchasing your birth control pills through a licensed online healthcare app or healthcare provider. Sites such as PlushCare offer communication with doctors who can help you determine which birth control method is right for you, in a platform that is convenient and can work with your schedule.

If you find that the consistency of taking birth control pills is not compatible with your lifestyle – if you often forget to take pills or are not able to take pills at the same time every day – you may want to consider alternative types of birth control.

Most PlushCare articles are reviewed by M.D.s, Ph.Ds, N.P.s, nutritionists and other healthcare professionals. Click here to learn more and meet some of the professionals behind our blog. The PlushCare blog, or any linked materials are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. For more information click here.

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