Missed Birth Control Pill: What You Need to Know About Effectiveness

Missed contraceptive pill?

I have been taking the contraceptive pill for four months.
I took this pack for five days, but I forgot to take it on the sixth night.
On the seventh day, I remembered after more than 18 hours.
I took one pill to make up for it and then took another one at the regular time (which means I took two pills in one day at two different times).
Is this approach correct? Will it reduce the contraceptive effectiveness? Also, during the gap between stopping the previous pack and starting the fifth pill, I had unprotected intercourse.
Is there a chance of pregnancy? Should I use condoms for the next seven days, or can I continue without them since the effectiveness of the pill is maintained?

Xuan, 10~19 year old female. Ask Date: 2018/02/21

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I have been taking the contraceptive for four months.
I took the pack for five days, but I forgot to take it on the sixth night.
On the seventh day, I remembered after more than 18 hours, so I took one pill to catch up and then took another one at the regular time (which means I took two pills in one day at two different times).
Is this approach correct? Will it reduce the contraceptive effectiveness? (During the period from stopping the previous pack to starting the fifth day of the new pack, there was unprotected intercourse.
Is there a chance of pregnancy? Do I need to use condoms for the next seven days? Or can I continue without condoms since the effectiveness is maintained?)
Answer:
1.
This approach is correct and will not reduce contraceptive effectiveness.
2.
There is no chance of pregnancy from the unprotected intercourse between stopping the previous pack and starting the fifth day of the new pack.
3.
There is no need to use condoms for the next seven days.
4.
The contraceptive effectiveness is maintained, and you can continue without condoms.

Reply Date: 2018/02/21

More Info

When it comes to missed birth control pills, it’s essential to understand how this can affect the effectiveness of your contraceptive method. Birth control pills, particularly combination pills, work by maintaining consistent hormone levels in your body to prevent ovulation. Missing a pill can disrupt this hormonal balance, potentially leading to ovulation and an increased risk of pregnancy.

In your case, you mentioned that you missed a pill on the sixth day of your cycle and took it more than 18 hours late. According to most guidelines, if you miss a pill and take it within 24 hours, you should still be protected from pregnancy. However, since you missed it by more than 18 hours, it is crucial to consider the following:
1. Immediate Action: You did the right thing by taking the missed pill as soon as you remembered. However, taking two pills in one day (the missed one and the one scheduled for that day) is generally acceptable, but it can sometimes lead to side effects such as nausea or breakthrough bleeding.

2. Effectiveness: After missing a pill and taking it late, the effectiveness of your birth control may be compromised, especially if you had unprotected intercourse during the time you were not fully protected. Since you mentioned having unprotected sex after the previous pack and before starting the new one, there is a possibility of pregnancy, depending on when you ovulated.

3. Backup Contraception: It is advisable to use backup contraception, such as condoms, for at least the next seven days after missing a pill, especially if you had unprotected intercourse during the time you missed the pill. This precaution helps ensure that you are protected against unintended pregnancy while your hormone levels stabilize.

4. Pregnancy Testing: If you experience any signs of pregnancy, such as a missed period, nausea, or breast tenderness, it would be wise to take a pregnancy test. If you have concerns or experience unusual symptoms, consulting with your healthcare provider is recommended.

5. Future Pill Management: To avoid missing pills in the future, consider setting reminders on your phone or using a pill organizer. Consistency is key with birth control pills to maintain their effectiveness.

In summary, while you took the necessary steps after missing a pill, the risk of pregnancy may still exist due to the timing of unprotected intercourse. Using backup contraception for the next week is a prudent measure to ensure protection. If you have further concerns or questions about your birth control method or potential pregnancy, it’s always best to consult with your healthcare provider for personalized advice.

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