What to Do If You Miss a Birth Control Pill: Expert Advice

Missed birth control pill?

I have been taking birth control pills for over six months, but I think I forgot to take one the day before yesterday and didn't realize it.
I took a pill as usual yesterday, and today I just realized that I missed a pill.
Should I take an extra pill today, and will it still be effective?

Zhou, 20~29 year old female. Ask Date: 2021/09/03

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello,
Each type of combined oral contraceptive pill comes in different formulations.
It is important to take the contraceptive pills as directed.
If you forget to take a pill, you should take it as soon as you remember, and continue taking the next pill at the usual time.
If more than 12 hours have passed since the missed dose of an active pill, in addition to taking the missed pill, it is advisable to use an additional barrier method of contraception for the next seven days.
If more than 24 hours have passed since the missed dose, you should stop taking the current pack of pills for seven days (including the days you missed) and then continue with the next cycle.

Combined oral contraceptives (COCs) must be taken at the same time every day, and correct usage can achieve a 99% effectiveness rate in preventing pregnancy.
If you miss a pill and do not experience the expected withdrawal bleeding during the placebo period, you should consider the possibility of pregnancy.

Thank you! Wishing you safety and health.

Dr.
Chang

Reply Date: 2021/09/03

More Info

Missing a birth control pill can be concerning, especially if you've been diligent about taking your medication consistently. Here’s what you need to know and do if you find yourself in this situation.

First, it’s important to identify what type of birth control pill you are using: combination pills (which contain both estrogen and progestin) or progestin-only pills (often referred to as the "mini-pill"). The response to a missed pill can vary depending on the type.

1. Combination Pills: If you miss one pill, take it as soon as you remember. If you remember on the same day, you can take it along with your next scheduled pill. If you realize you missed a pill the next day, take the missed pill immediately and continue with your regular schedule. You may experience some irregular bleeding or spotting, but this is usually not a cause for concern. If you miss two or more pills, the guidance can differ based on the week of your pill pack:
- Week 1: Take the missed pill as soon as you remember and continue taking the rest of the pills as scheduled. Use backup contraception (like condoms) for the next seven days.

- Week 2: Take the missed pill and continue as usual. You should still be protected from pregnancy if you have taken the previous pills correctly.

- Week 3: If you miss a pill, take it as soon as you remember. If you miss two pills, you may need to skip the placebo pills and start a new pack immediately after finishing the active pills. Again, use backup contraception for seven days.

2. Progestin-Only Pills: These pills need to be taken at the same time every day. If you miss a pill by more than three hours, take it as soon as you remember. If you miss it by more than 12 hours, you should take the missed pill and use backup contraception for the next 48 hours.

3. General Advice: Regardless of the type of pill, if you have unprotected intercourse after missing a pill, there is a risk of pregnancy. If you are concerned about this, consider consulting with a healthcare provider about emergency contraception options.

4. Future Prevention: To avoid missing pills in the future, consider setting a daily alarm or using a pill organizer. Some women find it helpful to link taking their pill with another daily routine, such as brushing their teeth or having breakfast.

5. Consult Your Healthcare Provider: If you have any doubts or if you frequently forget to take your pills, it may be worth discussing alternative contraceptive methods with your healthcare provider. Options such as the patch, ring, or long-acting reversible contraceptives (like IUDs) may provide more reliable protection without the daily commitment.

In summary, if you missed a birth control pill, take it as soon as you remember, and follow the guidelines based on the type of pill you are using. Always consider using backup contraception for at least seven days if you've missed more than one pill or if you're unsure about your protection. If you have further concerns, don't hesitate to reach out to your healthcare provider for personalized advice.

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