What to Do If You Miss a Birth Control Pill

Even if you're typically a grade A student when it comes to taking your birth control pills, life sometimes gets in the way. In other words, missing pills can happen to the best of us. What should you do if you miss a birth control pill? It depends on a few things. This includes how long ago you missed the pill, how many pills you forgot to take, what type of pill you're using, and whether or not you've had sex in the last week.

If you've missed a pill, don't panic. This article explains what you should do in case you miss taking a birth control pill.

Combination Birth Control Pills

If you are using a combination birth control pill that contains both estrogen and progestin, here's what to consider.

If You Miss One Pill

If you miss one pill, take the forgotten pill as soon as you remember. You should still take today's pill at your regular time. If you don't realize you missed a pill until your regular time, take both pills at that time.

Missing one pill slightly increases your chance of pregnancy. Consider using a backup method. This can be an over-the-counter birth control option. You should take it for the next seven days.

If You Miss Two Pills

If you miss two pills in a row, take the two pills as soon as you remember and two pills the following day. Due to the higher dose of hormones, you may experience some spotting. And some people may experience nausea too.

Use a backup birth control method until your next period and pill pack.

If You Miss Three or More Pills

If you have missed three or more pills, you can:

• Begin a new pack of pills the following Sunday after missing the pills. You can do this even if you have started bleeding. You should continue to use an additional birth control method for the first 14 days of the new pack of pills.
• Take two pills for three days to get back on track. Do this while using a backup birth control method.
• Choose to stop taking the remainder of the pills, throw away the pack, and start a new pack.

If you miss three or more pills in a row, use a backup method of birth control until your next period and pill pack.

If You Miss a Placebo Pill

Most combination birth control pills have a placebo that doesn't contain any hormones. The placebo timeframe varies between pill brands. But it is usually all or part of week four for most combination pills and during week 13 for extended cycle pills. This is when withdrawal bleeding, which is like your period, occurs.

If you miss birth control pills during the placebo week, it does not increase your chances of becoming pregnant. These placebo pills are intended to help keep you on your daily pill regimen. For this reason, it's a good idea to keep taking them, even if you forget one. Stay on track and start your next pill pack on time.

Mini-Pills

The progestin-only pill, or mini-pill, does not contain any estrogen. Because of this, timing is much more important than it is for combination birth control pills. If you are using the mini-pill, here's what to consider.

If You Miss a Pill by Less Than 3 Hours

If it’s been less than three hours since your scheduled pill time, take the forgotten pill as soon as you remember. A backup method of birth control is not required.

If You Miss a Pill by More Than 3 Hours

If you are more than three hours late taking the mini-pill, take your missed pill as soon as possible. Return to your regular schedule the following day. You will want to use a backup birth control method for the next two days.

If you miss a mini-pill and don't remember until the next day, take your missed pill as soon as possible. Take your next pill at your scheduled time.

If you are a day late taking your mini-pill, use a backup birth control method for the next seven days.

Unprotected Sex If You Forgot the Pill

Birth control packaging materials talk about different effectiveness rates between "perfect use" and "typical use." The more effective rates associated with perfect use illustrate the difference between consistency and inconsistency.

Typical use means missing an occasional pill and/or taking it at varying times. It is between 91 % and 93% effective at preventing pregnancy. That means for every hundred patients on birth control, between seven and nine will get pregnant each year. Perfect use for many brands is about 99% effective. This means one patient in 100 will have an unplanned pregnancy per year.

The hormones in birth control pills prevent ovulation by blocking the natural hormonal fluctuations that prompt your ovaries to release an egg. Missing one or more pills reduces the amount of hormones in your body. This means you could ovulate and get pregnant if you have unprotected sex.

To prevent an unwanted pregnancy after missed pills, you'll need to use a backup birth control method. According to Planned Parenthood, these are your short-term backup options and how effective they are:

• External condoms = 98% effective
• Internal condoms = 95% effective
• Spermicide = 82% effective (when not combined with condoms)
• Fertility awareness/natural family planning = 76% effective
• Withdrawal before ejaculation = 73% effective

As noted above, the type of pill you're taking makes a big difference when it comes to whether and for how long you'll need to use the backup method. For combination pills, it depends on how many pills you miss.

For mini-pills, your backup need is determined by how late you took your pill.

If You Take the Pill for Heavy Bleeding

Missing pills can have an impact on your menstrual cycle and symptoms. If you take the pill to help decrease heavy bleeding and menstrual pain, missing one or more pills may cause changes to your period for a cycle or two. Symptoms may include:

• Breakthrough bleeding
• Early or irregular periods
• Heavier bleeding than is typical for you on the pill
• Absent or especially light periods
• Increased premenstrual syndrome symptoms

Hormones can be unpredictable. One person may have problems after a missed pill or two while another won't. If you miss your pill and are concerned about the return of heavy bleeding, contact a healthcare provider. They may be able to help you avoid symptoms and get your cycle back on track.

Tips for Remembering Your Pill

While anyone can miss a pill now and then, it's best to minimize how often you forget to take it. You may want to try several strategies to help you be consistent. Some ideas include:

• Build it into a routine, such as getting ready for bed or for work. This way, it becomes automatic.
• Set a daily alarm on your phone or download an app that sends you reminders.
• If you use a sorter for other daily pills, add your birth control pill to it as well.
• Put visual reminders in key spots, such as a sticky note on your bathroom mirror.
• Set the pack next to your toothbrush, coffee pot, or something else you use at the same time each day.
• If you're frequently away from home when it's time to take your pill, keep the packet in your wallet or purse.
• Even if you're rarely away from home when it's time to take your pill, keep a few extras in your wallet or purse just in case.
• If you're traveling, be sure to take it at the same time you would at home. If your pill time at home is 9 p.m., take it when it's 9 p.m. in your home time zone no matter what time it is where you are.

It also helps to know ahead of time what you should do if you miss a pill so it doesn't send you into a panic. You may also want to keep a supply of backup contraceptive products on hand so you're not caught unprepared.

If you realize after having sex that you've missed one or more pills, you may want to consider emergency contraception.

Frequently Asked Questions

Will I experience side effects due to missed birth control pills?

Depending on the number of pills missed and the type of pill you take, you may have breakthrough bleeding and, of course, an increased risk of getting pregnant. If you double up on pills to get back on schedule, you may experience nausea.

Is there a time limit for catching up on missed combination birth control pills?

The short answer is yes. You have about 24 to 48 hours to catch up on missed pills. After that window, the risk of pregnancy increases, and you'll need to use backup birth control.

Summary

It's important to take your birth control pill to avoid an unwanted pregnancy. But if you miss taking your pill, there are important steps you should take. These steps depend on how long ago you missed the pill, how many pills you forgot to take, what type of pill you're using, and whether or not you've had sex in the last week.

The best way to avoid an unwanted pregnancy is to remember to take your birth control pill. Setting an alarm on your phone or keeping extra pills in your purse or wallet are just two ideas to help you remember to take your pill on time.

A Word From Verywell

These tips are meant to be general guidelines and may vary depending the type of birth control you use and other factors. You should read and follow the instructions enclosed with your prescription to know exactly what to do about missed birth control pills. If you're still unsure, ask a healthcare provider or pharmacist.