What to do if I miss a birth control pill?

Birth control pills are an effective form of contraception — as long as you take them correctly. But sometimes, life gets busy, or you misplace your medicine, and you might miss your daily birth control pill.

If you miss a pill, don’t panic. Here’s what you need to know if you miss one or more doses of birth control or if you’ve lost your birth control pills.

How Do Birth Control Pills Work?

Birth control pills contain hormones that prevent your ovaries from releasing an egg. The pill also thickens your cervical mucus, making it hard for sperm to reach an egg, even if one is present. You must take the pill exactly as prescribed to maintain the right hormone levels.

There are two types of birth control pills — combination pills and progestin-only pills.

The combination pill has the hormones estrogen and progestin (a manufactured version of the hormone progesterone). It’s the most commonly prescribed type of birth control pill. You take this type of pill daily, but the time you take it can vary without affecting how well it works.

Combination pills can have:

  • The same amount of hormones in each active pill (called monophasic).
  • Varying hormone amounts (multiphasic).

If you have a 28-day pack of combination birth control pills, the last seven pills don’t have any hormones. They’re placebo pills and serve as reminders for those who prefer to take a pill every day. You can take them or not. It’s totally fine to miss one of these pills; they won’t affect how well the birth control works.

The other, less common type of birth control pill is the progestin-only pill, also known as the mini pill. It contains only progestin, and each pill is active; there are no placebo pills.

You must take the mini pill at the same time (within a three-hour window) each day.

These pills may not completely prevent ovulation. But they do thicken your cervical mucus, making it difficult for sperm to reach an egg.

When taken as directed, both types of birth control pills are about 99 percent effective at preventing pregnancy.

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What To Do if I Miss a Birth Control Pill

Most people who use birth control pills forget to take one occasionally. That’s stressful if you worry about getting pregnant, so having a plan is helpful.

It’s best to discuss what to do about missed doses with your doctor before you start using birth control pills. But here’s general advice about what to do if you miss a birth control pill.

Note that this advice applies to monophasic combination pills or the mini pill. Ask your doctor what to do if you miss a multiphasic combination pill, as the instructions can differ depending on the brand and what part of your cycle you’re in.

If you miss a dose of a monophasic combination pill

For combination birth control pills to work optimally, you must take the hormonal pills for at least seven consecutive days.

If you miss one active pill that contains hormones, take the missed pill as soon as you remember. Then, take your next pill at the scheduled time. It’s OK to take two pills on the same day or at the same time.

The chance of getting pregnant is minimal if you take both pills. Still, if you have intercourse, it’s wise to use backup birth control, like a condom, for the next seven days.

You don’t have to do anything if you miss a placebo pill since these have no hormones. You can even skip all of them if you’d like. Just make sure to start taking the pills again when it’s time for the new pack.

If you missed two or more pills, take the most recently missed pill as soon as you remember. It’s OK to take two pills on the same day or at the same time, but don’t take more than two. Discard the other missed pills and take your next dose as usual.

If you missed two or more doses in the last week of hormonal pills (days 15 to 21 for 28-day pill packs), you should:

  • Take one of the remaining hormonal pills each day.
  • Skip the placebo pills and, instead, start a new pack after you finish the remaining hormonal pills.
  • Use backup contraception or avoid intercourse until you take hormonal pills for seven consecutive days.

Generally, if you forget to take your pills for 48 hours or more, you have a higher chance of getting pregnant. Backup birth control is essential if you miss two or more hormonal pills. You should also call your doctor or visit a pharmacist to ask about emergency contraception if you’ve had unprotected sex.

If you miss a dose of the mini pill

The timing of your dose is crucial with progestin-only pills. You must take these pills at the same time each day to maintain your progestin level. If you’re more than three hours late in taking the mini pill, you’ve missed your dose.

There’s a greater chance of ovulation with the mini pill. So, missing one dose by a few hours means you can potentially get pregnant if you have unprotected sex.

If you miss a mini pill, take it as soon as you remember it. Then, take your next dose at the regular time. You can take two pills in a day until you take all of your missed doses.

Use backup birth control until you catch up, and then use the pills correctly for two consecutive days. Call your doctor to ask if you need emergency contraception if you’ve had unprotected sex.

What To Do if I Lost a Birth Control Pill

Sometimes, you might lose a birth control pill; say it pops out of the pill pack and rolls down the sink. Skipping that pill can increase your chance of pregnancy. But what to do about a lost pill depends on the type of birth control pills you take.

If all your pills have the same amount of active hormone (monophasic), take the last hormone pill in your pack in place of the lost dose. You can do this whether you take the combination or mini pill. You don’t have to do anything if you’ve lost a placebo pill.

Replacing a pill (or more) means you’ll be one short at the end of the month. Tell your doctor and ask if you need a replacement pack.

If you lose a multiphasic combination pill with varying amounts of hormones from week to week, you should call your doctor. The replacement instructions will depend on which pill you lost and where you are in your cycle. Make sure you use backup birth control.

Tips To Remember Your Birth Control Pill

It’s easier to remember to take your birth control pill if you take it at the same time each day. Think about things you do every day and add taking your pill to that routine. For example, take your pill every morning after brushing your teeth or having coffee.

These tips can also help:

  • If you have coffee or breakfast each morning, keep your pill pack nearby to remind you to take it.
  • If you use a pill sorter for other medications or supplements, add your pills to that.
  • Keep an extra package of pills in your purse if you’re away from home and your usual routine.
  • Use the reminder app on your phone or watch.

If you often forget to take your pills, tell your doctor. They can suggest an alternative birth control method like an IUD or birth control shots. You may find these to be a better fit for your lifestyle.

Centers for Disease Control and Prevention. Combined Hormonal Contraceptives. LINK

Centers for Disease Control and Prevention. Progestin-Only Pills. LINK

About UPMC Magee-Womens

Built upon our flagship, UPMC Magee-Womens Hospital in Pittsburgh, and its century-plus history of providing high-quality medical care for people at all stages of life, UPMC Magee-Womens is nationally renowned for its outstanding care for women and their families.

Our Magee-Womens network – from women’s imaging centers and specialty care to outpatient and hospital-based services – provides care throughout Pennsylvania, so the help you need is always close to home. More than 25,000 babies are born at our network hospitals each year, with 10,000 of those babies born at UPMC Magee in Pittsburgh, home to one of the largest NICUs in the country. The Department of Health and Human Services recognizes Magee in Pittsburgh as a National Center of Excellence in Women’s Health; U.S. News & World Report ranks Magee nationally in gynecology. The Magee-Womens Research Institute was the first and is the largest research institute in the U.S. devoted exclusively to women’s health and reproductive biology, with locations in Pittsburgh and Erie.