Birth control pills, also known as oral contraceptives, are the most common type of birth control in the United States. According to the Centers for Disease Control and Prevention (CDC), around 14 percent of women between the ages of 15 and 49 use birth control pills.
A lot of women have certainly missed their pill at one time or another. Even if you’re incredibly conscientious, it’s easy to slip up or accidentally lose your pills. Because this happens sometimes, it’s a good idea to know what to do if you miss a birth control pill.
How Birth Control Pills Are Taken
Even if you don’t take birth control pills yourself, you’ve probably seen a pack of pills at some point. They usually come in 28-day packs, with 21 days of active pills and seven placebos at the end. Oral contraceptives can also come in packs with longer durations, such as a 91-tablet pack with 12 weeks of active pills and one week of placebo. You may also see 28-day packs with only four placebo pills.
Birth control pills work by using hormones to disrupt a woman’s menstrual cycle and prevent pregnancy. For the pill to work most effectively, you must take them exactly as directed.
What to Do if You Miss a Birth Control Pill
What should you do if you miss a pill? That depends on how long it’s been since you last took a pill and how many pills have been missed.
If you’ve missed one dose of hormonal pills, take the missed pill as soon as you realize you’ve forgotten it. Don’t wait until when you usually take your pill. Take it immediately, then take your next pill at the normal time, even if you will end up taking two pills in one day. If you’ve only missed one dose, the CDC indicates that you don’t need to use backup birth control.
If you have missed more than one dose, take one dose as soon as you remember and throw away any additional missed doses. If you’ve missed more than one dose, you should use a backup method of birth control, such as condoms, for seven days. If you’re in the last week of active pills in your pill pack, you’ll need to take an additional step. When you reach the end of the active pills, do not take the placebo pills. Instead, start a new pack the next day.
Why Does the Type of Birth Control Pill Matter?
There are different formulations of birth control pills, including a progestin-only pill and the combined pill, which includes both estrogen and progestin.
Both combination pills and progestin-only pills prevent ovulation, although 4-in-10 women will continue to ovulate with progestin-only pills. Both thicken cervical mucus to keep sperm from reaching an egg, and thin out the endometrium—the lining of the uterus—making it harder to implant the egg.
Also called mini-pills, progestin-only pills are more sensitive and should be taken at roughly the same time each day. With mini pills, even taking your dose a few hours late can increase the risk of an unintended pregnancy.
If you’re taking a progestin-only pill, the American College of Obstetricians and Gynecologists (ACOG) recommends taking further steps to protect yourself. If you are more than three hours late taking your pill, the ACOG indicates you should immediately take the pill and then use a backup form of birth control as an added protection for two more days.
Not sure what type of birth control pills you are taking? Talk with your doctor or pharmacist, who can provide insight and give you directions.
Additional Birth Control Recommendations
What happens inside your body if you miss a birth control pill? You may experience spotting, also known as breakthrough bleeding, if you go more than 36 hours between doses. When you resume taking your pill and double up on doses the first day, you may have nausea and an upset stomach due to the increased hormones in your body.
Many women take birth control pills for reasons other than preventing pregnancy. If so, does it matter if you miss a dose? Not really. You can safely resume taking your birth control pill as directed when you realize you’ve forgotten a dose.
Finally, is emergency contraception ever recommended? The CDC recommends considering emergency contraception if you missed birth control pills in the first week of the dose pack and had unprotected intercourse in the previous five days.
