Table of ContentsView AllTable of ContentsCombination PillsProgestin-Only PillsBackup Birth ControlMenstrual Cycle EffectsAvoiding Missed Doses
Table of ContentsView All
View All
Table of Contents
Combination Pills
Progestin-Only Pills
Backup Birth Control
Menstrual Cycle Effects
Avoiding Missed Doses
The simple facts are this: If you missed onebirth control pill, you are still protected so long as you catch up within 24 hours. If you missed two birth control pills, you have lost protection against pregnancy and need to useemergency contraceptionif you hadcondomless sex. If you miss three birth control pills, you need to usecondomsfor the next seven days until you are back on track.
That’s just a brief overview of the things you need to know if you miss one or more doses of an oral contraceptive. Learn more about what to do and what to expect if you miss doses of a combination birth control pill (“the pill”) or a progestin-only “mini-pill.”
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Combination Birth Control Pills
Because of this two-in-one effect, combination oral contraceptives are slightly more effective than the mini-pill.Even so, the effectiveness of the pill can wane if doses are missed or skipped.
If You Miss One Pill
If you miss one pill, take the missed dose as soon as you remember and take the upcoming dose at your regular time. If you only realize you missed a dose at your regular time, take both pills together at once.
Missing one pill slightly increases yourchance of pregnancy. According to a 2023 study inObstetrics and Gynecologyinvolving 2,837 people on combination birth control pills, the risk of pregnancy after one missed dose is around 0.25%. While low, this is still three times greater than if you miss no doses.
Just to be safe, consider using a backup method of birth control, such as a condom,diaphragm, orsponge. You do not need an emergency contraceptive (a.k.a. the “morning after pill”) if you had unprotected sex the night before.
If You Miss Two Pills
If you miss two pills in a row, take the two pills together as soon as you remember and two pills the following day. Due to the higher dose of hormones, you may experiencespottingand possibly nausea.
Use a backup birth control method for at least seven days (because it takes a full seven days of consistent dosing to restore optimal protection against pregnancy).
Use emergency contraception if you have had unprotected intercourse. Studies suggest that your risk of pregnancy is 10 times greater if you miss two consecutive doses compared to missing no doses.
If You Miss Three or More Pills
If you have missed three or more pills in a row, you are vulnerable to pregnancy. To get you back on track, you can either:
Consider using emergency contraception if you had unprotected sex after missing your pills for 48 to 72 hours.
Can I Take Three Birth Control Pills If I Missed Three Days?There is no evidence that taking three birth control pills at once will protect you from pregnancy any better than two if you miss multiple doses. What it may do is increase your risk of side effects, which can include:Breast tendernessDiscolored urineDrowsinessHeavy vaginal bleedingHeadacheEmotional changesNausea and vomitingRash
Can I Take Three Birth Control Pills If I Missed Three Days?
There is no evidence that taking three birth control pills at once will protect you from pregnancy any better than two if you miss multiple doses. What it may do is increase your risk of side effects, which can include:Breast tendernessDiscolored urineDrowsinessHeavy vaginal bleedingHeadacheEmotional changesNausea and vomitingRash
There is no evidence that taking three birth control pills at once will protect you from pregnancy any better than two if you miss multiple doses. What it may do is increase your risk of side effects, which can include:
If You Miss a Placebo Pill
Most combination birth control pills have placebo (inactive) pills that don’t contain any hormones. For most brands, the pills for the first three weeks of a 28-day pack contain hormones, while those for the last seven days do not contain any hormones at all.
If you miss birth control pills during the placebo week, you are not at risk of becoming pregnant. Placebo pills are simply meant to keep you on schedule for taking pills. If you missed a placebo dose, simply get back to your regular dosing schedule and try not to skip any other doses.
Mini-Pills
Theprogestin-only pill, or “mini-pill,” does not contain any estrogen.
While combination birth control pills have adrug half-lifeof around 24 hours (meaning that 50% of the drug will have left your system after 24 hours), mini-pills have a drug half-life of only 12 hours.Because of this, the umbrella of protection is notably smaller, and missing doses place you at greater risk of pregnancy.
If it has been less than three hours since your scheduled dose, take the missed dose as soon as you remember. A backup method of birth control is not required.
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. 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.
Staying Protected if You Forgot the Pill
When taken as directed, combination birth control pills offer greater than 99% protection against pregnancy. In fact, the same study published inObstetrics and Gynecologysuggests that the conception failure rate—defined as the risk of pregnancy within the first 12 months of starting birth control—was only 0.09% with perfect use.
To better protect against unintended pregnancy, you’ll need a backup birth control method, some of which work better than others:
The type of pill you take along with the duration of the treatment gap make a big difference as to whether you need a backup birth control method (and how long you need to use it). If in doubt, speak with your healthcare provider or a community-based sexual health organization like Planned Parenthood.
If You Take the Pill for Heavy Bleeding
Missing birth control pills can have an impact on yourmenstrual cycleand symptoms. If you take the pill to help decrease heavy bleeding and menstrual pain, missing one or more pills can cause changes to your period for a cycle or two.
Symptoms may include:
Hormones can be unpredictable. One person may have problems after a missed pill 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:
It also helps to know how to use emergency contraceptives if you happen to miss doses and have unprotected sex.
Emergency Contraception and How to Use It
Summary
It’s important to take your birth control pill to avoid an unintended pregnancy. If you miss a dose, you may need to take special steps to “catch up” depending on how long ago you missed the pill, the number of doses you missed, and which type of pill you take.
You may also need to use a backup birth control method until you’ve built up enough hormones in your system to be fully protected from pregnancy.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Verma N, Cwiak C, Kaunitz AM.Hormonal contraception: systemic estrogen and progestin preparations.Clin Obstet Gynecol.2021 Dec 1;64(4):721-738. doi:10.1097/GRF.0000000000000634Zuniga C, Blanchard K, Harper CC, Wollum Z, Key K, Henderson JT.Effectiveness and efficacy rates of progestin-only pills: a comprehensive literature review.Contraception. 2023 Mar:119:109925. doi:10.1016/j.contraception.2022.109925Creinin MD, Jensen JT, Chen MJ, Black A, Costescu D, Foidart JM.Combined oral contraceptive adherence and pregnancy rates.Obstet Gynecol.2023 May 1;141(5):989-994. doi:10.1097/AOG.0000000000005155University of Florida Health.I missed a pill. What should I do?Mount Sinai.Birth control pill overdose.Bick AJ, Louw-du Toit R, Skosana SD, Africander D, Hapgood JP.Pharmacokinetics, metabolism and serum concentrations of progestins used in contraception.Pharmacol Ther. 2021 Jun;222:107789. doi:10.1016/j.pharmthera.2020.107789Planned Parenthood.12 types of birth control.Planned Parenthood.Will missing my birth control mess up my period?Additional ReadingBastianelli C, Farris M, Bruno Vecchio RC, Rosato E, Guida M, Benagiano G.An observational study of adherence to combined oral contraceptive regimens.Gynecological Endocrinology. 2016;33(2):168–172. doi:10.1080/09513590.2016.1240776Centers for Disease Control and Prevention.Progestin-only pills - reproductive health.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Verma N, Cwiak C, Kaunitz AM.Hormonal contraception: systemic estrogen and progestin preparations.Clin Obstet Gynecol.2021 Dec 1;64(4):721-738. doi:10.1097/GRF.0000000000000634Zuniga C, Blanchard K, Harper CC, Wollum Z, Key K, Henderson JT.Effectiveness and efficacy rates of progestin-only pills: a comprehensive literature review.Contraception. 2023 Mar:119:109925. doi:10.1016/j.contraception.2022.109925Creinin MD, Jensen JT, Chen MJ, Black A, Costescu D, Foidart JM.Combined oral contraceptive adherence and pregnancy rates.Obstet Gynecol.2023 May 1;141(5):989-994. doi:10.1097/AOG.0000000000005155University of Florida Health.I missed a pill. What should I do?Mount Sinai.Birth control pill overdose.Bick AJ, Louw-du Toit R, Skosana SD, Africander D, Hapgood JP.Pharmacokinetics, metabolism and serum concentrations of progestins used in contraception.Pharmacol Ther. 2021 Jun;222:107789. doi:10.1016/j.pharmthera.2020.107789Planned Parenthood.12 types of birth control.Planned Parenthood.Will missing my birth control mess up my period?Additional ReadingBastianelli C, Farris M, Bruno Vecchio RC, Rosato E, Guida M, Benagiano G.An observational study of adherence to combined oral contraceptive regimens.Gynecological Endocrinology. 2016;33(2):168–172. doi:10.1080/09513590.2016.1240776Centers for Disease Control and Prevention.Progestin-only pills - reproductive health.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Verma N, Cwiak C, Kaunitz AM.Hormonal contraception: systemic estrogen and progestin preparations.Clin Obstet Gynecol.2021 Dec 1;64(4):721-738. doi:10.1097/GRF.0000000000000634Zuniga C, Blanchard K, Harper CC, Wollum Z, Key K, Henderson JT.Effectiveness and efficacy rates of progestin-only pills: a comprehensive literature review.Contraception. 2023 Mar:119:109925. doi:10.1016/j.contraception.2022.109925Creinin MD, Jensen JT, Chen MJ, Black A, Costescu D, Foidart JM.Combined oral contraceptive adherence and pregnancy rates.Obstet Gynecol.2023 May 1;141(5):989-994. doi:10.1097/AOG.0000000000005155University of Florida Health.I missed a pill. What should I do?Mount Sinai.Birth control pill overdose.Bick AJ, Louw-du Toit R, Skosana SD, Africander D, Hapgood JP.Pharmacokinetics, metabolism and serum concentrations of progestins used in contraception.Pharmacol Ther. 2021 Jun;222:107789. doi:10.1016/j.pharmthera.2020.107789Planned Parenthood.12 types of birth control.Planned Parenthood.Will missing my birth control mess up my period?
Verma N, Cwiak C, Kaunitz AM.Hormonal contraception: systemic estrogen and progestin preparations.Clin Obstet Gynecol.2021 Dec 1;64(4):721-738. doi:10.1097/GRF.0000000000000634
Zuniga C, Blanchard K, Harper CC, Wollum Z, Key K, Henderson JT.Effectiveness and efficacy rates of progestin-only pills: a comprehensive literature review.Contraception. 2023 Mar:119:109925. doi:10.1016/j.contraception.2022.109925
Creinin MD, Jensen JT, Chen MJ, Black A, Costescu D, Foidart JM.Combined oral contraceptive adherence and pregnancy rates.Obstet Gynecol.2023 May 1;141(5):989-994. doi:10.1097/AOG.0000000000005155
University of Florida Health.I missed a pill. What should I do?
Mount Sinai.Birth control pill overdose.
Bick AJ, Louw-du Toit R, Skosana SD, Africander D, Hapgood JP.Pharmacokinetics, metabolism and serum concentrations of progestins used in contraception.Pharmacol Ther. 2021 Jun;222:107789. doi:10.1016/j.pharmthera.2020.107789
Planned Parenthood.12 types of birth control.
Planned Parenthood.Will missing my birth control mess up my period?
Bastianelli C, Farris M, Bruno Vecchio RC, Rosato E, Guida M, Benagiano G.An observational study of adherence to combined oral contraceptive regimens.Gynecological Endocrinology. 2016;33(2):168–172. doi:10.1080/09513590.2016.1240776Centers for Disease Control and Prevention.Progestin-only pills - reproductive health.
Bastianelli C, Farris M, Bruno Vecchio RC, Rosato E, Guida M, Benagiano G.An observational study of adherence to combined oral contraceptive regimens.Gynecological Endocrinology. 2016;33(2):168–172. doi:10.1080/09513590.2016.1240776
Centers for Disease Control and Prevention.Progestin-only pills - reproductive health.
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