No matter how well-organized you are, there will inevitably be a day when you completely forget to take your birth control pills or a scheduling conflict causes you to lose your birth control pills-taking mojo. Even the most sane woman may experience a spiral of terror and despair after realizing she has one too many pills in her pack. At this point, all you want to know is what to do next.
What Happens If You Forget To Take A Combination Pill?
The estrogen and progestogen in the combination pill prevent the monthly fluctuations in hormone secretion that result in egg development and, ultimately, ovulation. According to Melissa Peskin-Stolze, M.D., an ob-gyn at Stony Brook University Hospital in New York, “the progestogen component prevents ovulation, while the estrogen component primarily prevents the selection and emergence of the dominant follicle that produces the egg.” In the meantime, the progestogen-only pills function by thinning the endometrial lining and thickening cervical mucus (to deter sperm).
Elicia Harris, M.D., a board-certified ob-gyn at Women’s Health Advantage in Indiana, explains that pills are designed such that the hormones will only be at the therapeutic level for 24 hours. Your hormone levels will fall below the therapeutic range when you miss a pill, making you more likely to become pregnant if you have sexual activity then. Additionally, you might experience a few mild hormonal changes, such as nausea, headaches, and very minor bleeding.
What to Do If You Forget To Take A Combination Pill
The number of missing pills and the time in your cycle when they were missed determine the optimal course of action. According to Peskin-Stolze, if one pill is missed, nothing happens, so you should take it as soon as you remember, followed by your next pill at the scheduled time. Take both pills at the same time if it’s almost time for your next dose. Backup contraception isn’t typically required in this situation, but if you missed pills earlier in the pack or in the final week of the previous pack, you might want to think about it. Take the remainder of the pack as usual.
According to Peskin-Stolze, if you skip two pills and do so early in your cycle (i.e., the first two weeks), breakthrough ovulation may result from the body’s inability to control the stimulating hormones. In this case, you should make up the missed pills by skipping two pills over the following two days, continue taking the rest of the pack as usual, and use backup contraception for the following seven days.
According to Peskin-Stolze, you should immediately start backup contraception and start a new pill pack if you miss two pills in the third week or more than two hormonal pills at any time. Once the new pack has begun, use backup contraception every day for the following seven days.
What To Do When You Miss a Progestogen-Only Pill
Progestogen-only medications come in two different forms: a 12-hour pill that needs to be taken within 12 hours of the same time every day and a 3-hour pill that needs to be taken within 3 hours of the same time every day. According to Harris, if taken outside of this window, your hormone levels could drop below the therapeutic range, increasing your risk of becoming pregnant.
If you remember to take the missed pill as soon as possible, take the subsequent pill when you normally would, and proceed with the remaining pills in the pack as usual if you are less than three hours or, depending on the brand you’re taking, less than 12 hours late. Most of the time, a second method of birth control is not required, but if you frequently forget to take your pills, you may want to consider backup protection.
Take one pill as soon as you remember (even if you’ve missed more than one), then take the next pill as you normally would, and carry on with the rest of your pill pack as usual if you’re more than three hours late taking it or more than 12. As it takes 48 hours for the progestogen-only pill to fully take effect, use backup contraception for at least the following two days after you remember to take your missed pill. Use this technique wherever you are in your pill pack.
What to Look For When Choosing an Emergency Contraceptive?
Take emergency contraception, advises Peskin-Stolze, if you believe that your lack of protection may have resulted from improper pill-taking. (For instance, if you missed two or more pills in the first week of a combo-pill pack and engaged in unprotected sex during the seven days prior to the missed progestogen-only pill or the two days following—especially if forgetting pills is a regular occurrence.) For women over 17, EC is available over-the-counter and by prescription. According to Harris, it should be taken within 72 hours of unprotected sex to prevent pregnancy.
Bottom Line
These are merely general precautionary recommendations because various birth control brands use various hormonal formulations. According to Harris, some pills have three levels of hormones throughout, while others have one continuous level of hormone throughout the pack. But each day, take all of your active medications at the same time, regardless of the medication you’re taking.
In the end, it’s best to check in with your doctor for a consult if you’re unsure of what to do and the pamphlet in your pill pack is insufficient. And according to Harris, if you have trouble remembering a daily pill despite setting numerous alarms, think about switching to an IUD, which doesn’t require daily compliance and is a little more mind-freeing.