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What Should You Do If You Forget to Take Your Birth Control Pill?

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Reviewed by Veera Reproductive Care
  • 22 July
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Forgot to take your daily birth control pill? Don’t panic! Here’s what you should do.

If you take daily birth control pills, you probably have a reminder on your phone that nudges you to take one every day. But no matter how disciplined or organised you are, you’re likely to have days when taking the pill will slip your mind. What do you do when you skip a pill by mistake? Before you panic, read on!



What Happens When You Miss Taking a Birth Control Pill?

There are two types of birth control pills – the combination pill and the progestogen-only pill (or mini-pill). Both administer hormones to your body but work slightly differently to prevent you from getting pregnant.

The combination pill contains oestrogen and progesterone and works by preventing ovulation and you need to take the pill continuously for 7 days to ensure that this happens. On the other hand, the progestogen-only pills work by thickening the cervical mucus and thinning the endometrial lining.

The pills are formulated in such a way that the hormones are at the right level for only 24 hours. When you forget to take a pill, your hormone levels drop below the right level, which makes you more susceptible to get pregnant.



What Should You Do If You Miss a Combination Pill?

Your best course of action will depend on the number of pills you have missed. So, if you have missed just one pill, you can take it whenever you remember before your next tablet. If you recognise close to the time when you usually take your next medicine, you can consume both the pills at the same time. You would not need back-up contraception if you missed just one tablet.

However, if you miss two pills early in your cycle, ovulation can occur because your body may not be able to suppress the stimulating hormones. In this case, you can make up by taking two pills for the next two consecutive days. Keep the dosage of the rest of the pack as usual and be sure to use back-up contraception like a condom for the next seven days. If you had unprotected sex, take emergency contraception.

Missed more than 2 pills? Throw out the pack, use a back-up method like condoms for 7 days and restart a new pack. You may have some spotting in between your periods. If you had unprotected sex, take emergency contraception. Always check the packaging information of your birth control pill for more detailed information or consult a Veera doctor if you’re unsure.



What Should You Do If You Miss a Progestin-Only Pill?

Your plan of action will depend on the type of your progestin-only pill (or progesterone-only pill or POP). You need to know whether the pill has desogestrel as its progestin or not – check the label of the packet that your pills came in or ask Veera doctor about it.

If the POP contains desogestrel, and if you are less than 12 hours late for taking your pill, you should still be protected from pregnancy. Similarly, for a POP without desogestrel, if you are less than 3 hours late, you should be fine and do not need to use any additional contraception. Take the missed pill as soon as you remember and then continue with the rest of the pack as you normally would.

If you are more than 12 hours late (for a POP with desogestrel) or more than 3 hours late (for a POP without desogestrel), take the tablet as soon as you remember and then take the next pill as per your usual time. In this case, you would need back-up contraception like a condom for at least the next seven days. If you have unprotected sex during this time, you may need emergency contraception. Always check the packaging information of your birth control pill for more detailed information or consult a Veera doctor if you’re unsure.



How to Know if You Need an Emergency Contraception?

If you have not been taking your pills correctly, you may need emergency contraception. For instance, if you had unprotected for a couple of days sex and missed a few non-consecutive pills, you will need emergency contraception. Or if you were more than the requisite number of hours late in taking your progesterone-only pill, and had unprotected sex, you may need emergency contraception. That said, if getting pregnant would be detrimental to you, then err on the side of caution and take emergency contraception. The most common is the morning-after pill which you can take up to 72 hours of having unprotected sex. Learn more about emergency contraception: <Link Pending>



What if You Get Pregnant But Continue Taking the Pills?

If you have missed many pills and are having unprotected sex, you may get pregnant. There will be a period of time where you may not realize, however taking the hormones will not affect or harm the pregnancy. If your period is late, or you start to experience symptoms of pregnancy (nausea or vomiting, bloating, increased appetite, breast tenderness or enlargement), take a home urine pregnancy test right away. If it's positive, book an appointment with one of our gynaecologists or therapists to discuss your options whether it is continuing the pregnancy, adoption or abortion. Whatever your decision is, Veera is here to help you.


Bottomline.
No matter what birth control pill you are on, you should take the tablets at the same time every day. If you have trouble remembering taking a daily pill, you may want to consider IUD, Implant or Depo injection, which will not require your day-to-day compliance. If you have questions about any of the above, book an appointment with one of the gynaecologists on our portal.


Reviewed by: Dr. Shailly Prasad, MD/MBA, Resident Physician, Obstetrics & Gynecology.


Disclaimer: Content on Veera is provided for informational purposes only and is not intended as medical advice or as a substitute for medical advice given by a physician or trained professional.

References
[1] Curtis, KM., Jatloaoui, TC., Tepper, NK., et.al. U.S. Selected Practice Recommendations for Contraceptive Use. MMWR by CDC. Recomm Rep 2016;65.
[2] Regidor P. A. (2018). The clinical relevance of progestogens in hormonal contraception: Present status and future developments. Oncotarget, 9(77), 34628–34638. https://doi.org/10.18632/oncotarget.26015
[3] Reproductive Health Access Project. (2019, October). Pill User Guide. Retrieved July 22, 2020, from https://www.reproductiveaccess.org/resource/pill-user-guide/
[4] Reproductive Health Access Project. (2019, August). Progestin-Only Pill (Mini-Pill) User Guide. Retrieved July 22, 2020, from https://www.reproductiveaccess.org/resource/progestin-pill-mini-pill-user-guide/
[5] Stewart, M., & Black, K. (2015). Choosing a combined oral contraceptive pill. Australian prescriber, 38(1), 6–11. https://doi.org/10.18773/austprescr.2015.002

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