Medical Review by Jennie Stanford, MD, FAAFP, DABOM
Summary:
- Birth control pills are highly effective when taken consistently, but missing a dose can interfere with their effectiveness and increase the risk of pregnancy.
- If you miss a combination pill, take it as soon as possible, even if it means taking two pills on the same day. Progestin-only pills are more time-sensitive and require backup contraception if missed by more than three hours.
- Potential side effects from missing a pill include nausea, spotting, and breast tenderness, which are usually temporary.
- Backup contraception is recommended if you miss two or more combination pills or if you’re late on a progestin-only pill.
- Consulting a healthcare provider is advised if you’re unsure how to proceed or have missed multiple pills in the same cycle.
Birth control pills help prevent pregnancy by regulating hormones in the body
When taken correctly, birth control pills help prevent pregnancy by regulating hormones in the body. However, this protection relies on consistency, and missing a pill can interfere with its effectiveness.
Whether it’s because of a hectic schedule or simple forgetfulness, missing a dose is something that happens to many people. So, what should you do if it happens to you? Below, we’ll break down the immediate steps to take, the potential risks, and when to talk to your healthcare provider about birth control.
Two types of birth control pill
Birth control pills fall into one of two categories: combination pills, which contain synthetic estrogen and progestin, and progestin-only pills (POPs).
Progestin is a synthetic form of progesterone, and the ingredient most responsible for preventing pregnancy in both kinds of pills. It helps prevent ovulation and stops sperm from reaching the egg by making the mucus in your cervix thicker.
Estrogen can also help prevent ovulation—just not as much as progesterone does. Learn more about your different options for birth control here.
What to do if you miss a birth control pill
Consistency is the key to success with birth control medication. If you follow the instructions perfectly, the effectiveness of birth control pills is 99%—but common mistakes like missing pills bring their actual average rate of effectiveness down to about 91%.
That means the first thing to do when you realize you’ve missed a birth control pill is to act quickly. Here’s what to do based on the type of birth control you’re using:
Combination pills (estrogen + progestin):
If you miss one combination birth control pill, take it as soon as you remember—even if that means taking two pills on the same day.
If you missed your pill twice in a row during your first two weeks of taking the pill, take two pills the day you remember, followed by two more the next day. Then return to your regular schedule.
Then, continue with your regular schedule. Missing one pill generally won’t decrease your pregnancy protection, especially if you take it within 24 hours.
Progestin-only pills (POPs):
Birth control pills that only contain progestin are more time-sensitive. If you miss a POP by more than three hours, take the missed pill as soon as possible and continue your regular schedule.
In this case, it’s best to use backup contraception, like condoms, for the next two days, as even a small delay could increase your risk of pregnancy.
The potential risks of missing birth control pills
Missing a pill—especially more than one—can increase your risk of pregnancy. Studies show that the number of women who search online for pregnancy-related terms after missing a dose of birth control increases if they’ve missed two or more doses.
Progestin-only pills also have a shorter window of action than combined pills—so the risk of pregnancy is higher if you miss doses. Your healthcare provider may opt to prescribe combination pills or other birth control methods instead if you or they believe taking your birth control medication on time will be a problem.
Other possible side effects after missing a pill may include:
- Hirsutism: You might experience unexpected hair growth.
- Nausea: You might feel sick to your stomach.
- Irregular bleeding: You might experience spotting (vaginal bleeding outside your menstrual cycle)
- Breast tenderness: Your breasts might feel swollen or sore.
When to use backup contraception
In some cases, missing your birth control pill means it might be a good idea to use other forms of birth control to cover your bases. Here are a few situations where backup contraception is recommended:
- You’ve missed two or more combination pills in the same cycle.
- You’ve missed a progestin-only pill by more than three hours.
Backup contraception options include condoms or emergency contraception (Plan B® or other morning-after pills) if needed.
Consulting your healthcare provider
If you’re unsure what to do after missing a pill—or if you’ve missed more than one—it’s always a good idea to consult your healthcare provider. They can offer advice tailored to your specific situation and help make sure your birth control is still effective.
Situations where professional medical advice may be especially helpful include:
- Missing multiple pills in a cycle
- Experiencing any unusual side effects after a missed dose
- Needing advice on emergency contraception
At Lemonaid Health, we can put you in touch with US-based healthcare professionals who can advise you on your birth control needs. Whether you have questions about missed doses or need help choosing a different method, we’re here to help.
Find birth control support with Lemonaid Health
Missing a day of birth control happens, but it doesn’t have to compromise your health or peace of mind. Taking action as soon as you realize you missed a dose, using backup contraception when needed, and consulting your healthcare provider are key to staying protected. Remember, the most important thing is consistency, so be sure to take your pills as directed—and don’t hesitate to ask for help if you need it.
Lemonaid Health makes it easy to access birth control advice, consultations, and prescriptions online. Whether you’re looking to start birth control or have questions about missed doses, our team is ready to assist you. Connect with us today and get the birth control support you deserve.
