What Happens when you Miss your Pill?

Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team. Updated on February 11, 2021

You know that feeling of momentary panic when you realize you’ve forgotten to take your birth control pill? It’s like when you lose your wallet, keys, or phone, but the consequence is potentially getting pregnant Not fun! 

Thankfully, you have some leeway if you miss a regular birth control pill. Read on to learn more about what happens if you miss your pill and the course of action you should take to get back on track. 

How many active pills in a row have you taken?

The first thing to consider when you notice that you have missed your pill is how many active pills in a row you have taken prior to the skipped day. 

I’ve missed one to five pills

When you continually use the birth control pill, patch, or ring, your hormone levels remain stable for those three weeks that you are taking the active medication. A withdrawal bleed occurs when those hormonal levels drop, usually because you’ve entered the placebo week or have missed three or more pills in a row.

Previously, birth control pills contained 100 micrograms of hormones, whereas today, most pills contain 20-35 micrograms. When the microgram level was higher, the week of placebo pills was deemed necessary because the hormones in the active pills stayed in the body longer. However, now that there are fewer micrograms of hormones in the pill, taking the daily dose is especially important for increasing efficacy and preventing pregnancy. If you have taken your active pills regularly before the placebo week, you should still be protected during this time.

Let’s say you miss five days of your birth control pills in a row. In this scenario, you’ve essentially approximated the placebo week! Depending on the type of birth control pill you’re on, the period you take the sugar pills (placebo pills) can last anywhere from four to seven days. This is not a problem if you’ve already taken three weeks of active pills in a row leading up to this point, as the hormones will still be active in your body and working to prevent pregnancy.

However, if you’re only on the first, second, or third week of your pill pack and you haven’t taken a pill for three to five days in a row, you may not be protected from pregnancy. Furthermore, if you plan to have heterosexual sex, you should use an external barrier such as condoms. Not only will this provide extra protection from pregnancy, but it will also prevent the spread of STIs between you and your partner.

I’ve missed more than 5 pills

If you go more than seven days without the hormone, then you risk ovulation occurring — this is when an egg travels from your ovaries to your uterus for fertilization — therefore increasing the risk of pregnancy. However, this can happen quicker for women who have a high BMI (weight-to-height ratio) as this can lead to quicker ovulation; women who are overweight may experience ovulation just five days after being off of the pill, patch, or ring.

TL;DR: If you’ve missed five or more days of birth control and want to have sex, you should use a backup form of contraception as you are at risk of getting pregnant. Additionally, if you realize that you skipped a birth control pill in the days after you had sex, it may be a good idea to use emergency contraception such as Ella or Plan B.

What type of pill are you on?

The effects of skipping your birth control can vary depending on which type you are taking. If you’re not sure, there is a combination pill (which contains both estrogen and progesterone) and a “mini” pill (which contains only progesterone).  

I’m on the mini pill

If you’re using the mini pill and are at least three hours late to take it on a certain day, here’s what you need to do:

• Use a backup method if you plan on having sex in the next three days

• Use emergency contraception if you had sex in the previous three days before missing your pill

I’m on the combination pill

If you’re using the combination pill here’s what you need to do:

• If you’ve missed one pill: take the last pill you missed as soon as possible, even if this means taking 2 pills in 1 day

• If you’ve missed two or more: take the last pill you missed as soon as possible, carry on taking the rest of the pack as usual, and use a barrier method such as condoms to prevent pregnancy if you have sex in the next week. You may also need to use emergency contraception if you missed more than one pill in the first week of your pack and had unprotected sex.

Whether you lost a pill, forgot to take it, or simply didn’t want to take it, you’re not alone. Most people have skipped or forgotten to take their birth control at some point. However, it’s important to remember that in order for birth control to be effective at preventing pregnancy, it must be taken as prescribed. 

So, what’s next?

What happens if you miss a day of birth control?

The first step is to not panic. Missing just one day of birth control is not the end of the world, as you will still be protected from pregnancy if you have been taking it regularly. Take the missed pill as soon as you remember that you forgot it. If that happens to be the next day, take it with your next pill (taking two pills at once is okay!).

What happens if you miss two days of birth control?

If you missed two pills, take both pills as soon as possible. Then, take the next two pills the next day and continue on with your regular one-pill-per-day routine afterward.

What happens if you miss three days of birth control?

Three missed pills could lead to you getting your period and, more importantly, getting pregnant. If you’re sexually active, make sure to use a barrier birth control method like condoms. If you had penetrative intercourse in the previous five days, consider using emergency contraception.

What happens if you miss a week of birth control? 

Missing one week of birth control is more or less the equivalent of taking placebo pills for a week. You will likely get a period. If this happens, it’s necessary to use an additional form of contraception in order to prevent pregnancy, as you will no longer be protected by the hormones in your pill. If you purposely skipped your pills because you do not like your current prescription, consult a doctor; there are dozens of different types of pills available, so your doctor can help you find an alternative option that works better for your body and lifestyle. 

 

Can skipping your period prevent pregnancy?

Skipping your period is possible when you take birth control. If you’re on the pill, simply skip the last week (the placebo week or the week of no pills) and start your next pack right away. You can also ask your doctor to prescribe you packs that do not contain placebo pills. If you are always on an active pill, your risk of becoming pregnant will decrease. With that said, it’s important to remember that the pill alone won’t prevent the spread of STIs. 

To learn more about the benefits of skipping your period with birth control, check out our #PeriodsOptional page.

Now you know what happens when you miss a pill and how to make sure that you prevent unplanned pregnancy! 

How Can Pandia Help? 

One of the top reasons why women that women miss their pill is because they’ve run out! Whether due to having no time to run to the pharmacy or not being able to get a prescription renewed, running out of pills is a huge dilemma. Don’t let this happen to you. 

So, set it and forget it with Pandia Health, the most trusted provider for birth control delivery and the ONLY doctor-led, women-led, and women-founded. Let us worry about getting your birth control to you on time, so you don’t have to. Sign up today to get your prescription (new or old) delivered to your mailbox for FREE. You’ll never run out of birth control on our watch.

 

Disclaimer: The above information is for general informational purposes only and is NOT a substitute for professional medical advice. Always seek the advice of your doctor/primary care provider before starting or changing treatment.