Forgetting to take a daily birth control pill is a common occurrence, but the correct course of action depends entirely on the type of pill you take. While it is generally considered safe to take two combination pills in a day to make up for a missed dose, the guidelines are more stringent for progestin-only pills. Understanding the distinction is crucial for maintaining contraceptive effectiveness.
Combination Pills vs. Progestin-Only Pills
Oral contraceptives, or birth control pills, come in two main types, and knowing which one you use is the first step in responding to a missed dose. Most people use combination pills, which contain both estrogen and progestin. These pills work by preventing ovulation, thickening cervical mucus, and thinning the uterine lining. Because they maintain a steadier hormone level, they are more forgiving if you miss a dose.
Progestin-only pills, also known as mini-pills, contain only progestin and have a much narrower window for effectiveness. They work primarily by thickening cervical mucus and thinning the uterine lining, and may not always stop ovulation. {Link: Planned Parenthood https://www.plannedparenthood.org/planned-parenthood-orange-san-bernardino/about-us/blog/i-forgot-to-take-my-birth-control-pill-what-should-i-do}
What to Do for a Missed Combination Pill
If you are on a combination pill and miss a dose, follow these steps to get back on track while minimizing your risk of pregnancy.
- If you miss one active pill (within a certain timeframe): Take the missed pill as soon as you remember, even if it means taking more than one pill in the same day (the missed one and your regularly scheduled one). Backup contraception may not be needed in this specific scenario. {Link: Planned Parenthood https://www.plannedparenthood.org/planned-parenthood-orange-san-bernardino/about-us/blog/i-forgot-to-take-my-birth-control-pill-what-should-i-do}
- If you miss multiple active pills: Take the most recently missed pill as soon as you remember. Discard any other missed pills and continue taking your pills daily, even if it means taking more than one in one day. Crucially, you must use a backup method of contraception, such as condoms, or avoid sex until you have taken active pills for a specified number of consecutive days. Consider emergency contraception if you have had unprotected sex within a certain timeframe.
- If you miss inactive (placebo) pills: Missing a placebo pill has no effect on contraception. {Link: Planned Parenthood https://www.plannedparenthood.org/planned-parenthood-orange-san-bernardino/about-us/blog/i-forgot-to-take-my-birth-control-pill-what-should-i-do}
What to Do for a Missed Progestin-Only Pill (Mini-Pill)
Because mini-pills are more sensitive to timing, any missed dose should be taken seriously.
- If you are significantly late taking a mini-pill: Take the missed pill as soon as you remember. Then, take your next pill at the regular time, even if it means taking more than one in one day. Backup contraception is typically needed for a specified period after a late dose. {Link: Planned Parenthood https://www.plannedparenthood.org/planned-parenthood-orange-san-bernardino/about-us/blog/i-forgot-to-take-my-birth-control-pill-what-should-i-do}
Potential Side Effects of Taking More Than One Pill
Taking more than one birth control pill at once as directed for a missed dose is a safe way to correct the situation, but the resulting fluctuation in hormones may cause some minor side effects. These can include nausea, breakthrough bleeding (spotting), headaches, and breast tenderness. Taking the pills with food can help reduce nausea. These side effects are typically mild and will subside as your body readjusts to the hormone levels. Consult your healthcare provider if you experience severe symptoms or if breakthrough bleeding is heavy or prolonged.
Comparison of Missed Pill Actions
| Scenario | Combination Pill (Active) | Progestin-Only Pill (Mini-Pill) |
|---|---|---|
| One missed pill (within a specific window) | Take the missed pill immediately. Take the next one on schedule, even if it means more than one in one day. Backup contraception may not be needed. | Take the missed pill immediately. Take the next one on schedule, even if it means more than one in one day. Use backup contraception for a specified period. |
| Multiple missed pills | Take the most recent missed pill. Use backup contraception until you've taken active pills for a certain number of days in a row. Emergency contraception may be needed. | Take the missed pill immediately (if within a certain timeframe), then continue on schedule. Use backup contraception for a specified period and consider emergency contraception if relevant. |
| One or more missed inactive (placebo) pills | Discard the missed pill(s) and start the next pack on time. No risk to contraceptive effectiveness. | N/A (Mini-pill packs do not contain inactive pills). |
How to Prevent Missing Pills
If you find yourself frequently forgetting your pill, it's worth reevaluating your approach. The most effective contraception is the one you can use consistently and correctly.
Here are some strategies to help you remember:
- Set a daily alarm: This is a simple and effective reminder, especially for time-sensitive mini-pills.
- Pair it with a daily routine: Take your pill with a consistent daily activity, like brushing your teeth or drinking your morning coffee.
- Use a pillbox: A pill organizer with compartments for each day of the week can help you visualize if you've taken your dose.
- Consider another method: If daily pills are not a good fit for your lifestyle, talk to your doctor about long-acting reversible contraceptive (LARC) options, such as an IUD or an implant, which require much less user effort.
Conclusion
While taking more than one birth control pill at once is sometimes the correct procedure for a missed dose, the specifics depend on your pill type. For most people on combination pills, taking two in one day to catch up is a standard, safe procedure when a single dose is missed within a specific timeframe. However, the precise timing and potential need for backup protection are different for progestin-only pills and when multiple doses are missed. Following the specific instructions for your pill and considering a more foolproof method if you are prone to forgetting is the best way to maintain effective contraception. {Link: Planned Parenthood https://www.plannedparenthood.org/planned-parenthood-orange-san-bernardino/about-us/blog/i-forgot-to-take-my-birth-control-pill-what-should-i-do}
