Taking more than the prescribed dose of any medication comes with potential risks, and birth control pills are no exception. The question of whether one can take 5 birth control pills at once often arises from panic after missing pills or in a search for emergency contraception (EC). While a large dose of birth control pills is highly unlikely to be fatal, it is not a safe or effective strategy and can lead to a host of unpleasant side effects [1.2.1, 1.5.3].
IMPORTANT: What This Article Is NOT
This article is for informational purposes only and does not constitute medical advice. If you have taken more than your prescribed dose of birth control or are considering it, please contact your healthcare provider or Poison Control at 1-800-222-1222 immediately [1.5.1]. If you are having thoughts of harming yourself, call or text the 988 Suicide and Crisis Lifeline [1.5.4]. Taking a large dose of birth control pills will not end an existing pregnancy [1.5.4].
Understanding How Birth Control Pills Work
Oral contraceptives contain hormones, primarily estrogen and progestin (or progestin-only), that prevent pregnancy in three main ways [1.2.1]:
- Preventing Ovulation: They stop the ovaries from releasing an egg.
- Thickening Cervical Mucus: This makes it harder for sperm to reach an egg.
- Thinning the Uterine Lining: This makes it difficult for a fertilized egg to implant.
When taken correctly—one pill every day—they are over 99% effective [1.2.4]. Taking more pills does not increase this effectiveness [1.2.1].
What Happens in a Birth Control 'Overdose'?
Taking a large number of pills at once is considered an overdose, but it is not typically life-threatening because the hormones have low toxicity [1.5.3, 1.5.4]. However, a sudden surge of hormones can cause significant, uncomfortable side effects.
Common Side Effects of Taking Multiple Pills
The most frequently reported side effects include:
- Nausea and Vomiting: This is the most common reaction due to the high dose of hormones [1.3.1].
- Breast Tenderness [1.3.4]
- Headaches or Migraines [1.3.1]
- Drowsiness and Fatigue [1.3.6]
- Vaginal Bleeding: Irregular spotting or heavier withdrawal bleeding can occur, sometimes days after the overdose [1.2.8].
- Mood Changes [1.3.2]
In rare cases, more severe symptoms can occur that require immediate medical attention, such as signs of a blood clot (unusual leg pain or swelling, chest pain, shortness of breath) or a severe allergic reaction [1.3.2, 1.5.4].
The 'Yuzpe Method': An Outdated Form of Emergency Contraception
Using regular birth control pills for emergency contraception is a method known as the Yuzpe regimen [1.4.2]. It involves taking a specific number of certain combination birth control pills as soon as possible after unprotected sex, followed by a second dose 12 hours later [1.4.5].
However, this method is now considered outdated for several reasons:
- Lower Efficacy: The Yuzpe method is less effective at preventing pregnancy than modern dedicated EC pills [1.4.4, 1.4.6]. Its effectiveness is estimated to be between 56% and 86% [1.4.5].
- Higher Side Effects: The high dose of estrogen causes significantly more nausea and vomiting compared to other EC options [1.4.3]. Vomiting within an hour of a dose may require it to be repeated [1.4.6].
- Complexity: The correct number of pills varies drastically depending on the brand and formulation, creating a high risk of error without medical guidance [1.5.4].
Comparison: Yuzpe Method vs. Dedicated EC Pills
Modern emergency contraception is safer and more effective. Here is a comparison:
| Feature | Yuzpe Method (Combination BCPs) | Levonorgestrel (e.g., Plan B) | Ulipristal Acetate (e.g., ella) |
|---|---|---|---|
| Hormone(s) | Estrogen & Progestin | Progestin-only | Progesterone Receptor Modulator |
| Effectiveness | 56-86% [1.4.5] | Up to 85% (decreases over time) [1.4.6] | Consistently effective up to 120 hours [1.4.5] |
| Usage Window | Within 72 hours [1.4.5] | Within 72 hours (most effective) [1.4.6] | Within 120 hours (5 days) [1.4.5] |
| Side Effects | High rates of nausea (50%) and vomiting (19%) [1.4.3] | Lower rates of nausea (23%) and vomiting (6%) [1.4.3] | Headache, nausea, abdominal pain [1.4.5] |
| Accessibility | Requires specific pills and knowledge | Over-the-counter | Prescription-only |
What to Do If You've Taken Too Many Pills
- Don't Panic: A birth control overdose is rarely a life-threatening emergency [1.5.2].
- Seek Immediate Guidance: Call Poison Control at 1-800-222-1222 (in the U.S.). Have the pill packet with you so you can provide the name, strength, and number of pills taken [1.5.1].
- Know When to Go to the ER: Seek emergency medical care if you experience severe symptoms like chest pain, trouble breathing, sudden severe headache, fainting, or heavy, uncontrollable bleeding [1.3.2, 1.5.4]. An intentional overdose for self-harm also requires an emergency room visit [1.5.3].
- Manage Mild Symptoms: If advised it's safe to stay home, manage symptoms by staying hydrated, eating bland foods if nauseous, and resting [1.5.3].
Conclusion: Prioritize Safety and Correct Use
While the thought of an unintended pregnancy can be stressful, taking 5 or more birth control pills at once is not the right answer. It is an outdated and risky method of emergency contraception that causes significant side effects and is less effective than dedicated products like Plan B or ella. For routine contraception, consistency is key—taking one pill daily as prescribed. If you miss a pill, consult your pill pack's instructions or a healthcare provider; the advice is usually to take the missed pill as soon as you remember, even if it means taking two in one day, which is considered safe [1.2.3]. For emergencies, always opt for the safest, most effective method and consult a healthcare professional for guidance.
