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Missed birth control pills

Every day millions of women miss their contraceptive pills and if you don’t know what to do after missed birth control pills, you could have several problems including unplanned pregnancy and menstrual disturbances. In general, wrong (incorrect) use of contraceptive pills could be a major reason for unwanted pregnancies. Birth control pills work best if taken every day at the same time. Regardless of the reason, women used to miss pills, skip pills or stop pills at some point.

To prevent problems, you should know what is happening in your body when you miss one or two or three or more pills.

Birth control pills work to prevent pregnancy by preventing ovulation – actually by preventing the peak of estrogen and preventing the release of mature eggs from the ovaries to be fertilized. If you miss one or more pills, it would increase your chances of ovulation (release of mature egg) that could lead to fertilization and unplanned pregnancy.

Chances for getting pregnant depend on when and how many pills were missed. Maximum risk for ovulation and unexpected pregnancy was mentioned in cases when start of pills was delayed or active pills were missed during first or third weeks of pills use.

The main strategy of protection after missed pills should be either abstinence or back-up method of birth control.

Missed birth control pills – one missed pill

If you miss one pill, take it as soon as you remember or take two pills the next day at the same time and continue with the rest of the pack as usual. In these cases no additional contraception is needed and emergency contraception should not be used.

Missed birth control pills – two missed pills

Missed birth control pills

Missed birth control pills

If you miss 2 pills, double up on pills the next day and the following one – actually take 2 pills the day you remember and 2 pills the next day (2 pills during 2 following days) and continue with the rest of the pack as usual.

Highest risk for unwanted pregnancy was noted if pills missed earlier in the pack or in the last week of the previous pack. Consider using emergency contraception if you have had unprotected sex during previous 7 days and have missed 2 or more pills in the first week of your pack.

If pills were missed during other days and compensated as it is recommended above, no additional contraception is needed and emergency contraception should not be used.

Some experts recommend condoms or abstinence during 7 days in a row after 2 missed and compensated active hormonal pills.

When all active pills have been taken and monthly package is finished – start a new package the next day.

Missed birth control pills – three or more missed pills

If you miss 2 or more pills, your hormone levels are disrupted and contraceptive effect of birth control pills could be dramatically reduced. If you had unprotected sex during that time, emergency contraception should be taken as soon as possible.

If you miss 2 or more pills, better to discuss the issue with your doctor because depending on “missed schedule” you could be recommended ether to continue pills or to throw out the rest of the pill package and start over with a new package.

In all cases the back-up contraception would be needed.

Missed birth control pills – missed inactive pills

If you missed inactive pills, just ignore and continue your pills as schedules – every day at approximately same time.

In these cases no back-up or emergency contraception is needed.

Important to remember:

  • there should be no more than 7 consecutive inactive pills between packs;
  • some pill packs don’t have any inactive (placebo) pills.

Missed birth control pills – back-up methods

If you missed pills and confused, better to use for following days the back-up contraception such as condoms or abstinence (during 7-10 days after missed pills).

Sometimes you could need emergency contraception which should be taken during first 24 hours after missed pills.

Intrauterine devices (IUDs) also can be used as an emergency contraception within 5 days of unprotected sex, but this decision and procedure should be done by your health provider.

If you miss your period after missing one or more birth control pills, get pregnancy test.

Stopping pills

If you decided to stop birth control pills, better to finish the package fully and just stop taking next package.

Once you stop taking contraceptive pills, you can start ovulating again. It means you can get pregnant. Some women start ovulations after 1-2 months. Some women experience menstrual dysfunctions after stopping pills (amenorrhea, oligomenorrhea).


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