First, don’t worry. It happens to everyone, and it’s simple to get back on track. The rules on what to do if you’ve missed a pill (or taken it late) depend on which type of birth control you’re taking. Most specifically, they depend on whether you’re using combined pills or a progestin-only mini pill — but some individual brands have their own rules as well. Below, we’ll go over some basic guidelines for what to do if you’ve missed a pill and address the rules for some of the biggest BC brands.
Missing one or two pills every now and then is no big deal, but if you find yourself missing pills regularly, a daily birth control pill might just not be your thing. That’s ok too. If you’ve tried all the tips like setting an alarm on your phone (we’ve got a tip list further down the page), consider switching to a less high-maintenance contraceptive like the weekly patch, monthly ring or even a long-acting reversible contraceptive (LARC) like the injection or IUD.
Many types of birth control distinguish between a “late” and “missed” pill in terms of what you should do to get back on track. Depending on the brand, if you took your birth control 4 hours late, you might just need to take it once you’ve remembered — no harm, no foul. But with other medication, being just 12 hours late in taking your birth control pill can mean a drop in your protection against pregnancy.
According to the CDC, a combined pill is considered late if fewer than 24 hours have passed since the time you normally take your pill.[1] It’s considered missed after more than 24 hours. A progestin-only mini pill, however, is considered missed after just 3 hours.[2]
Are there ever times when you’ve missed one birth control pill and don’t need to do anything? Yes, if the pill you missed was one of the placebo pills in your pack. Many types of birth control include a few days or a full week of “spacer” pills which don’t contain any hormones but are meant to be taken to keep you in your daily habit.
A mini pill is a birth control pill that only contains the hormone progestin. Despite the name, it’s not actually any smaller than a combined birth control pill. Many women prefer mini pills because they get side effects when they take estrogen; for some women, like those over 35, progestin-only contraception is usually recommended.
Because mini pills only have one hormone and often contain lower doses compared to combined pills, your window for taking the pill is smaller — sometimes only 3 hours.
Here’s what you should do if your pill is late but not yet missed:
While your pill is late, you’re still protected from pregnancy. That means you don’t need to use a back-up birth control like a condom, and you don’t need emergency contraception if you’ve had sex.
If you’ve missed your mini pill, you’re not protected against pregnancy. Here’s what you should do:
Because combined pills work a little differently, they have their own rules for what you should do when you miss a pill. Here are some general missed pill guidelines for your combined oral contraceptive pill (COCP).
If you’ve missed one pill (anywhere in your pack) or started your pack one day late, you’re still protected and don’t need to worry. Here’s what you should do:
Yasmin is another common type of combined birth control but has slightly different rules for what you should do when you miss a pill.[3] That’s why it’s important to check the patient info that comes with your pill pack, so you know you’re following the correct instructions.
What to do with a missed Yasmin pill depends on where you are in your cycle and how many pills you’ve missed. If you miss one yellow pill:
For some types of birth control, when you miss a pill is as important as how many you’ve missed. This can be because your body is doing different things throughout your cycle, which changes how likely you are to get pregnant, or because the pill you’re taking has different levels of hormones throughout the month. If you’ve missed a pill in week 1, for example, you might need to do something different than if you’d missed a pill in week 2. The best thing to do when you miss a pill is to check the patient info that came with it, or to look up instructions for that specific pill.
So are you protected the first week of birth control? Maybe. If you start your birth control on the first day of your period, you’re protected right away. This is called being a Day 1 Starter or a First Day Starter, and you’ll see that term in the instructions for what to do when you miss a pill. If you start the pill at a different time, you should wait 7 days before having unprotected sex.
It’s possible to experience bleeding after missing birth control pills. This usually isn’t anything to worry about and some people can experience spotting or cramping throughout their cycle, even when they haven’t missed a birth control pill.
Bleeding after missing 2 birth control pills isn’t an issue as long as you follow your pill’s directions for getting back on track. This usually involves taking your missing pill and possibly using back-up birth control like condoms until you’re protected against pregnancy again.
It depends on how late you’ve started the pack. If it’s just one day, that’s no big deal. Just take the pill as soon as you remember, even if that means taking two in one day.
If you’re starting your pack more than one day late, you should wait a week before having unprotected sex. Use a back-up method like condoms in the meantime so you stay protected.
Have a meeting happening right when you normally take the pill? Or, are you traveling to a different time zone and not wanting to get up at 3am to take your medication? If you’re wondering “Can I change the time of my birth control pill,” the answer is thankfully yes. But there might be a few caveats.
You can usually take birth control an hour early without any problem. Some pills have a three-hour window during which you need to take them, but many are even more flexible. You should check the specific information provided with your pill to find out what the rules are.
If your pill has a three-hour window but you’re traveling to a different time zone, you can adjust the time day by day — for example, take your pill two hours after you normally do until it matches up with the time where you are. Using a back-up birth control like a condom can help you stay extra-protected while you do this.
Can you take birth control pills with food? Yes. Do you need to? Nope.
It’s uncommon to have stomach upset from taking your pill, but a small snack can help if you do experience this. There’s no other benefit to taking your pill with food, unless having your medication with a meal can help you get into the routine of taking it daily.
If you eat at regular times throughout the week (including working days, weekends, etc), you’re a good candidate for taking your pill with food. But if your meal-times depend on when you get up, when you’re hungry or when you have a break, you might end up taking your birth control inconsistently.
The birth control patch or vaginal ring might be better suited for your lifestyle, but they’re not necessarily easier to remember. The ring keeps you protected for a month and the patch for a week so they’re more low-key than your typical everyday contraceptive. If you’re good at sticking to routines like a weekly face peel or monthly brow appointment, a more long-term birth control will likely work for you. Just don’t let out-of-sight become out-of-mind. Some people find that a birth control that’s used less frequently can be easier to forget.
Additionally, the patch and ring aren’t suitable for everyone. There are so many different types of pill available that almost all women can find one that works for them — and is safe to take. But the patch and pill are both “combined” forms of birth control, meaning they contain both estrogen and progestin. If you need a progestin-only birth control (for example, if you’re over 35 and smoke), the patch and ring aren’t a good choice.
[1] www.cdc.gov. (2019). CDC - Combined Hormonal Contraceptives - US SPR - Reproductive Health. [online] Available at: https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
[2] www.cdc.gov. (2019). CDC - Progestin-Only Pills - US SPR - Reproductive Health. [online] Available at: https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/progestin.html#missed [Accessed 24 Aug. 2021].
[3] HIGHLIGHTS OF PRESCRIBING INFORMATION. (n.d.). [online] . Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/021098s019lbl.pdf.
