What to do if you miss a contraceptive pill
If you’ve missed a contraceptive pill, you’re not alone. It’s not always easy to remember to take a pill every day, but there are steps you can take if you forgot to take your pill.
When taken perfectly, the contraceptive pill is 99% effective in preventing pregnancy. This percentage gets lower with typical use – that is, if you forget to take a pill now and then. The pill is still around 91% effective with typical use, but that does mean you might need to take extra precautions if you’ve missed a pill.
What you need to do will also depend on which type of pill you are taking, either the mini pill or the combined pill. Read on to find out more in our helpful guide.
What type of pill are you taking?
If you’ve missed a pill, first check what type of pill you’re taking. There are 2 types of birth control pills available:
- the combined oral contraceptive pill
- the progesterone-only pill (POP), also known as the mini pill
The combined pill contains both an oestrogen hormone and a progestogen hormone. These active ingredients mimic the naturally occurring hormones that regulate your menstrual cycle.
Most types of pills provide contraception by preventing your ovaries from releasing an egg, also known as ovulation. If you miss pills, there’s a chance that your ovaries will release an egg as your hormone levels change. This is why it’s important to have a back-up method of contraception in case you forget to take your pills.
The combined pill is taken differently from the mini pill. When you take a combined contraceptive pill, you’ll usually have a 7-day pill-free break at the end of each 21-day cycle.
Some combined pill packs are called ED pills, meaning you take a pill every day without a break. ED packs contain 7 inactive pills, also called placebo pills, and have no medication in them. ED pills are mainly there to help you keep up your habit of pill taking, so you’re less likely to miss restarting your next strip of pills.
With the mini pill, you will continuously take the pill every day without any break.
If you've missed a pill, it's important to know which pill you're taking as the precautions you need to take may be different.
If you’ve missed one combined pill
If you’ve missed one combined pill, you’re still protected from getting pregnant. Take your missed pill as soon as you can, even if you need to take 2 pills on the same day. Then continue to take the next pills as usual.
If you’ve only missed a placebo (inactive) pill in an ED combined pill pack, carry on taking your pills as normal. You’re still protected as long as you have been taking the active pills correctly.
In either case, there is no need to use extra contraception.
However, you may need to consider how long it’s been since you’ve missed your combined pill. With combined pills you want to take them at the same time each day and within the same 24 hour window.
Less than 24 hours late taking the combined pill
If you’re less than 24 hours late in taking your combined pill, take it as soon as you remember. You’ll still be protected from getting pregnant. Continue taking the rest of the pills in your strip to stay protected.
More than 24 hours late taking the combined pill
If you’re more than 24 hours late in taking the combined pill, take the pill as soon as you remember. This means you might need to take 2 pills in the same day, and that is okay. You’ll need to use extra contraception, like condoms, for the next 7 days. Keep taking your pills as usual too.
If you’ve missed two combined pills or more
If you’ve missed two combined pills or more at any time during your cycle, your risk of pregnancy will be higher. Take your missed pill and your next pill as usual, even if this means you’re taking 2 pills on the same day. There is no need to take any other pills you’ve missed.
If you’ve had sex during the last 7 days, you should speak to a pharmacist or doctor, or go to a sexual health clinic for advice. You might need to use emergency contraception, like the morning after pill.
If you’ve missed pills from the 7 active pills at the end of your strip, you should skip your 7 day break (or placebo ED pills) and start your next strip straight away.
Use condoms, or another form of extra contraception, if you have sex within the next 7 days.
You may want to consider taking a pregnancy test to check if you are pregnant.
If you’ve missed a progesterone only pill (mini pill)
If you’ve missed a mini pill, you should check which pill you are taking. Some mini pills have a smaller time frame that you need to take the pill in.
You can check the patient information leaflet that comes with your pack to find out which type of pill you are taking. You can also ask your doctor or pharmacist about this.
3 hour progesterone only pill
Mini pills like Noriday or Norgeston need to be taken within the same 3 hours every day. If you are less than 3 hours late to take a pill, take it as soon as you remember. You’ll still have contraception and do not need to take any extra precautions.
If you are over 3 hours late in taking a pill, take it as soon as you remember. This may mean taking 2 pills in the same day. You should use condoms for the next 2 days.
Keep in mind that if you have had sex the week before you missed a pill or in the few days after, there’s a chance you might get pregnant. You may need emergency contraception, so speak to your doctor or sexual health clinic.
12 hour progesterone only pill
Pills that contain the active ingredient desogestrel, like Cerazette, should be taken within the same 12 hours every day.
If you are less than 12 hours late in taking this pill, take the pill as soon as you remember. You should have enough contraception and do not need to use extra protection.
If you are more than 12 hours late in taking a pill, take it as soon as you remember and use condoms for the next 2 days. If you’ve had unprotected sex after being more than 12 hours late, you’ll need to use emergency contraception.
What happens when you miss a pill?
What happens when you miss a pill depends on the type of pill you take.
If you miss a combined pill but remember to take it within 24 hours, nothing really happens and you will still be protected from getting pregnant.
But if you miss more than 2 combined pills, your chance of getting pregnant increases. Your chances of getting pregnant also increase if you are more than 12 hours late to take a mini pill, although this does not apply for the 3 hour mini pill.
This is because, without the hormones from the pill in your body, you may start to ovulate (release an egg), your cervical fluid will become thinner and the lining of your womb will thicken. All of these changes increase your chance of becoming pregnant if you’re having sex.
Can you get pregnant if you miss one pill?
If you miss one combined pill, you will not necessarily get pregnant. Try to remember to take your missed combined pill within 24 hours to reduce your chances of getting pregnant.
If you miss one mini pill, your chances of getting pregnant are higher compared to missing a combined pill.
If you take the appropriate precautions you can still protect yourself against pregnancy. This includes taking your mini pill as soon as you remember and using extra contraception, like condoms. Use extra protection for the next 7 days for the combined pill and 2 days for the mini pill. You should also check if you need the morning after pill.
What if you miss a pill and have unprotected sex?
f you miss one combined pill and have unprotected sex, you are still protected against pregnancy. Take your missed combined pill within 24 hours, even if you need to take 2 pills on the same day. Keep taking your combined pills as normal.
If you miss a mini pill and have unprotected sex, there is a chance you could get pregnant. Take your missed mini pill as soon as you can, even if you need to take 2 pills on the same day. Make sure to use extra contraception like condoms for the next 2 days. Continue to take your mini pill as usual.
If you miss a mini pill, and it’s been more than 12 hours since your last pill (or 3 hours if you take the 3 hour mini pill), you may need emergency contraception. These include Levonelle and ellaOne, which are available from most pharmacies. Levonelle can be used within 72 hours (3 days) and ellaOne can be used within 120 hours (5 days) after unprotected sex.
Both pills work by preventing ovulation from occurring. If you’re already pregnant when you take the morning after pill, it will not harm the developing baby.
If you take the morning after pill while you are ovulating (around midway through your cycle) or afterwards, it will not be effective. It’s a good idea to know your cycle, either by using an app to track your period or by keeping a calendar of how you feel throughout your cycle.
If you take Levonelle, you should take your next contraceptive pill within 12 hours. You need to use extra contraception, such as condoms, for 2 days if you are on the mini pill, 7 days if you are on the combined pill, or 9 days if you take Qlaira.
If you take ellaOne, you need to wait 5 days before you take your next pill. During these 5 days you need to use extra contraception such as condoms. After these 5 days, you need to continue to use extra contraception, for 2 days if you are on the mini pill, 7 days if you are on the combined pill, or 9 days if you take Qlaira.
You can also get the copper IUD (intrauterine device) inserted within 5 days of having unprotected sex. The IUD will act as emergency contraception as well as long term contraception.
How to remember to take your contraceptive pill
You can remember to take your contraceptive pill by setting a reminder on your phone or keeping the packet somewhere where you’ll see it in the morning.
Most contraceptive pills will have the days of the week printed on the back of the blister foil. This makes it easier for you to see if you have taken a pill on each day of the week.
You might want to use an ED pill instead of a 21 day pack, like Microgynon 30 ED. With ED pills, you’ll take a pill every day. During your 7 day pill break, you’ll take 7 inactive pills. This might be useful if you find it hard to remember to start the next pack with a 21 day birth control pill.
Dr Babak Ashrafi Clinical Lead for Service Expansion
Babak studied medicine at King’s College London and graduated in 2003, having also gained a bachelor’s degree in Physiology during his time there. He completed his general practice (GP) training in East London, where he worked for a number of years as a partner at a large inner-city GP practice. He completed the Royal College of GPs membership exam in 2007.Meet our doctors
Last reviewed: 21 Mar 2022