DrSugar is in the house! This week she's offering advice on when you've missed a dose, or two, or three, of birth control pills.
We receive countless questions from women who have inadvertently skipped a birth control pill, so I will be giving a general overview on what to do when you realize you have missed a dose. While this week's column will have general information on oral contraceptives and how to manage missing doses, I stress that it is best to talk with your health care provider who prescribed the pills about what to do. Different brands of pills have varying hormonal formulations and thus different potential effects when pills are missed. In some cases, you may be able to simply resume taking pills at your regular time the day after missing a pill and move on with life. In other cases, skipping even one pill (or extending the placebo week) could result in a serious threat to effective pregnancy prevention; it really depends on the type of pill you take. An additional factor to be aware of is that some brands of pills are multiphasic, meaning that pills in a single pack of birth control have differing levels of hormones. Depending on which pill you missed (or which "phase" pill it was), your health care provider may have different recommendations about how to proceed. This column will provide information from Planned Parenthood on the most common type of birth control pills, the combination pill.
Keep on reading to learn what to do if you miss a pill.
Depending on when you miss pills and how many pills you miss, you could become pregnant. Planned Parenthood reports that there is a highly increased risk of pregnancy if you go without taking the pill for seven or more days in a row. This could happen if you forget to start a new pack on time (i.e. right after the seven days of placebo you take during your period) or if you forget to take the last few pills in your pack. Planned Parenthood has a great chart on the general directions of what to do if you have missed pills.
- If you miss the first one to two pills at the beginning of the pack, then you should take a pill as soon as you remember and take the next pill at the usual time. If this happens you will need a seven-day backup method of birth control.
- If you miss one to two pills from day three through day 21 of your pack, then take a pill as soon as you remember and take the next pill at the usual time. If this happens, Planned Parenthood reports you do not need a backup method of birth control.
- If you miss three or more pills in the first two weeks of the pack, take a pill as soon as you remember and take the next pill at the usual time. Seven-day backup birth control will be necessary in this situation.
- If you miss three or more pills in the third week of the pack, do not finish the pack and throw it away. Start a new pack and use seven-day backup birth control.
While you need specific information from your health care provider about what to do, you may not actually need to have an in-office visit. If you can provide enough information to your provider (or one of her or his staff) over the phone, s/he may be able to give you an answer that way. You could also look for the explanatory pamphlet that comes with each pack of pills (usually a small, folded piece of paper), which may have some guidance about the brand's formulation and what to do in the case of a missed pill. If pregnancy is a concern, you could consider taking emergency contraception (EC). Women who are 17 or older can buy EC at nearly any pharmacy in the United States.
Hopefully this information is helpful; however, I urge anyone who misses birth control pills to contact their health care provider for specific instructions based on what type of birth control you are taking in order to be certain that you are doing the right things to help prevent pregnancy!
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