If taken outside of this timeframe, your hormones may fall below the therapeutic window, upping your risk of pregnancy, says Harris. There are two different types of progestogen-only pills-a 12-hour pill that must be taken within 12 hours of the same time each day, and a three-hour pill that must be taken within three hours of the same time each day. What To Do When You Miss a Progestogen-Only Pill Once the new pack is started, continue with backup contraception for the next seven days. If you miss two pills in the third week, or if more than two hormonal pills are missed at any time, you should initiate backup contraception right away and start a new pill pack the same day, says Peskin-Stolze. Watch men answer questions about birth control (spoiler alert-they're clueless): If you miss two pills and miss them early in your cycle (think: the first two weeks), breakthrough ovulation can occur due to the body’s inability to suppress the stimulating hormones, says Peskin-Stolze, in which case you should catch up by taking two pills for the next two days, take the rest of the pack as usual, and use backup contraception for the next seven days. Continue taking the rest of the pack as usual. Backup contraception isn’t usually needed in this case, but you may want to consider it if you missed pills earlier in the pack, or in the last week of the previous pack.
If it’s close to the time you’d normally take your next pill, take both at the same time. “If one pill is missed, nothing happens and you should take that pill as soon as you remember, then your next pill at the usual time,” says Peskin-Stolze. The best course of action depends on two factors: how many pills have been missed and when in your cycle they were missed. What To Do When You Miss A Combination Pill “When you miss a pill, your hormone levels will drop below the therapeutic level, which makes you susceptible to pregnancy if you have intercourse during that time.” You may also notice some slight hormonal changes like nausea, headaches, and some light bleeding. “Pills are formulated so that the hormones will be at the therapeutic level for only 24 hours,” says Elicia Harris, M.D., board-certified ob-gyn at Women’s Health Advantage in Indiana. RELATED: Your Complete Guide To Quitting Your Birth Control Meanwhile, the progestogen-only pills work by thickening the cervical mucus (to ward off sperm) and thinning the endometrial lining (which makes it less receptive to a fertilized egg). “The progestogen component prevents ovulation, while the estrogen component primarily prevents the selection and emergence of the dominant follicle that produces the egg,” says Melissa Peskin-Stolze, M.D., ob-gyn at Stony Brook University Hospital in New York. When you’re on the combination pill, which is made up of estrogen and progestogen, these hormones prevent the monthly fluctuations in hormone secretion that lead to egg development, and in turn, ovulation. (Kick-start your new, healthy routine with Women's Health's 12-Week Total-Body Transformation!) What Happens When You Miss A Combination Pill Realizing there’s one too many pills in your pack can send even the most rational woman into a spiral of panic and despair, where the only question you want answered is: Now what?
No matter how hyper-organized you are, there’s bound to be a day when taking your birth control pill straight-up slips your mind, or a disruption in your schedule knocks you out of your pill-popping groove.
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