Got to lunchtime and suddenly realised you forgot to take your contraceptive pill this morning? Or worse, looked at the packet and realised you missed it yesterday too? If you're not planning on procreating any time soon, that sudden feeling of pregnancy panic and anxiety about what you should do next can be very real.

Missed pill advice can be pretty confusing, so Dr Juliet McGrattan is here to walk you through what you should do if you forget to take you contraceptive pill and when you might need emergency contraception.

Remember: if you arent using your pill for contraception and only take it to treat medical conditions such as heavy periods, then theres no need to worry, you can just take the pill youve missed and carry on as normal.

There are three factors that are important to take into consideration when it comes to missing a pill: what type of pill you are taking, when you last took your pill and where you are in your pill packet.

Containing a combination of oestrogen and progestogen, combined oral contraceptives (COCs) are the most common type of contraceptive pill. Theyre taken daily with scheduled breaks for withdrawal bleeds.

After 21 days of daily pills, the level of hormones in your system is enough to protect you from pregnancy during a seven-day break. Its easy to see how missing a pill and extending this break by forgetting one just before or in the first few days after the break could put you at risk of pregnancy.

Take the pill as soon as you realise youve missed it and carry on as normal. Dont change the timing of the next pill, it doesnt matter if you end up taking two close together. Theres no need for extra contraception, your hormone levels wont have dropped enough to put you at risk of pregnancy.

When youve missed two or more pills, the level of hormones may have dropped enough to put you at risk of pregnancy. Take the most recent pill youve missed and leave the others. Carry on taking your pills as normal but to avoid pregnancy, either avoid having sex or use another method of contraception such as condoms for seven days.

If you are due to have a pill break within these seven days, dont take the break, just go straight onto the next packet. Remember, if you use an everyday (ED) COC then you will need to miss out the inactive tablets in the pack and go on to a new packet starting with the active pills.

You may need emergency contraception so read on.

If youve missed two or more pills, then you might need emergency contraception if youve had unprotected sex within the last seven days and if any of the following applies:

Its important to take emergency contraception as soon after sex as possible. The most effective form is insertion of a copper intra-uterine device (IUD) into the uterus (womb) but there are also hormone tablets that can be taken to prevent pregnancy. No method is 100 per cent effective but the sooner it is taken, the better. You can access emergency contraception in a number of ways including through a Family Planning clinic, your GP, your pharmacist or a sexual health clinic.

There are certain COCs where missed pill advice is different. If you are taking any of the following COCs; Qlairia, Daylette, Zoely and Eloine. Please read the information sheet that comes with the pills and contact your doctor or family planning clinic for further advice.

The progestogen only pill (POP) only contain progestogen, theres no oestrogen in them. They are taken continuously without a break so there are no pill free days and you simply finish one packet and go straight on to the next.

POPs need to be taken at the same time every day for them to be effective. For most POPs, there is a three-hour window in which to take them, for POPs containing the progestogen called desogestrel, there is a 12-hour window.

Simply take the late pill and carry on as normal, theres no need to worry.

If you are more than three hours late (or more than 12 hours for desogestrel POPs) Take the most recent pill you have missed and carry on. Dont change the timing of the next pill, it doesnt matter if you end up taking two close together. You are at risk of pregnancy so you need to abstain from sex or use another method of contraception for two days. If you have unprotected sex during these two days you may need emergency contraception. See the advice above regarding this.

If you miss a pill, then dont bury your head in the sand. Prompt action and emergency contraception if necessary can prevent unplanned pregnancies. Read the instruction leaflet that comes with your pill packet and speak to your GP, practice nurse, family planning clinic, pharmacist or sexual health clinic if you need advice. You can also get advice and information on the Family Planning Association website.

For contraceptive pills to be effective you need to be a good pill taker. Some people find this easier than others. Here are some things you can try to make sure you dont miss pills in the future:

Find the best time of day for you to take your pill. For some women this is in the morning but for others the evening or at lunchtime is best.

Associate pill taking with something you do every day such as brushing your teeth or making a cup of tea.

Set a reminder on your phone.

Use a specific pill taking app to keep you on track, some will give you advice about missed pills too.

For further advice and information on contraception, try one of the following:

Last updated: 30-01-2020

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Missed contraceptive pill: what to do if you miss the combined contraceptive pill or the progestogen only pill - Netdoctor

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