I love talking about birth control. If you’ve ever talked to me for an extended period of time, or heck, read any of these blogs on here, you know I love talking about birth control options. The pill, the patch, the shot, the ring, condoms, IUDs – the list goes on and on! It’s one of my favorite topics. Despite my passion for the pill (and other contraceptive methods), I found myself clueless recently when I realized I didn’t know what to do if I miss a birth control pill myself!

I’ve been on the combination hormonal pill (estrogen and progestin) for nearly a decade. During that time, I’ve never missed a pill. (Thank you for the applause!) Life got extra stressful recently and I was extra distracted because I opened up my pill pack one Friday afternoon to see Thursday’s pill staring me in the face. Since I had literally never missed a dose, I had no idea what to do. I immediately called my gynecologist and got some answers.

How does hormonal birth control work?

In order for the hormonal birth control pill to be most effective, you have to take it at the same time every day. The pill works in two ways: it thickens your cervical mucus so if sperm were to get into the womb, no implantation would occur. It also shuts down ovulation. This is the big one with the pill. If you’re not ovulating, no eggs are being released to be fertilized. If you miss a dose, this can throw off the delicate balance of hormones needed for ovulation to be shut down. This is why some people get pregnant immediately after coming off the pill. Of course, everyone’s body is different, but even one missed dose, depending on the timing, can cause problems. 

I called my gynecologist and asked to speak with a nurse. I told her I had forgotten to take yesterday’s pill, so I was 24 hours late on that dose. She said since I had only missed one pill this month, I could just take it with today’s pill, taking two pills at once. Since I only missed one pill in my monthly cycle, and I took it as soon as I remembered, I would still be protected contraceptive-wise. She did say that it’s possible I might have some breakthrough bleeding, or the length of my menstrual cycle at the end of my pill pack could be slightly different than normal, but I did not need to use any backup methods of birth control because I had only missed one pill. 

Protection if you miss a birth control pill

If I had missed more than one pill that month, I would not be protected contraceptive-wise and would need to use another form of birth control, such as condoms. If you miss more than one pill in a cycle, it throws off the process of stopping ovulation. If you miss more than one pill in a cycle, take your missed pill as soon as you remember, even if you have to take two pills in one day. Use condoms in addition to your pill until you have taken active pills for seven days in a row. You need active pills for seven days to reset your cycle. It’s also recommended to take emergency contraception such as the Plan B pill if you’ve had unprotected sex within the last five days if missing that second pill. If you have fewer than seven active pills left in your pack, take what’s left and skip the placebo pills to start your next pack early. 

In addition to not being protected against unwanted pregnancy during this time, you might also notice spotting. Your next menstrual cycle might be slightly longer or shorter than usual as well.

If you’re on a progestin-only pill, the protocol is slightly different. If you take your progestin-only pill anywhere between three and 12 hours late, then you’re late on your dose. Take the pill as soon as you remember, even if that means taking two pills in one day. It’s also recommended to use emergency contraception if you’ve had unprotected sex within the last five days of missing a pill. Use condoms in addition to taking your pill until you’ve taken your pill on time for two days in a row. Then your cycle is back on track. 

Backup methods when you miss a birth control pill

If you ever miss a pill and you’re unsure, call your gynecologist and ask to speak to a nurse. If you don’t have a gynecologist, call Planned Parenthood, and they can tell you what to do as well. Although this was my first missed pill in nearly a decade, people miss doses of their birth control all the time. Like I said earlier, the pill works best if you take it at the same time every day, but stuff happens and sometimes you forget. Take your missed pill as soon as you remember, and use a backup method of birth control if you missed more than one pill during your cycle. 

Trying a different birth control option

If you find that you’re missing pills frequently, consider a different form of birth control. Talk to your doctor to discuss what options are best for you. Birth control such as the ring or an IUD might be a good option since you don’t have to “take it” every day. If you love the pill, but find you keep missing doses, you can also have some strategies to help you remember to take it on time. You could set an alarm on your phone that goes off every day to remind you. You could also take it at a time of day when you know you’ll be doing the same thing, for example, if you eat lunch every day at the same time, take it with your lunch. Even if you’re not sexually active, taking the pill on time every day helps keep your hormones regulated and feeling good. When in doubt, call your gynecologist and ask for help.

Talking Birth Control Options with Your Friends

From the pill to the IUD to the non-hormonal IUD to condoms to the injection…(should I go on? there’s more) there are MANY options for birth control in this good year of 2020, so how do you know which option is right for you, or which ones to even consider? What are the pros and cons of all these different ways to prevent pregnancy, stabilize hormones, or manage periods or acne? If you’re considering starting a form of birth control or changing to a new form of birth control, it’s essential to talk to your doctor about it before making any changes! But, sometimes it’s helpful talking birth control options with your friends before you take your big questions to the doc. 

Talking openly about birth control with your friends is not only helpful and educational, but also helps normalize women talking openly about birth control methods. There seems to be a stigma around women talking about birth control methods unless they can clearly state that they are on said birth control for a medical reason other than not wanting to get pregnant. Yes hormonal birth control can help treat many conditions such as cystic acne, PCOS, or endometriosis, but it’s also just as valid to be on birth control just to prevent pregnancy. Openly discussing your preferred method, as well as your reasons for being on birth control, help bond you and your pals in friendship, normalize this conversation, and help you make informed decisions. 

Because of the varying levels of hormones in hormonal forms of birth control, such as the pill, implant, shot, NuvaRing, or IUD for example, everyone has a different reaction to these birth controls. Talking about how your body reacted to your preferred method, or even an old method you tried and didn’t like can help inform those around you! It’s also interesting to hear about how hormones affect us differently and see how people consider the pros and cons for themselves. Also, a lot of the time women’s health issues are dismissed, our pain is minimized, or all of our symptoms are blamed on our periods. Our hormones and reproductive systems are complex, and sharing our experiences, struggles, and preferences finding what works best for us helps us be more educated and make more informed and empowered decisions in advocating for our reproductive health. 

Maybe you’ve been on the pill forever, but are wanting something with less hormones. Ask your friends if they have an IUD and hear about their experience getting it inserted, adjusting to having something in their uterus full time, and see what they think. Maybe your friend is considering starting the pill, but is fearful of having bad side effects. Tell them about your experience and how the pill did or did not affect you. Do you have really bad periods and cramps so intense you can’t get out of bed? Ask your friends about their periods, their symptoms, and how they manage it! Not only will you learn more, but having these vulnerable conversations will also bring you closer together.

After chatting with your pals about birth control options, be sure to make an appointment with your doctor and tell them everything you’ve learned and are considering. Make sure you don’t make any birth control changes without consulting your doctor first.