Birth control pills and forgetful minds: what to do if you miss a pill


Birth control pills. Have you taken yours today? What to do if you forget to take yours?

It depends on what type of pill you are taking.

There are 2 types:
1) Combined oral contraceptives, which contain both estrogen and progesterone. The progesterone component stops you from ovulating which stops you from getting pregnant. A side effect of not ovulating is irregular periods and unscheduled bleeding. The estrogen component regulates your bleeding. Combined oral contraceptives are usually wonderful to help regulate periods, decrease bleeding, decrease pain with your period, decrease symptoms of PMS, improve your skin, etc. These wonderful side effects are why pills are so popular and a favorite of mine.

2) Progesterone only pills, also called the “mini-pill”. It could not be more clearly stated: these pills contain only progesterone. No estrogen. They prevent ovulation but don’t have the estrogen to regulate your bleeding so the main side effect is unscheduled bleeding. There is no placebo week. These pills are for women who want a pill form of birth control but SHOULD NOT OR CANNOT USE ESTROGEN (discussion this with your doctor!): This is you if:

  • you are breastfeeding (estrogen decreased milk production)
  • are a smoker (you should quit!!)
  • have a history of blood clots in your legs or lungs or disorder that puts you at high risk of having one
  • have migraine headaches with aura (lights or visual changes accompany your migraines)
  • have medical problems like uncontrolled high blood pressure / out of control diabetes / Lupus
  • have a history of breast cancer

I could go on and on about birth control pills. To get to my point:

What to do if you forget yours:

If you are taking combined oral contraceptives:

  • If you miss one pill: take it as soon as you remember, and take your next schedule pill on time. You may end up taking 2 pills at the same time or on the same day. That’s fine.
  • If you miss 2 days in a row: Take one of the missed pills as soon as you remember. Take the day’s pills as normal. So you forget Monday and Tuesday and remember Wednesday, take Tuesday’s pill and Wednesday’s pill. Then continue taking the pills like normal. You NEED to use a back up form of contraception for 7 days, like condoms or abstinence. If you had unprotected sex during the 2 days you missed, you should use Plan B (and read my post about it here).

If you are taking progesterone only pills:
Rules are MUCH stricter:
To be effective, you need to take the pill at the same time every day.

  • If you take the pill more than 3 hours late (or forget altogether), take the late / missed pill as soon as you remember – even if this means you take 2 pills on the same day. Then continue your daily pill on time. You NEED to use a back up form of contraception for 2 full days following.

What can help you remember to take your pill?

  • Incorporate taking your pill with part of your daily routine: brushing your teeth in the AM, watching the Daily Show at night, etc
  • Set an alarm
  • Request a text message reminder from (great resource!)
  • If you are just plain forgetful … well, we need to discuss things that are not so easy to forget.

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