Should You Actually Double Up If You Miss a Birth Control Pill?

We’ve all been there: You go to take your birth control pill and realize: Crap, I forgot to do this yesterday! Your mind becomes a nonstop reel of questions that slowly elevates your anxiety level toward the red zone. Should I double up and take two? Can doing this make me sick? And, of course: If I have sex any time soon, should I use a back-up contraceptive?

Take a deep breath. Here are the answers to all of your questions, and a breakdown of *exactly* what you should after you’ve missed a pill. (Hint: Panicking isn’t on the list.)

Can I get pregnant if I miss a birth control pill?

“The pill is only as effective as we are compliant,” says women’s health expert Sherry A. Ross, MD, the author of She-ology: The Definitive Guide to Women’s Intimate Health. Period. So that “99 percent effective” thing is only legit if the pill is taken correctly, and this means taking your pill at the same time every👏🏾 single👏🏾day👏🏾.

The effectiveness of your trusty pill plummets even further if you inadvertently miss a dose. This increases the risk of pregnancy to varying amounts, depending on two things:

  • Where you are in your cycle
  • What type of pill you’re taking

If that last bullet point left you scratching your head, look at the pack. If all of the pills are the same, they’re likely progestin-only, says Lauren Owens, MD, MPH, professor of obstetrics and gynecology at the University of Michigan. If one week has different colored pills, you’re likely on combination birth control.

If you’re still not sure what kind of pill you have, talk to your healthcare provider. If you *do* know the type you take, keep reading for the specific info that pertains to you.

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If you’re taking combined contraceptive pills…

If your pill is the kind that contains progestin and estrogen (which is what most women take, btw), “you’re at highest risk [of unintended pregnancy] if you missed a pill in the first week of a new pack and had sex in the last five days,” Dr. Owens explains.

If you miss a placebo or sugar pill, don’t sweat it. These do not contain hormones, so they don’t affect your odds of avoiding pregnancy.

If you’re taking progestin-only pills…

If you have progestin-only birth control and you’re more than three hours late taking it, you can get pregnant.

Typically, progestin-only pill packs don’t contain sugar pills, so definitely follow precautions if you miss any of your pills. Which leads us to…

Do I need to use backup or emergency contraception?

If you’re taking combined contraceptive pills…

“Since combined oral contraceptives prevent ovulation, you don’t necessarily need backup birth control or emergency contraception unless you have missed more than one pill,” Dr. Owens says.

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If you missed another pill during your last cycle or earlier in your current cycle and you’ve had unprotected sex, you may want to take emergency contraception (such as Plan B) if you’ve had unprotected sex, she explains.

If you haven’t had sex but missed more than one pill (again, during this cycle or between this cycle and the last one), use a condom when you have sex.

Continue using added protection until you have taken seven hormonal (read: not sugar pills) in a row. Or don’t have sex until then, Dr. Owens suggests.

If you’re taking progestin-only pills…

If you take progestin-only birth control and you’re more than three hours late taking it, use backup birth control until you’ve taken the pill on time for two consecutive days, Dr. Owens recommends.

If you’ve had sex after forgetting to take your pill, consider taking emergency contraception.

How do I “double up,” and are there any side effects?

Once you realize you missed your regularly scheduled pill, take it immediately, Drs. Owens and Ross say. Then, take your next pill when you usually would.

The most common side effect of doubling up is nausea, due to the high level of hormones. Some women find that taking their pill with a snack or a meal reduces this risk, Drs. Owens and Ross note.

How can I remember to take my pill regularly?

Both Dr. Owens and Dr. Ross recommend taking the pill when you complete a daily task such as brushing your teeth at night. That first habit will cue you to remember, “Oh yeah, time for my pill!” You can also set a reminder on your phone, or Dr. Owens suggests an app like BedSider, which sends funny text messages when it’s time to pop your pill.

And if you repeatedly forget your pill (and freak out over pregnancy), you may want to consider another form of birth control such as an IUD or the ring. “It can cause a lot of hormonal imbalance if you’re on the pill and don’t take it every day,” Dr. Ross says. “There are other just as good birth control options.” Talk to your healthcare provider to determine what’s best for you.

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