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I am on the 21-day contraceptive pill, and this week I forgot to take two of them. On the third night I realized this and, in my horror, took all three at once. Then last night I took one as usual. But today I got a period even though I have seven pills left to take. What should I do?
May 7, 2001 -- I often get questions from women about what to do after forgetting to take birth control pills. Anytime you're unsure, contact your physician for advice. While you're waiting for a reply, keep taking one hormone-containing pill (as opposed to the "reminder" pills in the last 7 days of a 28-day pack) each day. In addition, use another method of birth control when you have sex.
It's not uncommon for women to notice menstrual cycle changes after missing birth control pills. It is likely that missing the two pills caused spotting or breakthrough bleeding, which can look just like a period. Though this usually doesn't last long, contact your provider if the bleeding is prolonged or persistent. If you don't have a period at your regular time after missing some of your pills, contact your provider to find out if you need a pregnancy test.
Besides consulting with your doctor, another great resource is the patient package-insert instructions that come with your birth control pills. If you've lost or misplaced yours, ask your pharmacist for another copy.
According to product information for several brands listed in the Physician's Desk Reference (PDR), here's what to do if you miss one or more pills. These directions do not apply to the mini-pill, or progestin-only contraceptive pill. For specific advice about your particular birth control pill, please consult your physician.
If you miss one active tablet during weeks one, two, or three of your pill pack, take the tablet as soon as you remember. This means you may take two pills in one day. (The active pills are the ones containing hormones, not the blank "reminder pills" in a 28-day pack.) You do not need to use a back-up -- or extra -- method of birth control, according to the PDR.
If you miss two active tablets during weeks one or two of your pack, take two pills on the day you remember and two pills the next day. Then take one pill a day until you finish the pack. In addition to your birth control pill, use a back-up method of birth control (such as condoms, foam, or sponge) if you have sex within seven days of missing any pills.
If you miss two active tablets during the third week, or miss three or more active tablets in a row, the recommendations depend on when you started your pack of birth control pills.
If you are a Sunday starter: Keep taking one tablet every day until Sunday. On Sunday, throw out the rest of your pack and start a new pack of pills that same day. Use a back-up method of birth control if you have sex in the seven days after you miss pills.
If you are a Day One starter: Throw out the rest of the pack and start a new pack that same day. Use a back-up method of birth control if you have sex within seven days of missing any pills.
I advise that you to talk to your health care provider if you frequently have trouble remembering to take the pill. You can learn some ways to make pill-taking easier. Or you may want to consider switching to another type of contraception.
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