Missed pill

Question 1

What to advice if a woman misses 1 COCP pill?

Answer 1

If 1 pill is missed (at any time in the cycle)

• take the last pill even if it means taking two pills in one day and then continue taking pills daily, one each day
• no additional contraceptive protection needed

Question 2

What to advice if a woman misses 2 or more COC pills?

Answer 2

if 2 or more pills missed

• take the last pill even if it means taking two pills in one day (leave any earlier missed pills) and then continue taking pills daily, one each day

*the women should use condoms or abstain from sex until she has taken pills for 7 days in a row

• if pills are missed in week 1 (Days 1-7): emergency contraception should be considered if she had unprotected sex in the pill-free interval or in week 1
• if pills are missed in week 2 (Days 8-14): after seven consecutive days of taking the COC there is no need for emergency contraception
• if pills are missed in week 3 (Days 15-21): she should finish the pills in her current pack and start a new pack the next day; thus omitting the pill free interval

Question 3

What happens if a progesterone-only pill is missed by more than 12 hours?

Answer 3

if delayed by longer than 12 hours → contraceptive protection may be lost

Question 4

What to do if the progesterone-only pill is missed by more than 12 hours?

Answer 4

if delayed by longer than 12 hours → contraceptive protection may be lost

• Continue normal pill-taking but must also use another method, such as the condom, for the next 2 days
• emergency contraception if one or more tablets are missed or taken more than 12 hours late and unprotected intercourse has occurred before 2 further tablets have been correctly taken

Question 5

When do we need to use emergency contraception when progesterone-only pills are missed?

Answer 5

Emergency contraception if:

• one or more tablets are missed or taken more than 12 hours late and
• unprotected intercourse has occurred before 2 further tablets have been correctly taken