Vee asked
On Saturday, which is the last day of week 3 before my first placebo pill in the pack, I took the placebo pill instead of the last active pill. I didn’t realize that now at 12am after I got off of work. I took the active pill (that I was supposed to take on Saturday) just now anyway. I had sex earlier today though and on Saturday when I took the placebo pill on accident. I’m afraid I might’ve messed something up. Am I safe from pregnancy or I should get EC?
At a glance
- If you are taking a combined hormone pill (COC) and have missed one pill, take the missed dose as soon as you remember. Back-up or emergency contraception is deemed not necessary by the Centers for Disease Control unless you have missed previous doses in your current pill pack.
- If you are taking a progestin only pill (POP) and it has been more than 3 hours since your missed dose, you do need to use back-up birth control and emergency contraception should be considered if you have had unprotected sex.
Answer
To boil your situation down, you are taking a birth control pill product that contains 21 active, hormone-containing pills and 7 placebo pills.
You missed the last active pill of your pack (the last pill of week 3), and accidentally took a placebo (non-hormone pill) instead.
While missing the active pill is of concern (and I discuss what to do in the next section), there is no need to worry about taking a placebo pill off-schedule. It contains no hormones and is merely a placeholder. It will have no effect on your period or the contraceptive effectiveness of your pills.
Missed Active Pill During The Third Week
What to do if you miss one active pill during your third week depends on which type of birth control pill you are taking, as there are two:
- Combined Hormone Pills (which contain both an estrogen and progestin). These are the most common.
- Progestin-Only Pills, or POPs. These only contain progestin and are often referred to as 'mini-pills'.
Combined Hormone Pills
the vast majority of resources on the matter state that as long as you take the missed dose as soon as you remember, you should not be at a significantly increased risk of pregnancy, and it is not necessary to use back-up contraception.
This is a blanket recommendation for nearly all combined hormone pill products.
The CDC (Centers for Disease Control) has a nice infographic titled 'Recommended Actions After Late or Missed Combined Oral Contraceptives' shown below:
If we take a look at the prescribing information for one example combined hormone pill product, they recommend the same procedure as the CDC. Below is an excerpt from the Yaz prescribing information, a combined hormone pill.
Additional Information
If you are still unsure about what to do, or whether or not you have taken the previous portion of your pack as directed, you may want to consider an emergency contraceptive, just to be safe. Be sure to reach out to your doctor for appropriate advice for your specific medical situation.
References
- Elsevier ClinicalKey: Yasmin Monograph (Accessed 2/18/19)
- U.S. Selected Practice Recommendations for Contraceptive Use, 2013. CDC
- Yaz Package Insert
- Hormonal Contraceptive Options for Women With Headache: A Review of the Evidence. PubMed
