Missed a pill? Where it falls in the pack changes everything

Missing a combined pill is not all or nothing. How much it matters depends entirely on where in the pack it happens, because of the seven-day rule.

A missed pill in the middle is fairly forgiving

If you miss a pill in the middle of the pack, with seven or more active days before it and seven or more after, your ovaries have been switched off and stay off. The risk of pregnancy from that single miss is low. Take the missed pill as soon as you remember, even if that means two in a day, and carry on.

A missed pill near the break is the danger zone

Miss a pill in the last few days of a pack, or the first few days of a new one, and you effectively lengthen the hormone-free break. That is when the ovaries can escape, and there is often a rebound: an egg released precisely because of the missed pill. This is the situation where a missed pill genuinely raises your chance of pregnancy, sometimes above what it would have been with no pill at all. It is the opposite of harmless.

What to do

For one missed pill, take it and carry on, no extra steps needed. For two or more missed pills, take the most recent one, use condoms or avoid sex for the next seven days, and then: if it happened in the first week and you have had sex, consider emergency contraception; if it happened in the last week, skip the break and go straight into your next pack. The same thinking applies to a patch that has come off or a ring that has been out too long.

The simple version

The closer a missed pill is to the break, the more it matters. Protect the days either side of your hormone-free week, and when in doubt, use condoms and ask us.