Missed pills
What happens if you miss birth control pills for 2 days?
Quick answer
It depends on your pill. On a 30 to 35 mcg combined pill like Trust (levonorgestrel + ethinylestradiol), WHO says missing 2 hormone pills carries little or no risk: take one now and carry on. On a 20 mcg pill like Yaz (drospirenone + ethinylestradiol), 2 missed pills means condoms for 7 days.
On a progestin-only pill like Daphne (lynestrenol), take one now and use condoms for 2 days.
Why 2 missed pills is not the same on every pill
The pill works by keeping hormone levels steady enough to stop ovulation. How much room you have for mistakes depends on the dose. WHO sets out three groups:[src]
- Combined pills with 30 to 35 mcg ethinylestradiol (most Philippine pills). The stricter rule only starts at 3 missed hormone pills in a row. So 2 missed pills is in the "little or no risk" group.
- Combined pills with 20 mcg or less. The lower dose gives less margin, so WHO applies the stricter rule from 2 missed pills.
- Progestin-only pills. These have no weekly margin at all. Even one pill taken more than 3 hours late (12 hours for desogestrel pills) counts as missed. Two missed days is clearly in the "use backup" group.
Your brand at a glance
| Pill type | Brands | 2 missed pills means |
|---|---|---|
| Combined, 30 to 35 mcg | Trust, Lady (levonorgestrel + ethinylestradiol), Diane-35 (cyproterone acetate + ethinylestradiol), Yasmin (drospirenone + ethinylestradiol), Micropil (norethisterone + ethinylestradiol) | Take one now, carry on. No condoms needed per WHO. |
| Combined, 20 mcg | Yaz, Lizelle, Ermina (all drospirenone + ethinylestradiol), Minipil (levonorgestrel + ethinylestradiol) | Take one now, condoms for 7 days. Week 3: start a new pack with no break. |
| Progestin-only | Daphne, Exluton (lynestrenol), Cerazette (desogestrel) | Take one now, keep going daily, condoms for 2 days. |
| Changing doses | Qlaira (estradiol valerate + dienogest) | Follow the leaflet. General rules do not apply. |
Source for the rules: WHO Family Planning Handbook.[src]
What to do right now
- Take one hormone pill as soon as you remember. Leave the other missed pill in the strip or throw it away; you do not need to catch up on both.
- Keep taking one pill a day at your usual time. Two pills on the same day is fine.[src]
- If your pill is in the 20 mcg group and you missed them in the last hormone week, finish the hormone pills and go straight to a new pack, skipping the inactive tablets.[src]
- If the missed pills were brown iron tablets or inactive tablets, nothing changes. Throw them away and start your next pack on time.
Not sure which week you are in? The Missed Pill Helper asks for your brand and pack day and gives the WHO steps for your exact case.
If you had sex in the last 5 days
On a 30 to 35 mcg pill with 2 missed, WHO does not list emergency contraception as needed. On a 20 mcg pill or a progestin-only pill, and especially if the misses were in the first week of a pack, talk to a doctor today about emergency options.[src] A copper IUD within 5 days is the most effective one.[src] See emergency contraception in the Philippines. If unsure, talk to a doctor or pharmacist.
Frequently asked questions
Nakalimutan ko uminom ng 2 araw, mabubuntis ba ako?
Depende sa pills mo. Sa Trust o Lady (30 mcg), uminom ng isa ngayon at ituloy, maliit o walang panganib ayon sa WHO. Sa Yaz o Minipil (20 mcg), gumamit ng condom sa loob ng 7 araw. Sa Daphne, gumamit ng condom sa loob ng 2 araw.
Should I take both missed pills at once?
WHO says to take one hormone pill as soon as you remember and then carry on with one a day. Taking two on the same day is fine, but you do not need to take every missed pill.
Will I bleed after missing pills?
You might. Spotting after missed pills is common and does not tell you whether you are pregnant. Keep taking your pills and take a test if your next bleed does not come.
This guide is for information. Talk to a doctor before starting, stopping or switching birth control.
Sources
- Managing missed pills (Family Planning Handbook), WHO and Johns Hopkins CCP
- Emergency contraception (fact sheet), World Health Organization