Have you ever dropped a birth control pill down the sink? Have you crushed a few pills in the bottom of your purse? People sometimes lose pills. When that happens, it’s important to have plan of action to make sure this doesn’t affect your birth control’s effectiveness.

Birth Control Basics

Birth control pills are pills that help prevent pregnancy. They contain hormones. The two basic types of birth control pills that are prescribed are combination pills and minipills. Combination pills have, as the name suggests, a combination of two synthetic hormones, progestin and estrogen. Minipills contain progestin only.

Both types of pills work in similar ways. First, they stop ovulation. This happens each month when an egg is released from a woman’s ovaries for fertilization. If no egg is released, there’s zero chance of pregnancy.

Mucus buildup on your cervix can prevent sperm from working their way into your uterus. If the sperm makes it to the uterus, an egg could be fertilized if it had been released during ovulation.

Some birth control pills also thin the lining of the uterus to prevent implantation. If an egg is somehow fertilized, this thin lining will make it difficult for the fertilized egg to attach and develop.

Birth control pills are designed to maintain an even level of hormones in your body. Taking your pills daily and at the same time each day keeps this level of hormones consistent. If these levels fluctuate, your body could begin ovulation fairly quickly. This increases your risk of an unplanned pregnancy.

If you take combination pills, you do have a slightly increased level of protection against this hormone dip, as long as you start taking your pills again as soon as possible. If you take progestin-only pills, the window of protection is much smaller. This window lasts about three hours.

What to Do If You Lose a Pill

Call your doctor if you lose your pill. Ask for guidance about your particular pill type. Each one is different, and your doctor may be able to recommend the best strategy for you.

If you take the pill at night or can’t get in touch with your doctor’s office, you can take matters into your hands with these tips.

Read more: Is there a chance of getting pregnant while taking birth control? »

What to Do If You Missed a Combination Pill

Next time you have an appointment with your doctor, ask them which option they suggest if you ever lose your pill.

Your doctor may suggest one of these three options:

  • Take the next pill. Keep moving along in your pack. You’ll reach the end of your pack a day early and will have to begin your next pack early. This shift won’t affect the pill’s effectiveness.
  • Take the last pill of your pack. If you’re still taking active pills, take the last active pill in your pack in place of your lost pill. This ensures that all remaining pills are taken on the regularly scheduled day. You’ll reach the end of your pack and begin placebo pills a day early. You can start your next pack a day early, too.
  • Take a spare pill. If you have another pack of birth control pills handy, take one of the pills from that pack to replace the one you’ve lost. Keep that pack in the event you lose a pill at another time.

If you lose a placebo pill, which is one of the inactive pills at the end of your pack, you can skip this dose. You can wait until the next day to take your regularly scheduled dose. Because these pills don’t contain any hormones, missing one won’t increase your chances of getting pregnant.

What to Do If You Missed a Progestin-Only Pill

You don’t have as much wiggle room if you lose a progestin-only pill. You need to take one within a few hours of your scheduled dose time, or the effectiveness of your birth control pills may drop. The next time you have an appointment with your doctor, ask them what they suggest that you to do in the event you lose a pill.

You can also do one of the following:

  • Take the next pill. Take tomorrow’s pill instead. Although the day you take the medicine will now be a day off from the pill’s dates, this will keep your level of hormone constant.
  • Take the last pill of your pack. If you want to keep the days of the week lined up correctly, take the last pill in your pack in place of your lost pill. You can take the remainder of the pack as scheduled. You’ll reach the end of your pack sooner, but you can begin your next pack immediately after.
  • Take a spare pill. Take a pill from an unopened packet to replace today’s pill. This will keep your pills lined up for the remainder of your packet, and you’ll begin your next packet on time. Keep this extra set of pills handy in the event you lose another pill in the future.

When You Should Start Your Next Pack

If you take progestin-only minipills, start the next pack as soon as you end the one you’re currently using. Progestin-only pills deliver hormones with every single pill. You don’t get the placebo pills with progestin-only pill packs, so you can begin your next pack of pills just as soon as you reach the end of your pack.

If you take a combination pill, the answer depends on how you replaced the pill you lost. If you took the last active pill from your pack to replace the one you lost or you skipped ahead in your pack by one day, you’ll begin your placebo pills a day early. That means you’ll also reach the beginning of a new pack a day early. You can begin taking the next pack a day early without increasing your risks for an unplanned pregnancy.

If you took a pill from another pack, you should be on a regular schedule with your pills. In that case, you’ll begin taking your next pack on the same day you would if you hadn’t lost a pill. Take your placebo pills, and immediately begin your next packet.

Are There Any Side Effects?

If you lost a pill and skipped taking it entirely, you may experience some breakthrough bleeding. Once you resume taking your daily birth control pills, the bleeding should end.

If you take combination-only pills, you should use some form of backup protection if you skip a pill entirely. You should use this backup method for the next seven days. If you replace the lost pill with another pill, you should still consider using backup protection for a week afterward.

If you take progestin-only pills and skip your lost pill, your risk of getting pregnant will increase. Use a backup method of birth control for at least 48 hours after you resume taking your pills daily.

How to Maximize Your Birth Control’s Effectiveness

These best practices can help you can avoid an unplanned pregnancy or possible side effects caused by birth control:

  • Take the pill every day at the same time. Set a reminder on your phone, or pick a time of day that you can easily remember, such as breakfast. You should take your pill every day for highest effectiveness.
  • Limit alcohol use. Alcohol doesn’t influence the pill’s effectiveness, but it can impact your ability to remember to take your pill. If you take your pill and then throw up within a few hours, whether from illness or alcohol consumption, you may need to take another pill.
  • Check for interactions. Some prescription medicines and over-the-counter herbal supplements may impact your birth control’s effectiveness. Before you begin taking the pill or before you start another medicine, ask your doctor or pharmacist if it’s safe for you to mix the two substances.


You can easily remedy the problem by calling your pharmacist or doctor’s office and getting advice, moving ahead to the next pill in your pack, or replacing the lost pill with a pill from a new pack. Instead of waiting to figure out what to do until you’ve lost a pill, be proactive. Ask your doctor about how you should handle losing a pill so that you’ll know what to do if it ever happens.

Read more: Which birth control is right for you? »

If you lose pills frequently or find yourself skipping pills regularly, you may want to discuss switching to a new birth control option. One that doesn’t require daily upkeep may be better suited for you and your lifestyle. Birth control options such as a vaginal ring, patch, or intrauterine device can help you maintain protection against an unplanned pregnancy without having to take a daily pill.