Unprotected sex after one missed birth control pill isn’t catastrophic, though it might feel that way. Take a breath, and read on. We’ll tell you everything you need to know.
A quick note on terminology: Typically, the phrase “unprotected sex” refers to bareback penis-in-vagina intercourse. But here, we’re using it to refer to sex that took place without proper barrier or proper contraception.
That includes any sex that happened with a broken condom, expired condom, or other condom mishap — or with someone using an expired birth control method or not taking their birth control consistently.
Depending on the type of birth control pill you take, you might not have to do anything, but we’ll get into the deets in a minute.
Basically, if you take combination birth control pills, you’re still protected against pregnancy, because they provide a steady stream of medication in your system. *Happy dance*
If you take a progestin-only pill, your protection window is a lot smaller, so a trip to the pharmacy or clinic for emergency contraception (EC) might be in order, depending on when you took your last pill.
(FYI, EC should be taken within 72 hours, if possible, after unprotected sex. The sooner you take it, the more effective it is.)
Worth mentioning: Some morning-after pills are less effective for people who weigh more than 155 pounds, so keep that in mind as you decide which emergency contraceptive option is best for you.
| Last pill taken <24 hours ago | Last pill taken 24–48 hours ago | Last pill taken 48+ hours ago | |
|---|---|---|---|
| During the first week of pack | Combo pill: You’re protected. Continue taking your pills as usual. Minipill: Take a pill as soon as you remember — only one pill, even if you’ve missed more than one. Take the next pill at the usual time, even if it means taking two the same day. Use a back-up birth control method for the next 48 hours. | Combo pill: Take your next pill ASAP, and continue taking your pills as usual. Minipill: Follow the same instructions as for the first week of the pack (in top left square of this table). | Combo pill: Take the most recent missed pill. Toss any other missed pills. Continue taking the rest of your pack as usual, even if it means taking two the same day. Minipill: Follow the same instructions as for the first week of the pack (in top left square of this table). |
| During the second week of pack | Combo pill: You’re protected. Continue taking your pills as usual. Minipill: Follow the same instructions as for the first week of the pack (in top left square of this table). | Combo pill: Take your next pill ASAP, and continue taking your pills as usual. Minipill: Follow the same instructions as for the first week of the pack (in top left square of this table). | Combo pill: Take the most recent missed pill. Toss any other missed pills. Continue taking the rest of your pack as usual, even if it means taking two the same day. Minipill: Follow the same instructions as for the first week of the pack (in top left square of this table). |
| During the third week of pack | Combo pill: You’re protected. Continue taking your pills as usual. Minipill: Follow the same instructions as for the first week of the pack (in top left square of this table). | Combo pill: Take your next pill ASAP, and continue taking your pills as usual. Minipill: Follow the same instructions as for the first week of the pack (in top left square of this table). | Combo pill: Skip the inactive pills by finishing the hormonal pills in your current pack. Start a new pack the next day. Minipill: Follow the same instructions as for the first week of the pack (in top left square of this table). |
| During the fourth week of pack | Combo pill: You’re protected. Continue taking your pills as usual. Minipill: Follow the same instructions as for the first week of the pack (in top left square of this table). | Combo pill: You’re protected. Continue taking your pills as usual. Minipill: Follow the same instructions as for the first week of the pack (in top left square of this table). | Combo pill: You’re protected. Continue taking your pills as usual. Minipill: Follow the same instructions as for the first week of the pack (in top left square of this table). |
How long it’s been since your last pill will determine your next steps, along with the type of pill you take.
Combination pill (active)
Combination pills are those that contain estrogen and progestin, a synthetic form of progesterone. The first 3 weeks of a pack are active, and the last week of a pack are placebo pills.
When taken consistently, the active pills maintain the therapeutic drug level needed to stop ovulation. No ovulation = no unwanted pregnancy.
Also, a combo pill isn’t considered “missed” if it’s been less than 24 hours. Just take your missed pill and get back to livin’ and lovin’ as you wish.
Combination pill (placebo)
Placebo pills don’t contain any hormones. They’re basically placeholders to help you stay on schedule. This means you technically didn’t miss a *real* birth control pill.
Just get back to taking your pills as usual, and go forth and fornicate, friend.
Progestin-only pill
The protection window for progestin-only pills — or “minipills” — is only 3 hours. This means, if you took your pill 3 or more hours later than you normally take it and had unprotected sex, you could become pregnant.
First, take your missed pill. Next, get EC.
You have a couple of EC options to choose from, but the least expensive and most accessible is the EC pill, aka morning-after pill.
The EC pill typically costs between $40 and $50, and you can get it over the counter (OTC) in most pharmacies, regardless of age and without showing ID.
Again, the type of pill matters, and so does how many pills you’ve missed. Just remember that, no matter what, you have options.
Here’s what to do for each type if it’s been 24 to 48 hours since your last birth control pill.
Combination pill (active)
If you missed 1 or 2 active combination pills, you should still be protected against pregnancy.
Take your missed pill ASAP, even if it means taking two pills in the same day.
If you decide to have penis-in-vagina sex again, using a backup method of birth control is a good idea — especially if you’re in the early part of your cycle or the last week of your last cycle.
Combination pill (placebo)
Placebo pills don’t contain hormones, so you’re fine. Just start your next pack as you normally would.
There’s no need to stress if you had unprotected sex — at least not as far as pregnancy goes.
Progestin-only pill
If you use a progestin-only pill, you’re well past the protection window at this point and NOT protected against pregnancy.
Here’s what to do:
- Take one pill when you remember, even if you missed more than one by now.
- Take your next pill at your usual time, even if it means taking two on the same day.
- Go to a healthcare professional or pharmacy for EC, pronto.
The longer you go without taking your birth control pills and the more pills you miss, the higher your risk of pregnancy. But, even if it’s been over 48 hours since your last pill, you still have options.
Combination pill (active)
If you missed two or more active combination pills at this point:
- Take your most recent pill ASAP and throw out any other missed pills.
- Get back on track by taking the remaining pills in your pack as you normally would, even if it means taking two the same day.
- Use backup birth control or avoid penis-in-vagina sex until you’ve taken active pills for 7 consecutive days.
If the missed pills happened in the last week of your active pills (like days 15 through 21 of a 28-day pack), skip your week of placebo pills and start a new pack the next day.
Using EC isn’t a bad idea, especially if active pills were missed during the first week and the unprotected sex happened in the previous 5 days.
Combination pill (placebo)
You don’t need to do anything as long as you only missed placebo pills. Just keep taking your pills like you’re supposed to.
Progestin-only pill
You probably missed two pills by now. It’s not ideal, but it’s not the end of the world.
Do this ASAP:
- Take a pill as soon as you remember — only one pill, even if you missed more than one.
- Take the next pill at the usual time, even if it means taking two the same day.
- Use a backup method of birth control for 2 days after restarting your pills.
- Talk with a healthcare professional or head to a pharmacy for EC.
Hold your horses! Taking a pregnancy test too soon will give you an inaccurate result.
You should only take one if you don’t get a period within 4 to 6 weeks after the missed pill.
Reach out to a healthcare professional if you think you might be pregnant, whether you had a positive home pregnancy test or have early symptoms of pregnancy.
Early symptoms often include:
- unexpectedly late period
- unexplained nausea and fatigue
- tender or swollen breasts
If you forget to take your birth control pills often, it might be time to talk with a healthcare professional about birth control methods that you don’t need to take every day.
It may be worth checking out a birth control option that you only need to use once per week, once every few months, or even once every few years.
Adrienne Santos-Longhurst is a Canada-based freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed-up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddle board.