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Late taking my birth control pill, unprotected sex and now I am freaking out! #117/11

 I had unprotected sex on the 23rd of January and am freaking out that I could be pregnant. I have been on the pill for 4 years and I take the pill every day, but not at the same time (usually between 7am-11 AM) and hadn't missed a pill for at least a week before having sex. When I came home after having sex I freaked out and took a pill, but I’m pretty sure I had taken one that morning.

I have never had sex without a condom and I went to the pharmacy and asked about the morning-after pill, but the pharmacist said there was no need. But I am freaking out!  Will that in any way give me a chance of being pregnant?

 You really do not need morning-after contraception.  Pills can be taken late or you can even miss a pill and still be protected.


You are remarkable!  You are doing just great!!!


Below is some very important information from the World Health Organization on missing and late pills:                                              




What can a woman do if she misses combined oral contraceptives (COCs)?

For 30-35 µg ethinylestradiol pills:

Missed 1 or 2 active (hormonal) pills or if she starts a pack 1 or 2 days late

  • She should take an active (hormonal) pill as soon as possible * and then continue taking pills daily, 1 each day.
  • She does not need any additional contraceptive protection.

Missed 3 or more active (hormonal) pills or if she starts a pack 3 or more days late

  • She should take an active (hormonal) pill as soon as possible* and then continue taking pills daily, 1 each day.
  • She should also use condoms or abstain from sex until she has taken active (hormonal) pills for 7 days in a row.
  • If she missed the pills in the third week, she should finish the active (hormonal) pills in her current pack and start a new pack the next day.  She should not take the 7 inactive pills.
  • If she missed the pills in the first week and had unprotected sex, she may wish to consider the use of emergency contraception.


For 20 µg or less ethinylestradiol pills:

  • If the woman misses 1 active (hormonal) pill or starts a pack 1 day late, she should follow the guidance above for “Missed 1 or 2 active (hormonal) pills or if she starts a pack 1 or 2 days late.”
  • If the woman misses 2 or more active (hormonal) pills or if she starts a pack 2 or more days late, she should follow the guidance above for “Missed 3 or more active (hormonal) pills or if she starts a pack 3 or more days late.”


For both 30-35 µg and 20 µg or less ethinylestradiol pills:

Missed any inactive (nonhormonal) pills

  • She should discard the missed inactive (nonhormonal) pill(s) and then continue taking pills daily, 1 each day.


*    If a woman misses more than 1 active (hormonal) pill, she can take the first missed pill and then either continue taking the rest of the missed pills or discard them to stay on schedule.


 Depending on when she remembers that she missed a pill(s), she may take 2 pills on the same day (one at the moment of remembering, and the other at the regular time) or even at the same time.


From the World Health Organization’s Selected Practice guidelines - 2005



Email received on 1-29: “Thank you for your reply.  I am just getting really worried.  I have been feeling quite tired and have a sore stomach at the moment (I don’t think it is because I am constipated) and the other day I had some spotting on my undies.  There weren’t really very many spots, just a couple of noticeable ones.  They looked like the usual ones you get sometimes when you skip your period too much on the pill and you need to take a forced bleed, but I do know that you can get spotting a week or so after conception.  Just little things like that are really starting to cause me to worry.  Any feedback and/or advice would really be great.




A negative urine pregnancy test might be reassuring to you.  A serum pregnancy test definitely is not indicated.

Email reply on 1-30: “Great!  How soon can I take one?”


You can take the pregnancy test today.


To learn more about the advantages and disadvantages of the birth control pills, go to our website: www.managingcontraception.com and click on Choices.  You can also order this wonderful new educational book from our website or by calling 404-875-5001.  Do you have your copy yet?  



Key Words:  unprotected sex, pregnant, birth control pills, late pill, morning-after pill, protected, World Health Organization, missing pills message, tired, sore stomach, constipation, spotting, forced period, urine pregnancy test, serum pregnancy test, negative 


Robert A. Hatcher MD, MPH
Emeritus Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA

Contraceptive Technology 20th Edition & Managing Contraception

Managing Contraception for Your Pocket 2013-2014

Choices, English

The directors and owners of this website and any publications and information concerning health matters offered here advise a person with a particular problem to consult a primary-care clinician or a specialist in obstetrics, gynecology, or urology (depending on the problem or the contraceptive) as well as the product package insert and other references before diagnosing, managing, or treating the problem.
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