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Sexpert: Dec. 13, 2012

Dear Sexpert,

I’ve been on the birth control pill for the past six months, and I’m usually careful to not miss a day. I visited my best friend from high school last weekend, and I completely forgot to bring my pills with me.

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When I came back to school, I realized I had skipped two days. What will happen and what should I do?

— Anxious

Dear Anxious,

First things first, take a deep breath! Many women on the pill forget to take it at some point. What you should do will depend on the type of pill you take.

Some birth control pills are called combination pills because they have two hormones, estrogen and progestin. Some pills only have progestin. Most women on the pill take combination pills, but first check to see what kind of pills you are taking. For guidelines specific to your pill and what you should do, you should contact Sexual Health and Wellness Services at UHS or speak with your pharmacist.

If you are using combination pills and you forget to take one active birth control pill, take it as soon as you remember and take the next one at your regular time. If you don’t remember until the next day, then take two pills on that day. If you miss two active pills in a row in week one or week two of your pack, then take two pills on the day that you remember and two pills the next day. You will then be back on your normal schedule. If you miss two active pills in week three of your pack and you are a day one starter, throw out the rest of the pack and start a new pack that same day. If you miss more than two pills in a row, contact UHS or your health care provider for further instructions.

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There is an increased risk of pregnancy if you miss the pill and have sex during the seven days afterward. When you forget to take a birth control pill, you increase the chance of releasing an egg from your ovaries. You must use another birth control method for seven days.

Following missing birth control pills, the number of pills you have missed and when in your cycle you missed them will determine if you should use emergency contraception. If you missed one pill (more than 24 hours and less than 48 hours late) then emergency contraception is usually not needed. If you missed two or more pills (more than 48 hours late), then you should take emergency contraception to reduce your chances of becoming pregnant.

However, if you missed any of the pills without any hormones in them, the inactive pills, then don’t worry. Since there are no hormones in these pills, you are not at risk of pregnancy if you miss them. These pills are included in your pill pack to remind you to take your pill every day.

Often, when women miss a pill, they may experience spotting or light bleeding. Sometimes, women will feel nauseous if they take two pills to make up for a missed pill. Don’t worry if you feel a bit sick — it won’t last too long. It is important to stay on schedule with the pill for maximum efficacy, and it may be helpful to incorporate it into your daily schedule so you won’t forget. For example, you can take it after you brush your teeth, or set a daily alarm to remind you. Remember, though, the pill won’t protect you against STIs, so make sure to be safe and use the proper protection.

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— The Sexpert

Interested in Sexual Health? The Sexpert is always looking for passionate members of the community to join the team of sexual health educators who, along with fact-checking from University health professionals, help write these columns. Email sexpert@dailyprincetonian.com for more information and, of course, with your questions about sexual health. Don’t be shy!