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I Missed My Birth Control Pill and Had Sex — Can I Get Pregnant?

I Had Sex and Forgot My Pill: What to Do Right Now

If you had sex and forgot your birth control pill, do not panic—but act quickly. Your chance of pregnancy depends on the type of pill you take, how many pills you missed, when you had sex, and where you are in your pill pack.

Missing one pill does not automatically mean you will become pregnant. However, missing two or more combined pills—or taking certain progestin-only pills late—can reduce your pregnancy protection. Emergency contraception may help if you had sex within the last five days.

The first step is usually to take the missed pill as soon as you remember, even if that means taking two pills in one day. Then continue taking the rest of your pack on schedule.

Can You Get Pregnant If You Forgot Your Birth Control Pill?

Yes, pregnancy is possible after a missed pill, but the risk is not the same in every situation.

Pregnancy risk generally increases when you go longer without active hormones, miss multiple pills, start a new pack late, or take a progestin-only pill outside its permitted timing window.

What Happened? General Pregnancy Risk What to Do
One combined pill missed or less than 48 hours late Usually low Take the missed pill and continue the pack
Two or more combined pills missed Increased Take the most recent missed pill and use backup contraception for 7 days
Norethindrone mini-pill more than 3 hours late Increased Take it immediately and follow the pill’s backup instructions
Drospirenone mini-pill less than 24 hours late Usually low Take it as soon as possible and continue the pack
Started a new pill pack late after the placebo week May be increased Restart pills, use backup contraception, and consider emergency contraception

Missing pills during the first week of a new pack can be especially important because extending the hormone-free break may allow ovulation to occur.

I Had Sex and Forgot My Pill: What Should I Do?

If you forgot your pill and already had sex:

  1. Take the missed pill as soon as possible.
  2. Continue the rest of your pack on schedule.
  3. Identify whether you take a combined pill or a progestin-only pill.
  4. Use condoms or avoid sex if backup contraception is recommended.
  5. Consider emergency contraception if you had sex within the last five days and your pregnancy protection may have been reduced.
  6. Take a pregnancy test three weeks after the sex you are concerned about.

Do not stop taking your pills because you are worried about pregnancy. Stopping your birth control does not reduce the risk from sex that already happened and may make your cycle and pregnancy protection more unpredictable.

What If You Missed One Combined Birth Control Pill?

Combined birth control pills contain estrogen and progestin.

If you missed one active combined pill, or it has been less than 48 hours since the pill should have been taken:

  • Take the missed pill as soon as you remember.
  • Continue taking the remaining pills at your usual time.
  • It is okay if this means taking two pills in one day.
  • Backup contraception is generally not necessary.
  • Emergency contraception is usually not necessary.

Your pregnancy risk is generally low when only one combined pill is missed and you otherwise took your pills correctly.

What If You Missed Two or More Combined Pills?

If you missed two or more active pills in a row, or it has been 48 hours or longer since an active pill should have been taken:

  • Take the most recently missed pill immediately.
  • Leave the earlier missed pills untaken.
  • Continue the rest of your pack on schedule.
  • Use condoms or avoid sex until you have taken active pills for seven consecutive days.

Emergency contraception may be worth considering if you missed pills during the first week of your pack and had penis-in-vagina sex without a condom during the previous five days.

This is especially important if the missed pills extended your placebo week or hormone-free break.

What If You Missed Pills During the Last Week of the Pack?

If you miss two or more combined pills during the final week of active pills, you may need to skip the placebo pills or hormone-free break.

Finish the remaining active pills and start a new pack immediately instead of taking the inactive pills. This prevents the hormone-free interval from becoming too long.

Your exact instructions may depend on your pill brand and pack design, so check the package insert or ask a clinician or pharmacist to confirm what you should do.

What If You Forgot a Progestin-Only Pill?

Progestin-only pills, sometimes called mini-pills, have different timing rules depending on the medication.

Norethindrone Progestin-Only Pills

Traditional norethindrone progestin-only pills are generally considered missed when they are taken more than three hours late.

If your norethindrone pill is more than three hours late:

  • Take the missed pill as soon as you remember.
  • Continue taking your pills at the usual time.
  • Use condoms or avoid sex for the next 48 hours.
  • Consider emergency contraception if you had sex while your protection may have been reduced.

You may take two pills in one day if you take the missed pill and your regularly scheduled pill on the same day.

Drospirenone Progestin-Only Pills

Drospirenone progestin-only pills have a longer missed-pill window than norethindrone pills.

If you are less than 24 hours late taking an active drospirenone pill, take it as soon as you remember and continue the pack normally.

If you miss two or more active drospirenone pills, follow the instructions included with your specific medication. You may need backup contraception for seven days.

Because progestin-only pills do not all follow the same rules, check the name of your medication before deciding what to do.

Should I Take Emergency Contraception After Missing a Pill?

Emergency contraception may be appropriate if you had sex within the last five days and your birth control protection was reduced.

You may want to consider emergency contraception if:

  • You missed two or more combined pills during the first week of your pack.
  • You started a new pill pack late after the placebo week.
  • You took a norethindrone mini-pill more than three hours late and had sex without backup contraception.
  • You missed multiple active drospirenone pills.
  • You are unsure how long you went without reliable pill protection.

Emergency contraception is used to prevent pregnancy after sex. It is not an abortion pill and will not end an established pregnancy.

Should You Take Plan B or Ella?

The best emergency contraception option depends on how long it has been since sex, your regular birth control, your medications, your medical history, and other individual factors.

Plan B and Other Levonorgestrel Emergency Contraception

Levonorgestrel emergency contraception includes Plan B One-Step and several generic versions.

It works best when taken as soon as possible, preferably within 72 hours after sex. It may still be used up to five days after sex, although effectiveness can decrease as more time passes.

You can generally continue or restart your regular hormonal birth control immediately after taking levonorgestrel emergency contraception.

If you are unsure whether it can still work based on your timing, read Does Plan B Work After Ovulation?.

Continue your birth control and use condoms or avoid sex for the backup period recommended for your pill.

Ella

Ella contains ulipristal acetate and can be taken up to five days after sex.

There is one critical difference between Ella and Plan B: you should wait five full days after taking Ella before restarting hormonal birth control.

Starting birth control hormones too soon can reduce Ella’s ability to delay ovulation.

After taking Ella:

  1. Wait five days before restarting your hormonal birth control.
  2. Use condoms or avoid sex during those five days.
  3. Restart your pill on day six.
  4. Continue using condoms or avoiding sex for seven days after restarting your pill.

Ella does not protect you from pregnancy if you have sex again later in the same cycle. You can also read Plan B or Ella After Ovulation: Which One Actually Works? for a more detailed comparison.

Start an emergency contraception visit with MyBodyMyRx

MyBodyMyRx offers clinician-reviewed emergency contraception options, including Ella, with transparent flat-rate pricing, no subscriptions, and no mandatory mail-order pharmacy.

Should You Stop Taking Birth Control After Missing Pills?

No. Do not stop your birth control simply because you missed a pill or are concerned about pregnancy.

Continue taking your pills according to the missed-pill instructions for your medication. Stopping the pack can extend the time you are without hormone protection and increase the chance of ovulation.

If you take Ella, however, you must pause hormonal birth control for five days before restarting it.

If you are running out of pills or do not have refills available, learn how to refill birth control online without an in-person appointment.

What Happens If You Take Two Birth Control Pills in One Day?

It is usually safe to take two birth control pills in one day when you are taking a missed pill and your regularly scheduled pill.

You may temporarily experience:

  • Nausea
  • Spotting
  • Breast tenderness
  • Headache
  • Mild stomach discomfort

Taking two pills as directed after a missed dose does not usually cause serious harm. Do not take several missed pills at once unless the instructions for your specific medication tell you to do so.

If you recently started your prescription and are experiencing other symptoms, read When Do Birth Control Side Effects Go Away?.

Frequently Asked Questions

I had sex and forgot one birth control pill. Should I worry?

If you missed only one combined birth control pill and it has been less than 48 hours, your pregnancy risk is generally low. Take the missed pill as soon as possible and continue your pack normally.

The rules are different for progestin-only pills, so check the name of your medication.

Can I get pregnant from one missed pill?

Pregnancy is possible, but missing one combined pill usually does not substantially increase pregnancy risk. The risk may be higher if you missed a progestin-only pill, started a pack late, missed multiple pills, or extended your hormone-free break.

I missed two pills and had sex. Do I need Plan B?

You may need emergency contraception if you missed two or more pills during the first week of your pack and had sex without a condom within the previous five days.

Your exact recommendation depends on the type of pill you take and when the pills were missed. If you need help choosing an option, start an emergency contraception visit.

Should I keep taking birth control after Plan B?

Yes. You can generally continue or restart your hormonal birth control immediately after taking Plan B or another levonorgestrel emergency contraception product.

Should I keep taking birth control after Ella?

No. Wait five full days after taking Ella before restarting hormonal birth control. Use condoms or avoid sex during that time and for seven days after restarting your pill.

For more detail, read How Long Does Ella Delay Ovulation?.

Protect Yourself for the Rest of This Pack

Use condoms during the backup window recommended for your medication. Continue taking your pills unless your specific instructions tell you to pause them.

If you frequently forget pills, consider whether a method that does not require daily dosing might fit your routine better. Other options include:

  • The birth control patch
  • The vaginal ring
  • The birth control injection
  • The implant
  • A hormonal or copper IUD

You can start a birth control visit with MyBodyMyRx if you need a new prescription or want to discuss a method that may be easier to use consistently.

There is no shame in choosing a method that is easier to remember.

For now, focus on the next steps: take the missed pill, identify your pill type, determine whether emergency contraception is appropriate, use backup contraception when needed, and take a pregnancy test three weeks after the sex you are concerned about.

Dr. Jessica Isnetto, DNP, APRN-C, FNP-C

I’m the founder of MyBodyMyRx and a clinician with more than 20 years of experience in reproductive and women’s healthcare. I spent more than a decade caring for patients in person, and today I provide care through direct-to-patient telemedicine, with a clinical focus on birth control, emergency contraception, period delay treatment, and perimenopause and menopause care.

I built MyBodyMyRx because I care deeply about reproductive healthcare, access, choice and making sure people are treated fairly when they seek care.

Access matters. Having choices matters. And who gets to make those choices matters.

Our healthcare landscape is changing. I believe people need more options to protect their health—not fewer. Decisions about your body and your healthcare should be made by you, with guidance from a qualified clinician, not dictated by someone else’s beliefs, a corporate business model, or a company’s bottom line.

I have watched healthcare become increasingly transactional. Too often, patients are asked to pay before they even know whether a service can help them. They’re pushed toward subscriptions they may not need, bundled products they may not want, or a company’s preferred pharmacy. In other models, patients are expected to research medications, choose their own treatment, and essentially become their own provider before a clinician ever evaluates them.

I don’t think healthcare should work that way.

You deserve to understand your options. You deserve transparent pricing. You deserve to know whether you may be eligible for care before being asked to pay. And you deserve a clinician who is actually responsible for the clinical part of your care.

Healthcare first. Checkout second.

That philosophy is built into MyBodyMyRx.

You complete a medical intake for a preliminary eligibility assessment first. Then you decide whether you want to move forward and pay—or walk away with no risk. Only after you submit and pay does a clinician perform the formal medical review. When treatment is appropriate, your prescription can be sent to the pharmacy you choose.

I didn’t build MyBodyMyRx to steer you toward a particular medication, pharmacy, subscription, or product. I built it to give you another choice.

My job as a clinician is to help you understand your options, evaluate what is medically appropriate, explain important risks and benefits, and provide evidence-based care. Your job should not be to diagnose yourself or figure out what to prescribe yourself before anyone will help you.

I also believe being informed is part of having autonomy. That’s why education is an important part of MyBodyMyRx. I want patients to have access to clear, useful medical information without expecting them to become medical experts in order to receive care.

Being informed should give you more power in your healthcare—not transfer the responsibility for providing that healthcare onto you.

Areas of Clinical Focus

  • Birth control and contraceptive counseling

  • Emergency contraception, including ella (ulipristal acetate) and levonorgestrel

  • Period delay treatment

  • Perimenopause and menopause care

  • Direct-to-patient telehealth

Medical Content & Clinical Standards

I take the same evidence-based approach to the educational content published by MyBodyMyRx. Content is written or clinically reviewed and informed by current clinical guidelines, FDA-approved prescribing information, peer-reviewed medical literature, and established medical references.

Sources I commonly consult when researching and reviewing educational content include:

  • American College of Obstetricians and Gynecologists (ACOG)

  • Centers for Disease Control and Prevention (CDC), including the U.S. Medical Eligibility Criteria for Contraceptive Use and U.S. Selected Practice Recommendations for Contraceptive Use

  • U.S. Food and Drug Administration (FDA) prescribing information

  • The Menopause Society

  • World Health Organization (WHO)

  • Peer-reviewed medical literature and major medical journals

MyBodyMyRx exists because I believe reproductive healthcare should still feel like healthcare.

Not a sales funnel.
Not a subscription trap.
Not a guessing game.

Real clinical care. Fair treatment. Transparent pricing. And choices that remain where they belong—with you.

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Dr. Jessica Isnetto, DNP, APRN-C, FNP

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