Your missed contraception guide | Devon Sexual Health

Combined hormonal contraception (CHC) pills, patches and vaginal rings:

Pills need to be taken at the same time every day.
Patches changed on the same day every week.
Rings need to be changed every 3 or 4 weeks.
You are at risk of getting pregnant if you miss pills or delay in refitting your patch or ring.

Did you know, you don’t have to have a bleed each month? Some people using hormonal contraception choose to take it continuously, whereas others take a break of 4-7 days. You are in control.

If you’re unsure ask at your next check-up.

The progestogen-only pill (POP) also known as the mini-pill. The mini-pill must:

Be taken every day with no break.
Be taken at the same time every day.

Depending on the type of contraceptive pill you take, there are different guidelines to help you know when you use additional contraception. A ‘missed pill’ is:

- Desogestrel (e.g. Cerazette, Cerelle, Desrex & Zelleta)– taken more than 12 hours late (more than 26 hours since your last pill)
- Drospirenone (e.g. Slynd) – taken more than 24 hours late (more than 48 hours since your last pill). If you missed a pill on days 15-24, you should start taking a new packet without taking the green pills.
- Levonorgestrel or Norethisterone (e.g. noriday/norgestron) – taken more than 3 hours late (more than 27 hours since you took your last pill).

Your mini pill will be working normally again.

Desogestrel – after three days of taking pills correctly.
Drospirenone (e.g. Slynd) -after 7 days of taking your pills correctly. If you missed a pill on days 15-24, you can start taking a new packet immediately.
Levonorgestrel or Norethisterone – after three days of taking pills correctly.

The combined pill contains hormones which work to help prevent pregnancy. If you have missed a pill, take one as soon as you remember and the next one when it is due.

If it’s been less than 72 hours since your last pill AND you’ve taken the 7 pills before correctly (or you’re in the first week after a break and took the previous week correctly), you can continue as normal. No need for condoms or avoiding sex.

If it’s been more than 72 hours:

Always take the missed pill as soon as you remember, then keep taking the rest on time.
What you do next depends on where you are in your pack:

First week of the pack:

If you started late (more than 9 days after your last pill) or missed pills AND had sex during the break or since, you may need emergency contraception.
Use condoms or avoid sex until you’ve taken 7 pills in a row correctly.

Second week:

If you took pills correctly the week before and before your last break, you don’t need emergency contraception.
Still use condoms or avoid sex until you’ve taken 7 pills correctly.

Third week:

No emergency contraception needed if the previous week was correct.
Use condoms or avoid sex until you’ve taken 7 pills correctly.
Don’t take a break — start your next pack straight away.

If your contraceptive patch has fallen off:

Less than 48 hours – put a new patch on and change on your usual day
More than 48 hours – Apply a new patch as soon as you remember and change on your usual day. You may need extra contraception (or emergency contraception if you’ve already had sex), depending on when your patch has fallen off:
- First week – or more than 8 days since you started your break. You may need emergency contraception if you have had sex and need to use condoms or avoid sex for 7 days.
- Second week – If the patch has been used correctly until now, you won’t need emergency contraception if you’ve had sex. You need to use condoms or avoid sex for 7 days.
- Third week – If the patch has been used correctly until now, you won’t need emergency contraception if you’ve had sex. You need to use condoms or avoid sex for 7 days. Do not take a break and start your next patch straight after.

Vaginal rings are removed every 3 weeks and inserted every 4th week.

If your vaginal ring has fallen out:

More than 48 hours –

Insert a new ring as soon as you remember and change on your usual day
You may need extra contraception like condoms (or emergency contraception if you’ve had sex). depending on where you are in your cycle:

First week (or more than 8 days after a break):

You may need emergency contraception if you’ve had sex.
Use condoms or avoid sex until you’ve used the ring correctly for 7 days

Second week:

If the ring was used correctly before, you don’t need emergency contraception.
Still use condoms or avoid sex for 7 days.

Third week:

No emergency contraception needed if the ring was used correctly before.
Use condoms or avoid sex for 7 days.
Don’t take a break — start your next ring straight away.

Some hormonal contraception may be affected if you are sickness whilst using.

Sickness (vomiting):

Combined hormonal pill –

If you are sick within 3 hours of taking it, it may not be absorbed.
Take a new pill as soon as you feel you can keep it down.
If you can take a replacement pill within 24 hours of when you normally take your pill then you are still protected.
If not, then you will have missed a pill – see the missed pill advice above.

Combined hormonal patch or ring –

These are unaffected by vomiting unless they become detached or fall out (see info above).

Diarrhoea:

Bad diarrhoea can affect the combined hormonal pill.

Treat each day with diarrhoea as a missed pill day (see missed hormonal pill info above).