WOMEN are told by their doctor to “take their pill at the same time every day”.
But this information is rather vague and in fact, does not apply to everyone in the same way.
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Each pill has a “safety window”. As long as it’s taken within that frame, you are protected from pregnancy.
There are less than a handful of pills (out of the dozens on the UK market) that, without fail, must be taken at the exact same time every day. Others give a much broader time frame.
You may realise you are late taking your pill – say 9pm, rather than 10am.
But contrary to what you think, this does not necessarily mean you have missed it and are at risk of pregnancy.
The Lowdown is the one-stop source of contraception information, and created the missed pill calculator for women worried about a late pill.
Alice Pelton, the founder, said: “Safety windows can be so confusing!
“Lots of our community at The Lowdown report thinking they’ve missed their pill, when in fact their pill isn’t ‘missed’ yet.
“And then if they have missed their pill – having to use complicated instructions in leaflets to work out what to do next.
“It’s really important we educate women and contraceptive users about how this actually works, and that’s why we’re building digital tools to make it simple.”
If you do miss a pill, you are not as adequately protected against pregnancy.
Dr Melanie Davis-Hall, a GP and Medical Director for the website, said: “Missing a pill can make it less effective and may mean you are no longer protected from pregnancy.
“You may need to consider using emergency contraception or additional contraception such as condoms.
“What you need to do next will also depend on where you are in your pack of pills, whether you have taken a pill-free break before this packet (if you are taking the combined pill), and how many pills you’ve missed.
“This is all taken into account in our missed pill calculator.”
You can use the missed pill calculator here.
Dr Davis-Hall said: “Some people find that if they take their pill at the same time as an activity they do every day, like brushing their teeth, this can help them to remember.
“Alternatively you may want to consider methods which you don’t have to remember to use [such as the coil or implant].”
The rules are complex because there are so many types of pill.
But here, we explain how each pill works, and exactly how long you have to take it every day.
The combined pill
The combined pill is traditionally taken every day for 21 days, followed by a seven-day break during which you may have a withdrawal bleed.
It contains synthetic forms of progestogen and oestrogen.
All brands of the combined pill should be taken orally at the same time every day.
Microgynon, Rigevidon and Ovranette are examples of the combined pill and are the most commonly used type of contraceptive pill in the UK.
Names (as of March 2022): Brevinor, Cilestl, Cilique, Cimizt, Daylette, Dianette, Eloine, Femodene ED, Femodene, Femodette, Gedarel, Katya, Levest, Lizinna, Loestrin, Logynon, Loryna, Lucette, Maexeni, Marvelon, Mercilon, Microgynon, Microlite, Milinette, Norimin, Norinyl-1, Ovranette, Qlaira, Rigevidon, Sunya, Yasmin, Zoely.
What is the “safe window”?
The Lowdown says for the standard combined pill, a “missed” pill is when more than 24 hours has passed since you were due to take it, and 48 hours since the last dose.
For example, if you took your pill at 8pm on Monday, and were supposed to take it at 8pm on Tuesday, but it is now 8pm on Wednesday, you have missed Tuesday’s pill.
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The progestogen only pill (traditional)
The progestogen pill is what it says on the tin – it only contains progestogen, not oestrogen.
The NHS says this pill “must be taken within three hours of the same time each day”.
These progestogen-only pills were developed less recently and are less common.
Names (as of March 2022): Micronor, Noriday, and the Norgeston.
What is the “safe window”?
This type of pill has the smallest safety window.
The Lowdown says “you really need to make sure you take these pills on time”.
If you took your pill at 8pm on Monday evening, and by Tuesday night at 11pm you have still not taken your pill, you are no longer adequately protected.
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The progestogen only pill (desogestrel)
The desogestrel pill is the same as the progestogen pill, however as well as thickening the mucus in the cervix to stop the sperm reaching the egg, it also stops ovulation.
These types of pills must be taken within 12 hours of the same time each day.
Names (as of March 2022): Aizea, Cerazette, Cerelle, Desogestrel, Desomono, Feanolla, Hana, Lovima and Zelleta.
What is the “safe window”?
The Lowdown says the safety window for the desogestrel pill is 12 hours. You have 12 hours from the time you usually take your pill, to take it.
It means that, if you took your pill at 8pm on the Monday, you technically have until 8am on Wednesday to take the pill.
After this, you’ve missed it.
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The contraceptive pill you MUST take at the same time every day
The traditional progestogen only pill must be taken within the same 3-hour window every day. It is the shortest safety window of all birth control pills.
The brands, as of March 2022, are:
- Micronor
- Noriday
- Norgeston
What should you do if you miss a pill?
The Lowdown says: “Always take your missed pill as soon as possible, sometimes this will mean you take two in one day.
“As long as you take your pill within the safe window, you are still protected against pregnancy.
“However, traditional progestogen-only pills have a shorter safe window of three hours, so there may be a higher risk of missing your pill in this case.”
The NHS says its advice may be different to what is found on your manufacturers leaflet, which is more cautious.
It says to get further advice from a family planning clinic, NHS walk-in centre, NHS 111, GP or pharmacist.
Melanie King, Pharmacist at Pharmacy2U, told UK Times: “[Pharmacists] have access to all of the prescribing information for all the pills that are available, which includes advice about what to do if you’ve missed a pill, and can talk through this advice with you.
“Missing pills regularly can compromise their contraceptive effect.
“Your pharmacist can help you by discussing ways of reminding yourself reliably each day, and helping you to find ways to make the pill part of your daily routine.
“You can also discuss other forms of contraception with your pharmacist or doctor – there are longer acting types of contraception that don’t involve taking a pill every day, which might be more suitable for you.”
