Recommendations for Oral Contraceptive Use

Below is the latest concise recommendations for OCP use. The most common mistake is starting later than 7 days. This makes ovulation more likely and pregnancy can occur if intercourse occurs after such a break. Starting the first Sunday after your period starts may be right on the edge of being too late.

Starting the pill:

  • You can start the pill any time in your menstrual cycle if you are sure you are not pregnant.
  • If you start the pill on the first day of your period you will be protected from pregnancy immediately.
  • You can also start the pill up to, and including, the fifth day of your period and you will be protected from pregnancy immediately.
  • If you start the pill at any other time in your menstrual cycle you will need to use additional contraception, such as condoms, for the first 7 days of pill taking.

If you forget to take a pill or start a pack late:

  • Missing pills or starting the pack late may make your pill less effective. The chance of pregnancy after missing pills depends on when pills are missed and how many pills are missed. A pill is late when you have forgotten to take it at the usual time. A pill has been missed when it is more than 24 hours since the time you should have taken it.
  • If you miss one pill anywhere in your pack or start the new pack 1 day late, you will still have contraceptive cover. However, missing two or more pills or starting the pack two or more days late (more than 48 hours late) may affect your contraceptive cover. As soon as you realise you have missed any pills, take the last pill you missed immediately. In particular, during the 7-day pill-free break your ovaries are not getting any effects from the pill. If you make this pill-free break longer by forgetting two or more pills, your ovaries might release an egg and there is a real risk of becoming pregnant.
  • Follow the advice below. If you are not sure what to do, continue to take your pill and use additional contraception, such as condoms, and seek advice as soon as possible.

If you have missed one pill, anywhere in the pack:

  • Take the last pill you missed now even if it means taking two pills in 1 day
  • Continue taking the rest of the pack as usual
  • No additional contraception needed
  • Take your 7-day break as normal

If you have missed two or more pills (i.e. more than 48 hours late), anywhere in the pack:

  • Take the last pill you missed now even if it means taking two pills in 1 day
  • Leave any earlier missed pills
  • Continue taking the rest of the pack as usual and use an extra method of contraception for the next 7 days
  • You may need emergency contraception see below
  • You may need to start the next pack of pills without a break see below.

Emergency contraception:

  • If you have had unprotected sex in the previous 7 days and you have missed two or more pills (i.e. more than 48 hours late) in the first week of a pack, you may need emergency contraception. Get advice from your contraception clinic, family doctor, or a pharmacist about this.

If SEVEN OR MORE pills are left in the pack after the last missed pill:

  • Finish the pack
  • Have the usual 7-day break.

If LESS THAN SEVEN pills are left in the pack after the missed pill:

  • Finish the pack and begin a new one the next day (this means missing out the break).