From the Guidelines
You should take the missed progesterone-only pill as soon as possible, which in this case is at 9:40pm, and then continue with your regular schedule, taking the next pill at 6pm the following day, and use backup contraception, such as condoms, for the next 2 days. According to the U.S. selected practice recommendations for contraceptive use, 2013, a dose is considered missed if it has been >3 hours since it should have been taken 1. Since you forgot to take your pill at 6pm and it's now 9:40pm, you are beyond the 3-hour window, but still, the recommendation is to take one pill as soon as possible and continue taking pills daily, one each day, at the same time each day, even if it means taking two pills on the same day 1.
Regarding the sex you had 2 days ago, you would have been protected by your previous pills that were taken on schedule, as the progesterone-only pill works primarily by thickening cervical mucus to prevent sperm from reaching an egg and sometimes by preventing ovulation 1. However, since you missed a pill, it's essential to use backup contraception, such as condoms, for the next 2 days to ensure you're protected against pregnancy.
- Key points to consider:
- Take the missed pill as soon as possible
- Continue with your regular schedule
- Use backup contraception for the next 2 days
- If you regularly struggle with timing, consider setting a daily alarm or exploring longer-acting contraceptive methods like implants or IUDs that don't require daily attention.
- It's also important to note that inconsistent or incorrect use of oral contraceptive pills is a major reason for oral contraceptive failure, and women who frequently miss POPs should consider an alternative contraceptive method that is less dependent on the user to be effective, such as IUD, implant, or injectable 1.
From the Research
Missing a Progesterone Only Pill
- If you take the progesterone only pill at 6pm every day and forget to take it one day, realizing it's 9:40pm, you should take the missed pill as soon as you remember 2.
- However, it's essential to note that the studies provided do not directly address the specific situation of missing a progesterone only pill and the risk of pregnancy if you had sex 2 days ago.
- The studies focus on the effects of progesterone and levonorgestrel on oviductal physiology, endometrial hyperplasia, and contraception 3, 4, 5.
- One study suggests that levonorgestrel and progesterone can reduce the ciliary beat frequency in fallopian tubes, which may lead to embryo retention in the oviducts 4.
- Another study found that the use of a levonorgestrel-releasing intrauterine system (LNG-IUS) does not jeopardize the chances of pregnancy in women seeking fertility treatment 5.
- A study on the coadministration of carbamazepine with an oral contraceptive found that it decreased levels of contraceptive steroids, increased breakthrough bleeding, and permitted ovulation during use of a low-dose OC 6.
Risk of Pregnancy
- The risk of pregnancy if you had sex 2 days ago and missed a progesterone only pill is not directly addressed in the provided studies.
- However, it's crucial to take the missed pill as soon as you remember and consider using a backup method of contraception, such as condoms, for the next 7 days 2.
- If you're concerned about the risk of pregnancy, you should consult your healthcare provider for personalized advice and guidance.