Missed pill (progestogen only pill)

If the progestogen only pill is not taken at a patients usual time then the patient should be informed that they should take the missed pill as soon as possible and carry on with the next pill at their usual time.

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Notes:

• with desogestrel (DSG) a delay in taking this pill of up to 12 hours is acceptable before needing to use extra precautions as described above
• traditional POPs only suppress ovulation in approximately 50% of cycles
  • therefore if more than 27 hours have elapsed between pills there is a risk that the contraceptive effect of the cervical mucus will be lost and additional precautions will be required to avoid pregnancy. However, ovulation suppression is maintained in DSG pill users who take their pills up to 12 hours late
• during regular POP use cervical mucus changes prevent sperm penetration into the upper genital tract and sperm in the lower genital tract do not survive for more than a few hours. Therefore sex that occurs before a missed pill does not present a risk of pregnancy and emergency contraception (EC) would not be required

Reference:

1. FSRH (February 2019). Progestogen only pills.
2. Doctor (March 2005). Ready Reckoner - contraceptive efficacy.