How many days after taking the pill am I protected?

Starting a new form of contraception can be daunting, especially when it’s one that works internally. Unlike physical contraceptive barriers, such as condoms, it can be difficult to know if you are or aren’t protected. There are plenty of questions that come from this uncertainty, and the answers to these questions depend on the type of pill, where you are in your menstrual cycle, and other factors too. Here, Team HANX (led by our co-founder and gynaecology doctor, Dr. Sarah Welsh) give you the lowdown on all the must-know facts to feel comfortable moving fully onto hormonal contraception.

How does the pill work?

To understand when you are and aren’t protected on the pill, you need to understand how the pill works in preventing pregnancy. 

Pregnancy arises when an egg, that’s been released from an ovary, is fertilised by the sperm. This then grows within the uterus, forming a foetus. There are a variety of ways of preventing pregnancy - some methods, such as condoms, prevent semen from entering the vagina, and others, such as the pill, use hormones.

Contraceptive pills prevent pregnancy by:

• Stopping ovulation so that the egg cannot be released to be fertilised.
• Thickening cervical mucus, making it harder for sperm to swim to the egg if it were to be released.
• Thinning the womb lining, so any eggs that may come through find it much harder to implant in the uterus and grow.

There are two types of contraceptive pill - the Combined Pill, and the Progesterone-Only Pill (commonly called the mini pill). Both types of contraceptive pill work by releasing additional hormones into your body. For the Combined Pill, this is oestrogen and progesterone, whereas the mini pill only contains progesterone. These hormones are naturally present within the menstrual cycle, but the additional hormones found in the contraceptive pill adjust the cycle and bodily functions to prevent pregnancy.

How long does it take the combined contraceptive pill to work?

The combined contraceptive pill can be started at any time during the menstrual cycle, but the point at which it becomes effective can vary. Whilst it’s tempting to give up on other forms of contraception immediately, depending on when you start the pill, you may need to use other forms of contraception.

• If you start the pill on the first day of your period, or on or before the 5th day of your cycle, you will be protected straight away.
• If you start after the 5th day of your cycle (5 days after your period has begun), you won’t be protected immediately and will need to take the pill for 7 days before you are protected.
• However, as cycles can change and fluctuate due to external factors, such as stress, if you are unsure where you are at in your cycle it’s best to use additional contraception for 7 days to be sure you are protected.

If you have just given birth, or had an abortion or miscarriage, guidance can differ. We always recommend checking with your GP if you’re in this situation, or have any other medical concerns that may impact your contraception.

How long does it take the mini pill to work?

Similarly to the Combined Pill, you can start taking the mini pill at any point during your cycle.

• If you are on days 1-5 of your menstrual cycle, you will be protected immediately.
• However, if you take it after these 5 days, you will need to use additional contraception for 2 days before relying on the pill alone.
• If you have a short menstrual cycle, or are unsure where in your cycle you are, it’s recommended to use additional contraception, such as condoms, for the first few days on the pill.

What to do if you missed a pill:

We’re all human, and sometimes after a long day you can find that you’ve missed your pill. It happens, but it can be hard to know if you’re still protected.

If you’ve missed a Combined Pill:

• If you have only missed one pill, you are still protected from pregnancy.
• Simply take the missed pill as soon as you remember, even if this means taking two in one day, and continue with your normal pill routine.
• If you have missed two or more pills, you will need to use extra contraception for the next 7 days.
• Take the most recent missed pill, but don’t take multiple pills if you have missed several days.
• For example, if you go on holiday and forget your packet and miss 3 pills, take the last one on your return and then continue with your pill routine.
• If you’ve missed two or more pills in the first week of a pack after taking a pill break, you may need emergency contraception if you have had sex in the previous 7 days.

N.B. When we say pill break, we mean the 7 inactive pills that most Combined Pills contain that trigger bleeding.

As the Combined Pill often includes a 7-day break, this can impact your level of protection against pregnancy when you miss a pill.

• If you have at least 7 pills left in the pack after the missed pill, simply complete that pack with the pill break as usual.
• If there are less than 7 pills, finish the pack and start the new pack the next day to ensure you remain protected, without taking the pill break.

If you’ve missed a Progesterone-Only Pill:

• If it’s been 3 hours or less, take your pill as soon as you remember and continue as usual.
• For some types of mini pill that use desogestrel (you can see examples in our pill guide here), this window expands for 12 hours.
• If it’s been more than this allotted time period, take a pill as soon as you remember.
• Continue to take pills as usual, even if this means there is a shorter gap than usual between the first and second pill.
• For example, if you usually take the pill at 9pm and you missed the previous day, you’re fine to take a pill in the morning when you remember and then take your usual pill as normal that evening.
• Use additional contraception for the next 48 hours after taking the missed pill.
• If you have had unprotected sex before you have realised you’ve missed a pill, you may need emergency contraception.

What happens if I’m sick or have diarrhoea after taking my pill?

Whilst the pill tends to be absorbed relatively quickly, if you’re sick or have diarrhoea 2 hours after taking the mini pill or 3 hours after taking the combined pill, then it’s unlikely to have been absorbed by your body. In this scenario, it’s recommended that you take the next pill immediately and continue as normal.

If you continue to have sickness or diarrhoea, count each day you are ill as a day that you have missed your pill, and follow the above guidance.

Final words

Whilst the pill is a very effective method of contraception, it needs to be taken at the same time every day for peak effectiveness. If you miss a pill (or more), it’s highly recommended that you use additional methods of contraception, such as Condoms, to avoid pregnancy.

If you’re struggling to get an appointment with your GP, we also sell a variety of contraceptive pills here at HANX - avoid the frantic 8am call just to be kept on hold, and make sure you get your preferred brand. Simply fill out a form for our pharmacy to review, and get the pill delivered easily and discreetly. 

• Shop the Combined Pill
• Shop Progesterone-Only Pill
• Shop Condoms
• Read more about contraception on our blog, Naked Truths.