In today's busy day and age, ladies want to be in control of their lives. In order to achieve an optimum work-life balance, priorities such as having children, need to be meticulously planned for the right time and when one feels ready to take on the responsibility. Hence contraception plays a very prominent role in the lives of young couples.

Many young ladies prefer the combined oral contraceptive pill, i.e. the one that has both oestrogen and progesterone hormones, as their choice of contraception. There are episodes when pills are missed owing to a busy lifestyle or as a result of various other reasons. So what is a "missed pill"?

A missed pill is defined as one that is 24 hours late.

A pill is "late" if you have forgotten to take it at the usual time.

If one combined pill is missed (between 24 and 48 hours of the last pill taken), then the missed pill should be taken as soon as remembered. The rest of the pack should be continued as usual. This means that you may be taking two pills in one day, first the missed pill, and then the usual pill at the usual time of the day that you would have taken.

In the event of one missed pill, there is still contraceptive cover, and no emergency contraception is needed, provided there haven't been any other episodes of missed pill in the current pack, or in the last week of the previous pack.

If two or more consecutive combined pills have been missed (more than 48 hours late), the last pill missed should be taken immediately, even if it means taking two pills in one day. Any earlier missed pills should be left in the pack. The rest of the pack should be taken as usual and an additional method of contraception (e.g. condom) should be used for the next 7 days. 

The timing of starting the next pack after missing two or more pills, depends on how many pills are left in the current pack. If seven or more pills are left in the pack after the last missed pill, the pack can be finished in the usual way, with a seven day gap as normal, prior to commencement of the next pack.

However, if less than seven pills are left in the current pack after the last missed pill, the pack should be finished, and the next pack should be started the next day, without the seven day gap.

There may not be effective contraceptive cover in the case of two or more missed pills in the first week of the current pack of combined pills. If there has been unprotected intercourse within the previous 7 days of the missed pills, in the first week of the pack, emergency contraception is needed, and you will need to see your gynaecologist regarding this.

The combined pills are an effective method of contraception, provided they are used correctly and episodes of missed pills are kept to a minimum.