Is It Possible to Overdose on Birth Control Pills?

The birth control pill has to be taken once a day, but work and stress can cause some women to forget. A study published in 2019 revealed 39 percent of participants had forgotten to take their pill at least once that month.

Forgetting to take one pill (or two...or three) is usually nothing to worry about, as you can simply take it whenever you remember. But what happens if you take an extra pill or more than the recommended dosage?

Most birth control pills contain the hormones estrogen and progestin, and they have very low toxicity. For the most part, these levels of artificial hormones are well-tolerated by most people, so taking an extra pill is unlikely to cause any harm.

"Taking two or three contraceptive pills in one day is nothing to be concerned about, and there is no need to seek medical attention unless you have any concerns," said Sarah Welsh, M.D., an OB-GYN and co-founder of HANX, a sexual wellness brand. "Simply continue the rest of your pack as normal, and although you will finish the pack earlier, you will still be protected against pregnancy."

While most people will not experience any side effects from taking one or two extra birth control pills, there is a small chance you could have nausea and vomiting. This will typically occur shortly after the extra dose, but it can be remedied with ginger tea and plenty of rest.

If you experience more severe symptoms, such as shortness of breath, vomiting that does not subside or any sharp pains, seek medical attention immediately.

Can you overdose on birth control pills?

Technically, it is possible to overdose on birth control pills, but it's not a common scenario.

"Extremely high doses of estrogen have a potential to result in major complications, such as stroke, heart attack, DVT and pulmonary embolus," said Megan Gray, M.D., an OB-GYN at Orlando Health Physician Associates.

However, Welsh added, "While high levels of these hormones can have side effects if taken in excess over time, it's likely you wouldn't experience harm after one very large overdose and it's unlikely any immediate side effects will develop."

Back in 1960, when the first oral contraceptive pill was approved, it contained 10,000 micrograms of progestin and 150 micrograms of estrogen. This dosage was exceptionally high and increased the risk of serious side effects, such as heart attack and stroke. In fact, 17 percent of the women from the initial trial reported significant side effects from taking the pill.

The dosage is much lower and safer now, with 1 birth control pill containing 20 to 50 micrograms of estrogen and 50 to 150 micrograms of progestin. This makes overdosing on birth control pills unlikely because the dosage is often too low to make any significant impact.

A 2017 report that looked into 54 patients who were admitted to the hospital after an intentional overdose of birth control pills revealed that none of the patients were severely sick. In fact, many of the patients were discharged the same day.

What do I do if I forget to take a birth control pill? 

If you ever miss a birth control pill, there's no need to worry. You should simply carry on taking the pill once a day as normal, as soon as you remember. If you are taking the progestin-only pill, it should be taken no later than three hours after your normal time, according to Ravina Bhanot, MBBS, B.Sc., DRCOG,founder of Zonas Fertility.

If you miss two pills or more, Bhanot recommends you use another form of protection, such as condoms, to protect against unplanned pregnancy.

Birth control tips to remember

"A simple change in your normal routine could easily throw you off, and mean you double up on pills by accident. The best way to avoid this is have a regular routine and always take your pill after doing something you do every morning, such as having breakfast, showering, or doing your teeth," Welsh said. 

"Place your pills next to your toothbrush, so you remember to take it after you've brushed your teeth at night," Bhanot added.

Other ways to remember to take your birth control pill are setting an alarm on your phone or using a pill box that includes the days of the week on it. If you are often traveling or work for long periods of time, you can purchase a miniature version and carry it with you inside your bag.