If a combined OC pill is missed during the third week, what is the recommended action?

• A. Continue with the current pack; no backup
• B. Skip the placebo week and start the next package; backup for 7 days
• C. Take two pills the next day
• D. Stop contraception for a cycle

Answer: (B)

When a combined estrogen-progestin pill is missed in the third week, the priority is to avoid a hormone-free interval that could allow ovulation. The best approach is to skip the placebo pills and start the next pack right away, effectively continuing active hormone exposure without a break. To ensure protection during this transition, use backup contraception for seven days after starting the new pack. This keeps hormone levels steady and minimizes the risk of pregnancy from the switch. Other options either leave a gap, complicate the schedule, or unnecessarily halt contraception, which is why they aren’t recommended in this scenario.