The pill is 92% effective with typical use, whereas it's 99.7% effective with perfect use. "Typical" users are described as people who miss the occasional pill, or don't always use the pill as directed, and "perfect" users are people who always take their pills as directed. The progestin only pill ("mini pill") are more important to take at the same time every day because they don't have the addition of estrogen to help to prevent pregnancy, like the combination pill has. Doctors recommend their patients on the combination pill to take their pill at the same time every day to develop a routine, but it has more breathing room than the mini pill does. Since you take your pill at about the same time every day, you're considered a perfect user (99.7% protection against pregnancy). That with the addition of the condom should be more than enough to prevent pregnancy. Using a condom and birth control together after a week of taking the pill late (about 6+ hours after your routine time) should be fine. You could even go ahead and use condoms the day after missing a pill while continuing to take your pill at your routine time. Condoms alone are 98.8% effective with perfect use and about 85% effective with typical use. Also, if you were to become pregnant (which is very unlikely in your case), there would most likely be pregnancy symptoms, unlike what you're used to. In any case, if you're feeling worried, feel free to take a pregnancy test! In my opinion, you probably wouldn't need to, seeing as you're a perfect user and also use a backup method of birth control (condoms). There are lots of good websites to read for more information about the pill. Also, you can ask your doctor any questions you have. Planned Parenthood has a good FAQ section about each method of birth control, here's the page about the pill: http://www.plannedparenthood.org/learn/birth-control/birth-control-pill I'm a new pill user as well, so I understand your paranoia! Also, an important side note: birth control can work very different for each person. If you come across a horror story of someone having an accidental pregnancy on birth control, it DOES NOT mean that it will happen to you! And if the pill is causing too much stress and worry, there are plenty of other methods of birth control that could be easier for you and your lifestyle, but you seem to be a safe and responsible user and you should be extremely well protected against pregnancy. I hope this helps, good luck!