Placebo pills help you stay on course by taking one daily until the next month. Skipping them can reduce or stop periods. You can speak to your doctor for more advice.
Birth control pills are generally safe, reliable, and easy to use. One of the most common questions is whether it’s necessary to take the last week of birth control pills in your monthly pack.
The answer comes down to how well you can stay on schedule without that last week of pills. These are placebo pills, and they aren’t used for preventing pregnancy. Instead, the pills allow you to stay on track with your daily pill.
Birth control pills work by preventing the ovaries from releasing an egg. Normally, an egg leaves an ovary once per month. The egg enters the fallopian tube for about 24 hours or so. If it isn’t fertilized by a sperm cell, the egg disintegrates and menstruation begins.
The hormones found in birth control pills prevent your ovaries from releasing an egg. They also thicken the cervical mucus, which makes it harder for sperm to reach an egg if one is somehow released. The hormones can also thin the uterine lining, which makes it difficult for implantation to occur if an egg does get fertilized.
Many combination birth control pills come in 28-day packs. There are 3 weeks’ worth of active pills that contain the hormone or hormones necessary to prevent pregnancy.
The last week’s set of pills typically consists of placebos. Placebo pills are placeholders meant to help you stay on track by taking one pill every day until the next month starts.
The idea is that if you stay in the habit of taking a pill every day, you’ll be less likely to forget when you need to take the real thing. The placebos also allow for you to have a period, but it’s usually much lighter than it would be if you weren’t using oral contraceptives.
Even though you’re taking placebo pills, you’re still protected against pregnancy as long as you’ve been taking the active pills as prescribed.
No, you don’t have to take the placebo birth control pills.
Some people choose to skip the placebos and continue taking active pills. According to ACOG, this is safe to do. But if you choose to take the placebos, you don’t need to worry about pregnancy as long as you take the rest of the active pills in the pack.
Depending on the manufacturer, the placebo birth control pills in the pack might even contain certain vitamins or minerals such as iron or folic acid, which can be good for you, but they’re not necessary to stop pregnancy from occurring.
However, if you choose not to take the placebo pills, you might need refills more often, and not all health insurance may cover them. You might consider asking your doctor if they can prescribe you birth control with 4 weeks of active pills and no placebos, or inquire whether that’s an option for you.
Skipping the placebo pills can have many benefits. For example, if you tend to get migraine attacks or other uncomfortable symptoms when you take placebos, you may find that those symptoms disappear or are reduced significantly if you stay on active pills during this time.
Also, if you tend to get prolonged periods or if you have periods more frequently than normal, this may help you better regulate your period. Remaining on the active pills allows you to skip your period with minimal side effects.
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Continuous birth control can result in some light bleeding or spotting in between periods. This is very common. It typically happens during the first few months you’re on the pill, and then it may not happen again.
It’s sometimes referred to as “breakthrough bleeding.” It’s not always clear why breakthrough bleeding occurs, but it may be due to your uterus adjusting to a thinner lining, also known as the endometrium.
You should speak with your doctor if you have spotting or any other symptoms that concern you.
Birth control pills aren’t the only way to stop your periods. An intrauterine device (IUD) is a long-term birth control solution that’s well-tolerated by many people. An IUD is a T-shaped device that may or may not be treated with progestin.
An IUD can both thin the uterine wall to help prevent implantation and increase cervical mucus to keep sperm away from the egg. Depending on the type of IUD you get, you may notice that your monthly flow is heavier or lighter than it was before implantation.
Another pill-free option is the birth control shot, Depo-Provera. With this method, you receive a hormone shot once every 3 months. After the first 3-month cycle, you may notice lighter periods or you may not get a period.
Other pill-free options can include the implant in the arm (nexplanon) and the birth control patch.
You can skip the placebo pills if you take your active pills as prescribed and don’t miss days routinely. However, birth control pills don’t protect you from sexually transmitted diseases (STIs).
You should use a barrier method, such as a condom, to protect against STIs.