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Do I Need to Take My Last Week of Birth Control Pills?

The last week of birth control pills can safely be skipped with most brands. These pills don’t contain any hormones, and you’ll still get the same level of pregnancy protection as long as you take the rest of the pills in the pack at the same time every day. However, it’s important to consider whether you’ll remember to start your next pack of pills on time if you skip the placebos. In addition, make sure you understand how placebo pills are impacted by pill pack size.

What Are Placebo Pills?

The last week of combination birth control pills in each pack consists of placebo pills or “sugar pills.” These pills contain no active hormones, which is what causes your period to occur during that week. Also, they serve as reminders to keep taking your pill at the same time each day.

As long as you take your pills on time throughout the rest of your pack, you are not at a greater risk of pregnancy during the last week of birth control pills. While the nonactive pills don’t contain any hormones, the active ingredients in the rest of the pills protect you throughout this seven-day period, even if you don’t take the placebo pills.

In some cases, the last week of pills in a pack does contain a low level of active hormones. You should always discuss with your provider whether you need to take the last week of pills in your pack before you decide to start skipping them.

Mini-Pills Are Different

If you take progestin-only pills (also known as the mini-pill), your birth control pack won’t include any placebo pills. Most progestin-only pills come in a 28-day pack that consists of 28 active pills. To get the best level of pregnancy protection with this type of contraceptive, you must not skip any of your pills and make sure to take one pill at the same time each day with no breaks between packs.

Ways to Deal With Birth Control Placebo Pills

If your birth control pack contains placebo pills, there are a few things you can do with them:

  • Take Them Anyway: Even though the last week of your pack consists of placebo pills, you can still take them right on schedule as though they were like the hormonal pills in your pack. You’ll get your period during the placebo week, which makes the arrival of your period fairly easy to predict. The biggest benefit of taking placebo pills is that you stay in the habit of taking your pill on time every day. If you worry that you won’t remember to start your next pack on time after a week has passed, it’s best to just take the placebo pills so you stay on schedule.
  • Skip Them: Once you have had all the hormonal pills in your pack and only the placebos are left, you can toss out the pack since you don’t need them to maintain pregnancy protection. You’ll start your next pack after seven days with no pills. With this method, you will have your period each month during the week where you’re not taking pills. Be sure to confirm with your care provider that it’s safe to skip the pills before throwing them away.
  • Go Straight to the Next Pack: After taking all the hormonal pills in your pack, you can start a new pack of pills rather than taking the placebos or waiting seven days. This is called an extended-cycle or continuous-use birth control regimen, and it means that you don’t take a break between hormonal pills. With this method, you won’t get your monthly period as usual. A continuous-use regimen can help alleviate PMS symptoms such as cramping and headaches, but it may cause some spotting or breakthrough bleeding, especially in the first few months. You shouldn’t start an extended-cycle regimen without talking to your medical provider about it.

The method you select should be based on your own personal preferences, your ability to stay on schedule with your pills, and your care provider’s recommendations.

Pill Pack Sizes

In most birth control pill packs, there are seven days of placebo pills. However, pack size can vary considerably and affect how frequently you’ll have placebo pills:

  • 28-day pack: This is the most common pack size for birth control pills. It includes 21 active pills and seven inactive placebo pills.
  • 21-day pack: Some pill brands get rid of the placebo pills and include only 21 active pills per pack. After going through three weeks of pills, you wait seven days before starting the next pack. If you have this type of birth control, you can’t skip the last week of pills in your pack because all the pills have active ingredients.
  • 91-day pack: Brands like Seasonale are designed to give you a longer cycle and fewer periods. These packs contain 84 active pills followed by seven inactive pills, essentially giving you a period once every three months.

It’s important to note that certain pill brands have fewer than seven days of placebo pills per pack. For example, there are some pill packs that contain 24 active pills following by only four placebo pills. Although these pack sizes are less common, be sure you understand exactly which pills in your pack are placebos before you consider skipping them or switching to a continuous-use regimen.

If you have questions about the placebo pills in your birth control, talk to your medical provider. They can answer your questions about how many inactive pills are in your pack and whether it’s safe to skip them.

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