Last week of birth control pills: What to know about placebo pills

There are many different types of birth control pill. One of the most common is the combination pill, which contains synthetic forms of the hormones estrogen and progesterone.

Different types and brands of the pill may include various amounts of placebo pills in their packs. Common types of combination pill packs include:

  • 28-day pill packs: For most brands, the pills for the first 3 weeks of the pack contain the hormones, while those for the last 7 days do not contain any hormones at all. These pills are known as placebo pills, and they are there to help people make a habit of taking the pill regularly. Some newer pill brands use fewer placebo pills.
  • 21-day pill packs: These pill packs contain 21 days of pills with active hormones. A person will then wait 7 days before starting a new pack, during which time they will not take any placebo pills.
  • 91-day pill packs: Some types of pill contain 84 active pills and 7 inactive pills. People taking these pills should only get their period once every 3 months.

What are placebo pills?

In most cases, the placebo pills are sugar pills that do not contain any active hormones. However, some brands of pill also include other vitamins or minerals, such as iron or folic acid.

The placebo pills are there to mimic the natural menstrual cycle, but there is no real medical need for them.

People usually get their period while taking the placebo pills because the body reacts to the drop in hormone levels by shedding the uterine lining.

Many women find that they skip a period or experience lighter bleeding while taking birth control pills, especially over time.

This may be due to a few vital functions of the pill, which works by:

  • stopping ovulation
  • thickening cervical mucus to block sperm
  • keeping the lining of the uterus thin to prevent implantation

When the uterine lining is thin, there will be less blood and tissue to shed during the hormone-free period.

While it can be alarming to miss a period while taking the pill, it is common and can be completely normal.

If a person is concerned that they may be pregnant, they can take a home pregnancy test or see a doctor.


In packs of combination birth control pills, the placebo pills are usually sugar pills. People do not need to take them to make the birth control pills effective, but it may be helpful to keep to a daily routine of taking the pill.

While people do not need to take the placebo pills each month, they should speak to their doctor before manipulating their pills to skip their periods.

With typical use, birth control pills are 91 percent effective at preventing pregnancy, regardless of whether or not people take the placebo pills.

It is best to consult a doctor or pharmacist with any questions or concerns about taking the pill or distinguishing between the active and inactive pills.

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