Everything you need to know about placebo (sugar) birth control pills
In this article
What's the lowdown?
Placebo pills contain sugars and sometimes other nutrient like iron, but do not contain any active hormones
They are commonly found at the end of pill packets and are a different colour to the pills that contain hormones
You are still protected from pregnancy when you take the placebo pills as long as you have taken the rest of the pills in the packet correctly
You usually have a bleed while taking placebo pills, but they can be skipped to miss a bleed
Have you ever wondered why some pills in your birth control pill packet are a different colour? This is often because they contain different levels of hormonesâŚ.or even no hormones at all! Letâs find out whyâŚ
What are placebo pills?
Placebo pills are also called birth control sugar pills, dummy or reminder pills. They are pills in your packet that donât contain any hormones. Sometimes they contain other ingredients that might be useful for your health, like iron.
Why are there placebo pills in birth control?
Traditionally, placebo pills were used in combined contraceptive pill packets to build in a break in a â21/7â regimen. The 21/7 regimen is where hormone pills are taken for 21 days in a row, followed by a 7 day break, which may be called the hormone free interval or pill free break. During this break, you will usually have a bleed which is caused by the withdrawal of hormones.
It can be hard for some users with busy lifestyles to remember to restart another pill packet after a 7 day break of not taking any pills. And forgetting to restart a packet puts you at risk of unplanned pregnancy, so placebo pills were designed to help. After the 21 active pills containing hormones, 7 placebo pills are put into a combined contraceptive pill packet so users can finish an entire packet and start a new one the next day. Nowadays, placebo pills are used in Slynd (the progestogen-only pill brand containing the hormone drospirenone) as well as combined pill packets and there may be 2, 4 or 7 placebo pills in a pack.
Whatâs in placebo pills?
Different brands of pills contain different ingredients in their placebo pills. Birth control sugar pills are named because they are made from sucrose and lactose, which are both types of sugar.
Some US birth control pills also have reminder pills that contain iron or other nutrients. This is designed to help supplement the iron lost in a withdrawal bleed during the placebo pills but usually isnât medically necessary.
Any ingredients in inactive birth control pills that are not hormonal are called âexcipientsâ. Some people may have side effects which are related to the excipients in the pill, rather than the hormones, which is possibly why some people experience different side effects with different brands, even if the hormones they contain are exactly the same.
Do I have to take the placebo pills or can I skip them?
You can skip placebo pills, itâs completely safe. This is called continuous pill taking or taking the pill back-to-back and is a great way to manage side effects like headaches or mood swings which some people find worsen during the break.
Am I protected from pregnancy on the sugar pills?
Yes, you are protected from pregnancy if you have sex while you are taking sugar pills or placebo pills in your pill packet. This is as long as you have taken the other pills in the packet correctly. If you have missed any pills, see our missed pill calculator to work out what to do.
Do the placebo pills prevent pregnancy?
If you only take placebo pills, you will NOT be protected from pregnancy. The pill contains hormones which prevent you from releasing an eggâŚ.you need the hormones for it to work! If you have taken the hormonal pills for 21 days in a row, you will be protected from pregnancy while you take placebo pills. However, if you take more than 7 placebo pills in a row OR do not take 21 hormonal pills between each block of placebo pills, you may be at risk of getting pregnant.
Placebo pills in the UK
Which contraceptive pills contain placebo pills?
The contraceptive pills which contain placebo pills are:
Slynd is the only mini pill brand (progestogen-only pill) that has placebo pills. All the other brands are combined hormonal pills.
Placebo pills in the US
Which birth control pills contain placebo pills?
In the US, most brands of birth control pills contain placebo or reminder pills. These are often a different color from the hormonal pills, and there are usually 4 to 7 in each packet. The brands which do NOT contain sugar pills are:
What are the sugar pills in birth control?
The sugar pills in birth control are made of sucrose or lactose, and sometimes contain extra nutritional supplements like iron. They are included in a birth control pill packet as a break from the hormones. When you take the sugar pills, you will usually have a bleed.
I skipped my placebo pills and still got my period, why?
Skipping the last week of birth control pills is a great way to prevent bleeding. However, itâs not perfect, and it can take time for your body to adjust. In the first few months that you skip the placebo pills, you are likely to still have some spotting or bleeding. As you continue to take your birth control without the sugar pills, this bleeding will usually get less and less over time. We have a full article dedicated to how to do this.
Will skipping placebo pills cause side effects?
Skipping placebo pills can actually help with side effects from birth control. Side effects like headaches and mood swings are often worse during the sugar pills due to hormone withdrawal. By continuing the hormonal pills instead, these side effects may improve. However, by skipping placebo pills, you can get more breakthrough bleeding or spotting. This does tend to settle over time, if you keep skipping placebo pills each month.
Are all the coloured pills in the packet the same?
Most pill packets contain pills of one colour which all contain hormones. As weâve discussed some also contain placebo pills which are one colour with the hormone pills another colour. There are however also some pill brands which are âmultiphasicâ meaning the hormone pills contain different levels of hormones, which can mimic the hormonal fluctuations seen in the menstrual cycle, and so are different colours. If your pill packet contains pills of different colours itâs important to take these in the correct order as they were intended.
So there we have it, a run down of the colorful placebo / dummy / reminder / sugar pills in your packet. Now youâre fully informed! If you use a pill that has placebo pills, even if you choose to skip them – leave a review!
Dr Fran Yarlett
Dr Fran is Medical Director at The Lowdown and works as a GP in Sheffield with a special interest in complex medical patients and womenâs health.
Our medical review process
This article has been medically reviewed for factual and up to date information by a Lowdown doctor.
