Placebo Pill Question?

[Aly_]

Hi there! I am on a Tri Cyclen 28 day pill pack. My last week of pills are just placebos, or as my package calls them, "reminders." I usually don't take the placebo pills this week, not to start a new pack and skip my bleed, but just to give myself a break from taking pills. (honestly I am thinking of switching to the Implant just to avoid pills altogether, but don't know anyone who has it and am curious about people's experiences!) I still experience my bleed and have never missed it. I know placebos just help you get into the habit of taking the pill correctly, but I've been on it for 3 years, and I always remember to start my new pack on time the following Sunday (even have a weekly alarm for it just in case!) The package says that the placebos do not contain any hormones, so is it okay that I am just not taking them? Thanks!

[Heather]

Yep! They really are usually just placebos -- I say usually because some pill formulations put a little iron in their placebo pills, but that doesn't change the effectiveness of the method, it just bumps up iron during times you have a withdrawal bleed, that's all.

I'm not an implant user, but as a longtime contraceptive counselor, I'm happy to talk to you about the implant if you'd like!

[Aly_]

Hi! Sorry to be away, I did not realize I got a reply! Yes, I would like to know about the Implant I was wondering if most women typically lose their periods on it? That scares me, only because I've heard it isn't good to just stop getting your period due to hormones, as you might not know if the reason you've lost it is actually due to being underweight, amenorrhea, or the fact that you are pregnant. I was going back and forth between the IUD and the Implant, because I believe an IUD you do still experience a bleed, but I feel as though I would prefer the Implant procedure more. Also, I have juvenile rheumatoid arthritis, so my doctor said that methods such as the shot will not work for me due to my bone and joint health. Also also, lol, I saw on its birth control bingo page that other medications/drugs affect the effectiveness of it, I was wondering what these might entail? Thank you!

[Alexa]

Hey Aly!

Okay, a couple of things -- I'm not an Implant user, but also am a sexual health counselor. I AM, however, a very long-time user of the IUD, so I'll talk a bit about that, too!

It is possible for your period to lighten or disappear with either the Implant or the hormonal (NOT the copper) IUD, though it is not guaranteed. Skipping your breakthrough bleed while on birth control is generally fine for your health. Of course, if your provider knows your body and makes any specific recommendation against it, I would take that into consideration -- but I would also seek a second opinion, just in case. Some doctors are out-of-date or pick up on the stigmatization of being sexually active and that can leak into their practice.

Insertion of the Implant can feel a bit less invasive than that of the IUD (the Implant is inserted into the arm using a syringe, while the IUD is inserted through the cervix). That being said, the hormonal IUD can last up to 7 years, and the Implant lasts only 3. So it's a matter of weighing those pros and cons, among others.

I like this quick article from Bedsider on which medications might interfere with birth control. People on most medications can still take hormonal birth control, but may just want to consider their context when choosing a method (like your doctor's mention that the shot isn't a good option for you).

It sounds like you've already found our Birth Control Bingo: The Contraceptive Implant article -- what other questions do you have?