Missed pills
Can I skip the brown pills?
Quick answer
Missing the brown iron tablets in a pack like Trust (levonorgestrel + ethinylestradiol) does not lower your protection, as long as you start the next pack on the right day.[src] Skipping them to go straight into new hormone pills is different: it delays your bleed, and it is a change to ask your doctor about first.
Two kinds of skipping
When people ask this, they usually mean one of two things, and the answer is different for each. We cover what the brown tablets are in what are the brown pills in Trust? This page is about what happens when you do not take them.
- Leaving them out but still waiting 7 days before the next pack, the same as if you had taken them.
- Jumping straight from the last hormone pill to the first hormone pill of a new pack, with no brown days at all.
Leaving them out but keeping the calendar
WHO's guidance on non-hormonal pills is short: if you miss any, throw them away and carry on.[src] They do not protect you, so leaving them out does not make you less protected.
The real risk is the calendar. When there are no tablets to take, it is easy to lose count and start the next pack on day 9 or 10 instead of day 8. A late start makes the hormone-free gap longer than 7 days, and WHO treats that like missing hormone pills in week 1, the riskiest place to miss them.[src] That is the whole reason 28-tablet packs exist. So if you leave the brown pills out, put the restart date in your phone or the pill tracker.
Jumping to the next pack
Going straight into a new pack's hormone pills means no hormone-free days, so you often get no bleed that month. It does not reduce protection. Many doctors are fine with it for combined pills, for example before a trip or an event. [TODO: source: NHS or FSRH guidance on taking combined pill packs back to back (tailored regimens)] Things to know before you try:
- Spotting or a light bleed is common, especially the first time.[src]
- You will use packs faster, so you need your next pack, and a prescription that covers it, sooner.
- You will have leftover brown tablets. Just throw them away.
- Ask your doctor before doing this regularly, especially if you have health conditions or take other medicines.
If your aim is to delay a bleed for a specific date, see can Trust pills delay your period?
It depends on your pack
| Pack | What "skipping" means |
|---|---|
| 21 hormone + 7 iron: Trust, Charlize (levonorgestrel + ethinylestradiol) | Missed brown tablets: no effect on protection. Jumping: delays the bleed. |
| 24 hormone + 4 inactive: Yaz, Lizelle (drospirenone + ethinylestradiol) | Same idea, but the hormone-free time is only 4 days, so a late restart eats into a smaller margin. These are 20 mcg pills, so WHO's stricter missed pill rule applies sooner.[src] |
| 21 hormone, no extra tablets: Diane-35 (cyproterone acetate + ethinylestradiol), Yasmin (drospirenone + ethinylestradiol) | There are no brown pills. The 7-day break is counted on the calendar. Skipping the break means starting the next strip on day 22. |
| Progestin-only: Daphne (lynestrenol), Cerazette (desogestrel) | Every tablet is a hormone tablet. Never skip any. |
If unsure, talk to a doctor or pharmacist.
Frequently asked questions
Pwede bang hindi inumin ang brown pills?
Oo, iron lang ang laman nila kaya hindi bababa ang proteksyon. Pero siguraduhing masimulan ang bagong pack sa tamang araw, pagkatapos ng 7 araw. Kung gusto mong diretso sa bagong pack para hindi datnan, tanungin muna ang doktor.
I skipped the brown pills and started the new pack early. Am I still protected?
Starting hormone pills early does not reduce protection on a combined pill. You may get spotting. If you also missed hormone pills, use the Missed Pill Helper.
Can I skip the inactive pills in Yaz too?
The 4 inactive tablets in Yaz can be missed without lowering protection, as long as you start the next pack on time. Ask your doctor before running packs back to back.
This guide is for information. Talk to a doctor before starting, stopping or switching birth control.
Sources
- Managing missed pills (Family Planning Handbook), WHO and Johns Hopkins CCP
- Combined pill: risks and side effects, NHS