I have endometriosis, is it safe to skip my placebo pills or only take 4 out of 7 so i'm not in so much pain? also on nexplanon to control irreg bleed

Unclear: It is not clear exactly what you are referring to. If you are on Nexplanon then there normally one would not also be taking birth control pills. Sometimes doctors will give a low dose birth control pill if a Nexplanon user experiences breakthrough bleeding. Normally in those cases one does not take the placebo pills at all. Clarify the plan with the prescribing doctor

SKIP: placebo, no problem, some have iron but usually there so you don't forget when to start new pack.