The mini pill

Another type of progesterone-only contraceptive pill

The mini pill is another name for the progesterone-only pill. It's a form of hormonal contraceptive containing synthetic versions of the progesterone hormone to prevent unwanted pregnancy. When used properly, it's 99% effective. 

How does the mini pill work? 

The mini pill prevents sperm from entering the womb from the vagina by thickening the mucus surrounding the cervix. Certain types of the mini pill can prevent ovulation from occurring too, the newer ones containing desogestrel as the active ingredient. 

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How do I take the mini pill? 

The mini pill needs to be taken at the same time every day for it to be effective. The older types of mini pills give you a 3-hour window in which to take it, while the newer ones can be taken within 12 hours of your scheduled time. You can start it at any time during your cycle, but if it's after the fifth day of your period you won't be protected from pregnancy right away so you should use a barrier method of contraception for the first 2 days of taking the mini pill. The pill is taken every day without a break, so when you finish one pack, start a new one the next day. 

How effective is the mini pill?

The mini pill is 99% effective with perfect use. It's estimated that it's only 91% effective with typical use, however, largely due to not remembering to take it within the specific daily time window. 

What's the difference between the mini pill and the combined pill?  

The contraceptive pill is usually referred to as just 'the pill.' The mini pill only has one type of hormone in it; progesterone, which makes it different from the combined pill as it contains both progesterone and estrogen. This means there are slight differences in the way that each type of pill work: 

  • The mini pill is taken daily for 28 days while the combined pill is taken for 21 days with a 7 day break in between packs 
  • The combined pill can be used to control your period but the mini pill doesn't work in this way
  • Your periods may be irregular or stop altogether with the mini pill 
  • The mini pill must be taken within a specific time frame to be effective. The combined pill has more leeway 

The mini pill also doesn't pose the same risk of blood clots as the combined pill. This means it's safe for most women to use, even if you have high blood pressure or are a heavy smoker. It's also safe to take if you are breastfeeding. 

How do I start the mini pill? 

Before you start taking the mini pill, decide what time of day is going to be best for you to take it. It's best to pick a time where you'll be able to access it easily and be likely to remember. The advantage of the mini pill is that you can start taking it at any time during your cycle, whether you're on your period or not. Starting within the first 5 days gives you immediate protection from pregnancy, otherwise, you'll need to use another barrier method of contraception for the first 2 days of taking the pill. After giving birth, you can start taking the mini pill after 21 days. 

What happens if I take the pill too late? 

There are two types of the mini pill; the older type which must be taken within 3 hours of your usual time and the newer form of desogestrel pill which needs to be taken within 12 hours. 

If you're on the 3-hour pill, as long as you take it within this timeframe you're still protected against pregnancy. For example, if you were due to take it at 9am and you only remember at 11:30am then just take it as normal and you don't need to take further action. 

Once it's been more than 3 hours, you won't be protected against pregnancy. Take your missed pill as soon as possible and keep taking the rest on time. You'll also need to use an additional form of contraception like condoms or a diaphragm for two days. Visit your GP or a pharmacist if you have unprotected sex during this time, letting them know that you are on the progestogen-only pill and you need emergency contraception. 

For the 12 hour pill, follow the same steps but within a 12 hour time period. So if you should have taken your pill at 9am and it's now 9pm, then consider this a missed pill. Your contraception will be affected. If you take it before 9pm then you will not need to do anything, just make sure you keep taking the rest of your pills on time. 

Is the mini pill safe to take? 

The mini pill is generally safer to use than the combined pill, patch or ring. Without the estrogen hormone, the risk of blood clots and further complications this can cause is not present. There are still some circumstances which might prevent you from being able to take the mini pill, however: 

  • If you might be pregnant 
  • If you are taking certain medications 
  • If you have unexplained vaginal bleeding 
  • If you have heart disease or arterial disease 
  • If you've had a stroke 
  • If you have liver disease 
  • If you have a history of breast cancer 
  • If you have a liver tumour 
  • If you have severe cirrhosis 

If you are on medication to treat HIV, Hepatitis C or epilepsy then the mini pill might interfere with your treatment. This also applies to the antibiotics Rifampicin and Rifabutin, an antifungal called Griseofulvin and the herbal remedy St. John's wort. Both the copper and hormonal coil, alongside the contraceptive injection, are not affected by these treatments so these may be more suitable options if you are taking any of the above medications. 

Are there side effects? 

Any form of hormonal contraception can cause side effects. Some women might not experience any, while others suffer through discomfort at first. Common side effects are: 

  • Nausea
  • Vomiting 
  • Headaches
  • Migraines 
  • Acne
  • Breast tenderness 
  • Irregular periods 
  • Changes to sex drive 
  • Mood changes 
  • Depression 
  • Ovarian cysts (non-harmful) 

Symptoms like these usually go away after the first couple of months of taking the pill. If they persist and are having a debilitating effect on you then seek advice from your GP. 

View our full range of contraceptive pills.

Sources: 

NHS > The progestogen-only pill
NHS > Which medicines affect my contraception? 
 

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