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The progestogen-only pill or the mini-pill: everything you need to know

22 April 2021 Blog

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    There are two types of contraceptive pill: the combined pill, and the progestogen-only pill, sometimes called the mini-pill. The mini-pill is a daily pill that only contains one hormone: progestin. In this blog, we give you all you need to know about the mini pill.

    To find out more about the combined pill, read our blog: "The combined pill: what it is and how it works"

     

    What is the progestogen-only pill (mini pill)?

    The progestogen*-only pill, also known as the “mini-pill”, is a daily tablet that contains one hormone. The hormone makes it harder for sperm to get into the uterus (womb) and may also change the lining of the uterus so an egg cannot develop in it. It sometimes prevents an egg from being released by the ovaries each month.

    The progestin-only pill needs to be taken at the same time each day.

    *The terms “progestin” and “progestogen” are both used to refer to the mini-pill: progestin is an artificial form of progesterone that is used for medical purposes.

     

    How do I use the mini-pill?

    In your first appointment with a doctor or clinician, you will discuss a range of contraceptive methods to find the one that suits you. Often, you will talk about your lifestyle, preferences, needs and medical history, and the clinician will assess the risks and benefits of contraceptive methods for the individual, considering all alternatives.

    When taking your first pill, choose a convenient time to take it. This can be any time of the day. Once you've chosen a time you must then take one progestin-only pill at this same time every day

    After you finish all the pills in the pack start a new pack the next day so there are no breaks between packs.

    Effectiveness of the mini-pill

    The mini pill works well at preventing pregnancy. However, its ability to stop a pregnancy largely depends on a person using it properly. With typical use up to 7 out of 100 users will become pregnant. Remember, if you do not have a routine and think you will not be able to take a pill at the same time each day, the mini pill may not be the right method for you.

    If you start to take the mini pill during the first five days of your period, you will be protected against pregnancy immediately. If you start to take the pill on any other day, you will not be protected against pregnancy until you’ve taken the pill for two days.

    If you are accessing our termination of pregnancy services (for a medical abortion or a surgical one), contraception counselling is part of your treatment. We offer a range of LARC contraception methods, but if you haven’t quite made up your mind about contraception or we can’t give you what you want at the time - for example if you’ve had your abortion tablets posted to you - do consider having a temporary method to tide you over.

    We call this a bridging method, to get you from now until you get the method of your choice without putting you at risk of an unwanted pregnancy. The mini-pill is the perfect example of an effective bridging method due to how quickly it protects against pregnancy.

     

    Advantages of the mini pill

    As with all contraceptive methods, there are a range of advantages and disadvantages to taking the progestin-only pill (mini pill).

    The mini pill and periods

    One advantage of the mini pill is that your period may become lighter, or stop altogether. If you prefer to have regular periods, this may not be the right method for you. It is also important to note that you may still get spotting between periods. This is normal when taking the mini pill.

    Other advantages include:

    • It can be used when you are breast feeding.
    • Your fertility will return to normal immediately after you stop using the mini pill.
    • You can start it straight after childbirth, abortion or miscarriage.
    • It is not used during sex so will not affect spontaneity.

    There are also less risks associated with the mini pill than with the combined contraceptive pill. To find out more about the risks associated with the combined pill, read our blog: “The contraceptive pill and blood clots: everything you need to know

     

    Disadvantages of the mini pill

    One of the disadvantages of the mini pill is that the pill has to be taken once per day, at the same time. Forgetting to take the pill on a daily basis could make it fail. It is important to consider whether you would be able to take the pill at the same time each day when choosing the right contraceptive method for you.

    Other disadvantages of the mini pill include:

    • Some users develop more frequent or irregular bleeding while taking the mini pill.
    • Some users may experience headaches, breast tenderness and acne, but these symptoms generally get better within the first few months of using the pill.
    • The pill may not work if you have vomiting and diarrhoea.
    • Use of some medications, such as those for seizures (fits), HIV or for tuberculosis, can make the pill less effective. Check with your medical provider if your medications are compatible with use of the pill.
    • It is possible that some users may experience weight gain as a side effect of the mini pill, although there is little causal evidence to suggest this.

    How to avoid sexually transmitted infections (STIs)

    Condoms are the only contraceptive method which protect against sexually transmitted infections. To ensure protection from both pregnancy and infection, we recommend "dual protection". This means using a male or female condom in addition to the contraceptive method of your choice to prevent pregnancy.

     

    What to do if you miss a mini-pill

    What to do if you miss a mini pill depends when you missed your pill, how many pills you have missed, and whether your mini pill contains desogestrel or not.

    For information on what to do if you miss a combined pill, read the NHS website: What should I do if I miss a pill (combined pill)? 

     

    "CHOICE": MSI UK's digital contraception counsellor

    At MSI UK, we believe that the essential element is that contraception and quality advice are readily available. This is why we have developed “Choice” our digital contraception counsellor in order to offer personalised contraceptive advise to anyone using the platform: you can go through a questionnaire to find out which contraceptive methods is most suitable for you based on your needs and circumstances.

    For more information about the different contraceptive options visit MSI’s digital contraceptive counsellor by clicking here

    Useful links:

    We would advise anyone worried about possible side effects from the contraceptive pill to seek advice from their GP before discontinuing.

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