Pills containing only progestin are often called minipill as they contain smaller quantity of hormones than usual contraceptives containing both estrogen and progestin. They protect from unwanted pregnancy, and their advantage is that they can be used by women who, for numerous reasons, are not allowed to use estrogens, for example, breastfeeding women or women immediately after having an abortion or a surgery.

Their efficiency is good, as in ideal conditions only one out of 200 women in the first year of taking pills gets pregnant. However, typical users of minipill often take a pill late, or miss it, so one in 20 women in reality gets pregnant in the first year of using minipill.

The table shows percentage of pregnancies for different methods of contraception, during the first year of usage.

Hatcher RA, Trussell J. Stewart F. Stewart OK, Kowal D, Guest F. Cates W. Pollcar M. Contraceptive Technology 1994-1996. New York NY: Irvington Publishers. 1994.

How does a minipill work?

• It thickens the cervical mucus and prevents the sperm from reaching the egg
• In 50 % of cases it prevents ovulation (releasing an egg from ovary)
• It has an effect on other hormones, Fallopian tubes and uterus

Who shouldn’t take minipill?

• If there is a possibility you are pregnant
• If you have breast cancer
• If you bleed between menstrual cycles and your doctor did not determine it is harmless
• If taking pills for epilepsy or tuberculosis

Warning and risks connected to using minipill

• No study has proven that minipill increase the risk of heart disease or cancer.
• In case you feel sudden or severe pain in lower abdomen, you may have ectopic pregnancy or have an ovarian cyst – see your physician immediately.
• Ectopic pregnancy – since minipill protects from pregnancy, risk of any type of pregnancy is very low. However, in case pregnancy does happen, there is a greater chance it is an ectopic pregnancy.
• Ovarian cysts – these cysts are fluid-filled sacs and appear more often in women who use minipill. Usually they dissolve by themselves and do not cause any problems.

Sexually transmitted diseases

Minipill do not protect from sexually transmitted diseases such as chlamydia, gonorrhea, condyloma, herpes or AIDS.

Side-effects

• Irregular bleeding – this is the most common side-effect of minipill. Menstrual bleeding can be either late or early, or you can bleed in between cycles. If you are late with taking a pill, or miss it, bleeding is also possible.
• Rare sides-effects are headache, breast sensitivity, nausea and dizziness. There are also rare cases of gaining weight, acne or face and body hair growth.

Usage

• Minipill are to be taken every day at the same time, although new generation pills allow for a 12-hour delay. If you take the pill late or miss it, the risk of pregnancy increases.
• A new pack of pills should be taken the day after taking the last pill from the previous pack. There is no break between packs.
• You might have slight bleeding or spotting between menstrual bleedings. No matter what, do not stop taking pills.
• In case you vomit soon after taking a pill, use a condom in the next 48 hours.
• In case you wish to stop taking pills, you can stop anytime.

How to start taking it?

• It is the best to take the first minipill on the first day of menstrual bleeding.
• If for some reason you start taking the minipill on some other day, use a condom in the next 48 hours
• If you had an abortion, you can take a minipill day after curettage

In case you miss a pill

• In case you are 3 hours late in taking the pill
• take the pill immediately
• take the next one at your usual timing (e.g. if you take the pill at 8 am, and forget to take it until 12 am, take it as soon as you remember, and the next one the next day at 8 am) but use a condom in the next 48 hours

If breastfeeding

 If you are only breastfeeding, you can start taking minipill 6 weeks after giving birth

• If you use supplement alongside breastfeeding, you can start taking mini-pills 3 weeks after giving birth
• Minipill will not alter the quality or quantity of your milk, or in any way influence health of your baby

In case you are changing from classic combined contraceptives

 Take the first minipill immediately the day after the last contraceptive pill

Pregnancy on a minipill

• In case you get pregnant stop using minipill immediately. Although researches have shown that minipill do not harm the embryo in the mother’s womb, it is better not to take medicine during pregnancy. You can do a pregnancy test if you missed a pill or were late in taking it and did not use a condom, or in case menstrual bleeding is absent for 2 months
• Minipill will not affect your ability to get pregnant. If you wish to get pregnant, just stop using them. There is no need to make a pause before pregnancy