WHAT IS THE MINI-PILL (PROGESTERONE ONLY PILL)?
What is the Mini-Pill?
The birth control Mini-Pill is similar to the regular birth control Pill, but the important difference is that the Mini-Pill does NOT have estrogen in it. It is only progesterone, which allows it to be used for a wider range of women. (Click here to learn more about estrogen vs. estrogen-free birth controls.)
To avoid confusion, I made a separate post for the Pill, which has different hormones from the Mini-Pill. The Mini-Pill is progesterone ONLY, or called the Progesterone Only Pill (POP). The traditional Pill is COMBINED estrogen and progesterone, otherwise called the Combined Oral Contraceptive (COC).
However, the downside of the Mini-Pill is that it is very finicky and high-maintenance. You have to take it at the same time every DAY, within 1-3 hours. There is no way to catch up on a missed dose. If you’re late by 3 hours, you are no longer protected and will need to use a backup birth control method for 7 days.
It is 99.7% effective when used perfectly, but it is incredibly hard to stick to its strict schedule! It’s a big pain to have to think about and carry around for many women. If you have other medications you take every day, it would be easier to add this in. Most women who need birth control are young and healthy, however. The effectiveness with typical use is only 91%.
Other reasons for not taking the pill “perfectly” include using other medications that interfere with the pill’s effects such as seizure meds or antibiotics, being sick and vomiting, or not being able to refill the prescription to start a new pack right away.
It’s for this reason that I strongly recommend the longer acting birth control options. The Patch, the Ring, the Shot, the Implant/Rod and the IUD, all are easier to use and you don’t have to think about them every day. The best ones are the Implant/Rod and the IUD, which last for years without you needing to do anything once they’re put in.
If you do decide on the Mini-Pill, I recommend setting a daily timer on your phone so you take it at the same time every day. Some people can swallow them without water, but I would suggest always carrying the pills and some liquid with you.
The Mini-Pill comes in a pack of 28, Unlike the regular Pill (which contains both estrogen and progesterone), all the pills of the Mini-Pill pack contain hormone, and each one has the same amount. There are no blank/”sugar pills” that would be used to have a “withdrawal bleed”/”fake” period like the regular Pills.
Since the Mini-Pill delivers a steady amount of hormone, you will no longer ovulate (ovaries release an egg every month) or have real periods. You will have irregular bleeding/spotting, or possibly eventually have no bleeding at all.
Some women are very bothered by this and others don’t mind. Also, every body reacts differently, so it’s worth trying. Usually as your body gets used to it, you will have bleeding, but it does not mean you will always bleed that way. I recommend all women give it a good 3-6 months, ideally a whole year, for the bleeding pattern to stabilize.
Other side effects may include bloating, headaches, nausea, and breast tenderness. These tend to get better as your body gets used to it as well. There is no association with weight gain.
There is only one way to take the Mini-Pill, which is 1 pill every day, continuously. Unlike the regular Pill, which can be taken differently in order to skip “periods,” you cannot regulate your bleeding at all with the Mini-Pill. If you want to put off bleeding for a vacation or special event, I’d recommend using the regular Pill, The Patch, or the Ring.
Like all other hormonal birth control methods, you need to wait at least 7 days for it to take effect. You are not protected from pregnancy until after 7 days of using this! So use backup methods such as condoms, abstinence, or even overlapping with a previous hormonal birth control is fine.
If you are late for a dose of the Mini-Pill, even by a few minutes after the 3 hour window, you will no longer be protected from pregnancy! You HAVE to take it at the same time every day, within a window of 1-3 hours! Start taking it correctly or start on a different birth control, and you’ll need to use a backup birth control method for another 7 days while you wait for it to take effect.
That’s it for the Mini-Pill! As always, feel free to message me with any questions or concerns!
Because of the estrogen in it, the Pill is NOT safe to use in certain cases, such as for women with migraine headaches with an “Aura” (changes that signal the headache is coming on), smokers over age 35, women who’ve just had a baby less than 4-6 weeks ago, or anyone with a previous blood clot or stroke. There are many other conditions that you can learn more about here. MAKE SURE TO GO THROUGH YOUR MEDICAL HISTORY THOROUGHLY WITH YOUR DOCTOR BEFORE STARTING ON THIS BIRTH CONTROL!!!
If you forget and miss a day, you can take two Pills the next day to try to catch up, but this is less effective than if you had not missed it at all. If you miss 2 days, you can take 2 Pills as soon as you remember, and then 2 the next day. Any longer gap than that cannot be caught up on. You should just restart taking the Pill once a day and use a backup birth control method for 7 days.
That’s it for the Pill! As always, feel free to message me with any questions or concerns!