Mini Pill

The mini pill is also called a progestogen only pill (POP) that contains only progestogen and is a highly effective long-term contraceptive. It is thought to provide 99% effectiveness if taken appropriately in preventing pregnancies.

Being a progestogen only pill (no oestrogen) provides key benefits which are discussed below.

It is an oral contraceptive method that contains only progestogen (also known as progesterone) and is over 99% effective at preventing pregnancy. It is well tolerated and especially suitable for women who have experienced side effects of the combined pill in the past, whilst still giving the same high level of protection.

It works via three principle mechanisms to prevent pregnancy:

1. Thickens the cervical mucus therefore preventing the sperm from reaching the egg.
2. Alters the lining of the womb by making it thin therefore inhospitable for the fertilised egg to embed onto it.
3. Prevent ovulation.

The mini pill does not contain oestrogen, it therefore does not carry the same risk profile as the combined pill. This is advantageous and is the chosen form of contraception over the combined pill in the following women:

• Breast feeding mothers

• Current smoker

• Women who have high blood pressure

• Women who have had blood clots in the past

• Women who are overweight

• Women over the age of 35

• The mini pill should be taken once daily at the same time for the full 28 days of your cycle

• There is no seven-day break

• You should start your next pack straight after completing one

• Important to take the mini pill as close to your usual time as possible

• When starting the pill, pick a time of the day that is most convenient for you

• Most women find first thing in the morning or last thing at night to be the easiest

This is common for many women. It is very important to take it as soon as you remember.

There are a few important points to note (only applies to our mini pills):

1. If you have missed your regular time, you can still take these upto 12 hours of your regular time i.e. you normally take it at 9am, you have forgotten to take that morning but remembered before 9pm the same day, so long you take it before 9pm (i.e. 12 hours) you remain protected.

2. If you are more than 12 hours late, in this case take the tablet as soon as you remember (two tablets in one day is fine to take). Remember that you will have reduced protection for the remainder of the cycle so seek additional barrier contraception such as condoms.

3. If you have had unprotected sex and missed your pill, you could still receive emergency contraception.

Bleeding whilst on the pill-This is a common occurrence and even more so when you first start taking it. Sometimes this is referred to as spotting or breakthrough bleeding. Don't be alarmed, your body is just adjusting to the new hormones. It is recommended to carry on taking the pills, if you experience withdrawal bleeding for over 3 months or large volume bleeding consult your own doctor.

Although the mini pill is well tolerated it should be used with caution in certain women:

• Vaginal bleeding with unknown cause

• Severe cardiovascular or peripheral vascular disease

• Severe liver disease

• If you have a diagnosis of porphyria (blood-based disease)

• Personal or family history of breast cancer It is very important for you to accurately state your full medical history, including all the medications you are currently on and any allergies you have when filling our consultation. This allows our doctors to make the best treatment recommendation for you.

Breastfeeding It is known that some progestogen passes into your breast milk and therefore to the baby. It is widely considered that the mini pill is safe to use in breastfeeding mother.

They contain different hormones

The combined pill contains two hormones, oestrogen and progesterone. The mini pill contains only progesterone. For this reason, the mini pill may be more suitable for you if you cannot take oestrogen. The side-effect profile is also different.

Timings of daily tablets

Mini pills should be taken at the same time each day. The combined pill should also be taken at the same time every day but if you miss One pill, as long as you take it within 24 hours it is still effective.

No Seven Day break

The mini pill should be taken every day, the combined pill is taken for 21 days and you have a seven-day break.

Before starting the pill, or switching your hormonal birth control, you should discuss the best option for you with your doctor.

Changing from one form of oral contraceptive to another is straightforward. It is important not to have a break when swapping.  When you start the new mini pill, take the first one the day after you have completed your last active pill (21 day cycle ). It is advised that you use a condom for atleast the first two days when you start the mini pill to prevent pregnancy.

If you start the mini pill after the dummy pills or your pill free break, you will need to use condoms for atleast the first two days when the switch happens.

We advise that you should speak with your GP or family-planning nurse before changing over.

Carefully read the instruction leaflet in the pill pack for more advice.

1. The mini pill can be started at any time during your menstrual cycle.
2. Prevention of pregnancy is determined by where you are within your cycle.
3. Starting on days 1 to 5 of your period (the first 5 days after your period starts): You will be immediately protected, unless you have an extremely short period, in this case use a condom for the first 2 days.
4. Starting after day 5: you will need to use additional contraception methods such as a condom until you have taken the mini pill for 2 days.
5. Starting in the first 21 days after birth: providing you are suitable to take it; the mini pill can be started immediately after giving birth. If you start taking it in the first 21 days after giving birth you will be protected.
6. Starting after 21 days from birth: you will need to use additional contraception, like condoms, until you have been taking the mini pill for 2 days.
7. Choose a time of day to take the pill that you are most likely to remember.

All contraceptive pills, including the mini pill, work by changing natural sex hormone levels. These changes can have an impact on your sex drive. Progesterone can lower your sex drive, although some women have reported an increase in the desire to have sex. If you report any changes to your sex drive and this is of concern, consult your own doctor.

The change is very simple. Start the new pill the day after you have finished the old pack. You will be protected immediately so long you do not miss any days and stick to the same timings.

It does not protect you from sexually transmissible infections (STIs). The best way to reduce the risk of STIs is to use barrier protection such as condoms and dams with all new sexual partners

The reason you are taking the mini pill is to prevent a pregnancy. It has no known effect on your long-term fertility. This is also true for how long you are on the medication for, this has no effect on your future chances of becoming pregnant.

The mini pill can cause your periods to become lighter, irregular or can stop completely. Spotting or breakthrough bleeding between periods can also occur.

All of these tend to improve after 3 months of taking the mini pill as the body gets a chance to adjust to the new hormonal status. If you have any concerns regarding this or any other side-effects please consult your doctor or pharmacist.

The mini pill unlike the combined pill is not linked to weight gain.

The mini pill might not work if:

• You miss a pill or take it more than three hours late
• You vomit within three hours of taking it
• You have very severe diarrhoea
• You are taking some medications or natural remedies (check with your doctor, nurse or pharmacist).

Taking the mini pill can make acne worse if you already have it whereas the combined pill may help clear it up. The effect of this varies from person to person.

You can stop immediately. If you want to prevent pregnancies, you will need an alternative method of contraception.

If you have vomiting or severe diarrhoea, you may not absorb the mini pill, and therefore will not be adequately protected to prevent a pregnancy. You should use an additional method of contraception (such as condoms) until you get your next period.