Mini pills are oral contraceptives that only contain progestogen. This mimics a hormone that’s naturally produced by the ovaries.
They’re a good alternative for women who can’t take oestrogen or who have a bad reaction to the combined pills.
Mini pills are to be taken continuously, with each pack starting as soon as the last one ends. A 7-day break isn’t needed on these pills, and taking one will mean that you aren’t protected against pregnancy during this time and for up to 2 days after.
Progestogen only pills (POP) thicken the mucus in the cervix, making it difficult for sperm to reach the egg, and they have a 99% success rate of preventing pregnancy.
"Mini pills are a reliable form of contraception. They can be used by more women than the combined pill as they don’t contain any oestrogen. They are no less effective at preventing pregnancy, and many women report experiencing fewer side effects with a progestogen-only pill than with the combined oral pills. Neither of the oral contraceptives will protect you against STIs, though, so you might want to still use barrier methods if you’re unsure of your partner’s sexual history."
What are mini pills?
Mini pills describe a group of hormonal contraceptive tablets that only contain progestogens. Progestogen is similar to a hormone produced in the ovaries, progesterone.
The name ‘mini pill’ suggests that these pills are smaller than the combined pill, or that they aren’t as effective, but this simply isn’t true. The name comes from the fact that they only contain one hormone as opposed to combined oral contraceptives (COCs) which also contain oestrogen.
Progestogen only pills (POPs) are a great alternative to the combined pill for those that can’t take oestrogen, and many women report experiencing fewer side effects on POP than on COC.
How do mini pills work?
Mini pills typically work by thickening the mucus in the cervix, making it difficult for sperm to reach the egg. Some mini pills (for example, those containing desogestrel as the active ingredient) can also stop an egg from maturing, making them a very effective method of contraception.
When used correctly, POPs have over a 99% success rate, meaning that less than one woman in every 100 taking the medication will get pregnant.
Like with combined oral contraceptives, the mini pill won’t stop you from getting any STIs, so if you’re sleeping with someone and you don’t know their sexual history or whether they’re carrying any infections, it’s recommended that you also use a barrier method such as condoms. Even if you know the sexual history of your partner, you can still use condoms alongside the pill, giving you a double safety net of pregnancy prevention.
How do you take the mini pill?
Similar to the combined contraceptive, the mini pill must be taken at the same time each day. If you start the pills on days 1-5 of your period, you’re protected straight away (though you can always condoms to be sure). If you start it on any other day of your period, you won’t be protected for 2 days, so make sure you use other methods during this time.
There are usually two types of progestogen only pills available, some with a 12-hour timeframe, and others with just 3 hours. If you miss a dose, you should take it as soon as you remember unless it’s out of the timeframe, but you should continue as normal the next day. If you do completely miss a dose, you should use condoms or other barrier methods for the next two days until you’re fully protected again.
Mini pills don’t require you to take a break for 7 days at the end of each pack. Once you’ve finished a strip of 28 pills, you must start the next strip the day after. This is also known as continuous use. Up until very recently, it was recommended that those taking the combined pill should take a 7-day break, though new guidelines have contradicted this.
I vomited after taking the pill
If you vomited within 2 hours of taking the pill, you should take another one straight away as you might not be protected. It’s thought that any time after these initial two hours should still cover you though.
Severe diarrhoea can also cause the pill to not work properly, so if you’re suffering from this, or are vomiting a lot, use other, non-oral methods of contraception whilst you recover. If you don’t feel well enough to have sex, try not to feel pressured into it by your partner. If you do, please inform the police.
Are there any side effects with the mini pill?
Some women that take POPs experience side effects such as:
- Tender breasts
- Changes to periods
- Mood swings/feeling depressed
- Reduced sex drive
- Oily skin
- Weight gain
Anecdotally, many women claim to experience fewer side effects with a progestogen only pill in comparison to combined oral contraceptives, but if you’re taking a mini pill and are suffering with any of the above symptoms, please make an appointment with your GP who may be able to change the brand of pill you’re taking or find other suitable contraceptives.
Some women may also develop harmless ovarian cysts with POP. These are usually asymptomatic, but can cause some pelvic pain. They’re normally nothing to worry about and disappear on their own.
There is also some research into whether the mini pill increases your risk of developing breast cancer. Whilst the research is still new and there’s not yet enough evidence to suggest either way, it is thought that any increased risk would only be small, and similar to that of women who are using the combined pill.
Can I take the mini pill?
Most women are able to take the mini pill due to the fact it doesn’t include any oestrogen, though there are certain groups that might be at risk and should speak to their GP before deciding on a contraceptive method. This includes women that:
- Might be pregnant
- Don’t want to alter their periods
- Take other medications that might affect the mini pill
- Have ever had unexplained vaginal bleeding
- Have heart disease
- Have arterial disease
- Have ever had a stroke
- Have liver disease
- Have breast cancer (especially when it is suspected to be caused by sex hormones)
- Have severe cirrhosis
Other than women with the above exceptions, most should be fine to take the pill. The mini pill is safe to use up until the menopause and can even be used by breastfeeding mothers, something which the combined pill isn’t recommended for.
Can the mini pill make you infertile?
There’s no evidence to suggest that the mini pill will affect your fertility. Many women are able to get pregnant straight away when they stop using the contraceptive, though some find that it may take a few months for their ovulation or menstrual cycle to return to normal. If you think you might want children in the future, the mini pill is safe to use.