Minipill (progesterone-only birth control pill)

What is a minipill?

A minipill (progestin-only pill or POP) is a form of birth control you take by mouth each day to prevent pregnancy. It contains progestin, a man-made (synthetic) version of the hormone progesterone. Unlike other forms of birth control pills that contain both estrogen and progestin, the minipill contains just progestin. The minipill is available by prescription only.

Minipills prevent pregnancy by:

• Thickening your cervical mucus, making it difficult for sperm to travel to your uterus.
• Thinning the lining of your uterus to prevent a fertilized egg from attaching to it.
• Stopping ovulation (when your ovary releases an egg).

How effective is the minipill?

If you take the minipill at the same time every day, it’s 99% effective. If you skip pills or don’t use the medication exactly as prescribed, it’s 91% effective.

Is the minipill less effective than other birth control pills?

Yes, but only a little. Progestin-only pills don’t prevent ovulation as well as combination birth control pills. Therefore, its effectiveness is slightly lower.

How are minipills taken?

Minipills come in packs of 28 pills. As soon as you get the pills, you can begin to take them. Or, take the first pill during the first five days of your next period. If you take your first pill more than five days after the start of your period, use backup birth control (like a condom) for two days.

Take a minipill once a day at the same time each day (within the same three-hour time frame). When you finish a pack of pills, take a pill from a new pack the very next day. There should be no break between packs of pills.

Once you start, don’t go a day without taking the minipill. If you forget to take a pill by more than three hours, take it as soon as possible (even if that means you’re taking two pills in one day). Also, use a condom or avoid sex for the next two days.

Follow the prescription label. Birth control can only prevent pregnancy when you use it correctly. Ask questions if you don’t understand the dosage instructions or how to take the minipill.

What happens if I miss a minipill?

Your body absorbs progestin quicker than other hormonal birth controls, so it’s important to take it at the same time each day. If you miss a pill by more than three hours, you should take it as soon as you remember. Use backup birth control or refrain from sex for two days.

If you vomit or have diarrhea within a few hours of taking the minipill, you should also use backup birth control until two days after your vomiting or diarrhea subsides.

If you’re unsure about what to do in the event of a missed pill, use a backup form of birth control until you can speak with a healthcare provider.

What are the benefits of the minipill?

The benefits of the minipill can include:

• Lighter, shorter and less painful menstrual periods.
• You can take it immediately after giving birth, even if you’re breastfeeding (chest feeding).
• You’re able to get pregnant immediately after stopping the minipill.
• It doesn’t affect sexual intimacy like barrier forms of birth control.
• It’s helpful for people who are unable to take estrogen-containing birth control pills.

Do you get a period on the minipill?

Yes, you still get your period on the minipill. Your period may be irregular when you start taking the minipill. This is normal. Speak with your healthcare provider if this lasts more than three months.

What are the disadvantages of the minipill?

Some of the disadvantages of the minipill are:

• It’s slightly less effective compared to combination birth control pills. That’s because it doesn’t prevent ovulation as well as estrogen-containing pills.
• If you become pregnant and take the minipill, you’re at risk for ectopic pregnancy.
• The minipill (and all birth control pills) doesn’t protect you from sexually transmitted infections (STIs).
• You have to take it at the same time every day.
• Some medications make it less effective.

What are side effects of the minipills?

The minipill doesn’t contain estrogen. For some people, this means fewer side effects. However, the minipill may cause unpredictable bleeding for the first few months. You may experience spotting, heavy bleeding or no bleeding at all. Irregular bleeding typically resolves within six months.

Other side effects might include:

• Breast tenderness.
• Nausea.
• Headaches.
• Weight changes.
• Acne.
• Increased hair growth.

Is the minipill safe?

Overall, the minipill is safe. However, before taking the minipill:

• Tell your healthcare provider if you’re allergic to any medications or drugs.
• Share your complete medical history with your provider.
• Tell your provider if you’re breastfeeding or planning on becoming pregnant.
• Tell your provider about all the vitamins, prescription or nonprescription medications you’re taking.

You should also avoid smoking cigarettes or using tobacco products while taking minipills as this can increase your risk of heart attack and stroke.

Who is the minipill best for?

The minipill is a good birth control option for people who are breastfeeding (chest feeding) or who can’t take estrogen due to certain medical conditions. Other people who may benefit most from the minipill are people who:

• Have high blood pressure.
• Have a history of blood clots.

Who should not take minipills?

You shouldn’t take the minipill if you’re pregnant or think you may be pregnant. The minipill may be harmful to people who have:

• Breast cancer or a history of breast cancer.
• Unexplained vaginal bleeding.
• Liver tumors.
• Jaundice.
• Hepatitis.
• Liver disease or cirrhosis of the liver.

You also shouldn’t take the minipill if you can’t take it at the same time each day. Medications for HIV & AIDS or to control seizures may interfere with the minipill’s effectiveness.

What are other uses for minipills?

Some people take minipills to manage abnormally heavy menstrual periods.

When should I call my healthcare provider if I take minipills?

Contact your healthcare provider if:

• You become pregnant while on the minipill.
• You experience severe stomach pain.
• You don’t get a menstrual period after three months.
• You have bleeding that lasts longer than seven days.
• You have severe headaches.
• You have any questions about dosage or taking the minipill.

A note from Cleveland Clinic

The minipill is just one of many birth control options available to people wishing to prevent a pregnancy. Talk to your healthcare provider about if the minipill is right for you based on your health history and lifestyle. It’s important that you take the minipill at the same time each day.