Department of Genito Urinary Medicine and Sexual Health
The Mini Pill

There are two main types of pill which vary in hormone content and the way they work. The most widely used are the combined pills which have two hormones, oestrogen and progestogen.

Combined Pill

  • progestogen
  • oestrogen

There are also pills (often known as mini-pills) which have progestogen only and no oestrogen. This leaflet gives you some information about the mini-pill. (An information leaflet is also available on choosing and using the combined pill.)

Mini-Pill

  • progestogen
How effective is the Pill?
Tests show that for every 100 women who take the mini-pill very carefully and consistently, one will get pregnant in a year. But with less careful and consistent use, one to four will get pregnant. The mini-pill is even more effective in women over 40 years old. Free leaflets on all family planning methods are available, so you can compare whether the mini-pill works better or is easier to use than other methods. To make the pill as effective as it can be, remember:
  • To take it regularly, and at the same time each day.
  • To use another contraceptive method as well if you miss a pill or are sick, have severe diarrhoea, or are taking medicines which may interfere with the way the pill works.
Who is it suitable for?

The pill has the great advantage that it doesn't interfere with intercourse. As long as you remember to take your pill every single day without a break, you can have intercourse as often as you like, without having to take any other contraceptive precautions.

The mini-pill is a possible alternative for older women or others who cannot use the combined pill, because it has no oestrogen, and because it is believed to add little or nothing to the risks of heart disease and strokes. It is suitable for women who are breastfeeding as it does not reduce the milk flow.

Are there any problems?

Taking the mini-pill may cause irregular bleeding. Some women find that their periods are much lighter; others have no periods at all. Bleeding at odd times often happens. This is called breakthrough bleeding. Some women have repeated breakthrough bleeding throughout the month. A change of mini-pill may help. If your period is more than two weeks late, consult your doctor or clinic.

One risk of any pregnancy is that occasionally it develops outside the womb, usually in a fallopian tube. This is called an ectopic pregnancy. Although it is rare, it can be dangerous. You should see your doctor straight away if you have sudden lower abdominal pain. Be sure to mention to the doctor if you have had a previous pregnancy in the tube, since this may mean it would be better for you to use another method.

Cysts on the ovary are common in mini-pill users, but are not dangerous. These may cause pain, but sometimes there are no symptoms. These cysts usually disappear when you stop taking this pill.

How does the Pill work?

The mini-pill does not always stop the ovary releasing an egg each month (ovulation). It thickens the fluid (mucus) at the neck of the womb (cervix) which makes it hard for sperm to travel through. The mini-pill also makes the lining of the womb less likely to accept a fertilised egg.

What else do you need to know?
It is important that you see your doctor at regular intervals. This will probably be every six months once you are settled on the pill. If you have any worries talk to the doctor or nurse sooner.
Where do you get the Pill?

Only a doctor can give you the pill. Family planning clinics and most family doctors prescribe the pill. You will be asked your medical history to make sure the pill is suitable for you. Your blood pressure should be taken too.

Where do you go for family planning?
You have four choices:
  • Your own family doctor (GP)
  • Another GP of your choice who gives family planning advice to other GPs' patients too
  • A family planning clinic
  • A Brook Advisory Centre (especially for under-25s) Partners are welcome. All advice and supplies are free.
What happens when you go for family planning?

The doctor or nurse will talk to you about the methods. Together you can decide what is best for you. An examination may be needed which is a good idea in any case. Don't be embarrassed: feel free to ask the doctor or nurse any questions about your sexual relationship or family planning or safer sex. You will be asked to come back soon to make sure you are happy with your choice.

How to take your Mini-Pill
How to take your pill This is all you have to do:

Take the first pill of the first pack on the first day of your next period. This is day one of your cycle - the day when bleeding starts.

You will be protected at once.

Take your first pill from the bubble marked with the correct day of the week.

Take a pill every day till you finish all the pills in the pack.

IT IS REALLY IMPORTANT TO TAKE THE MINI-PILL AT THE SAME TIME EACH DAY
Then start a new pack me very next day. You will be taking pills through your periods and there must be no break between packs.

If you start this pill on any other day, you will need to use other family planning as well, such as the condom, for the first 48 hours of the first pack.

Which do you have?

  • Femulen Neogest
  • Micronor Norgeston
  • Microval Noriday
What to do - If your periods are different
This is quite normal with the mini-pill. Periods may be irregular and you may have some bleeding between periods. You may even have no periods at all. Make a note of what happens so you can tell the doctor or nurse.
What to do - If you forget a Pill

Take it as soon as you remember, and take the next one at the right time. This may mean taking two pills in one day. If you take the mini-pill more than three hours late, you are not protected. Continue to take your pills normally but you must also use another method, such as the condom, for the next 48 hours.

What to do - If you have a stomach upset

If you have vomiting or very severe diarrhoea the pill may not work. Continue to take it, but you may not be protected from the first day of vomiting or diarrhoea. Use another method, such as the condom, for any intercourse during the stomach upset and for the next 48 hours.

What to do - If you have to take other medicines

Several medicines may interfere with the way the pill works. These include some drugs that treat epilepsy and tuberculosis. Other medicines, such as sedatives and tranquillisers, might also have this effect. You may have to use another method as well, such as the condom, while you are taking the medicines - and for a further 48 hours. Your doctor may advise you to use these extra precautions for longer. Always tell the doctor you are on the mini-pill.

What to do - If you miss a period

This often happens with this pill. If you have taken all your pills properly at the right time it is most unlikely you are pregnant. Continue with your pills as normal. If your period is more than two weeks late, consult your doctor or clinic. If you think you might be pregnant see your doctor sooner. If you have any sudden lower abdominal pain as well as a light or delayed period, see the doctor immediately. These might be the warning signs of an ectopic pregnancy.

What to do - If you are changing pill brands

If you are starting the mini-pill after any brand of combined pill this is what you do. Take the first mini-pill the day after the last of your old kind. Do not leave any break at all.

What to do - If You Smoke

Smoking increases the risks to your health and increases some of the risks of the combined pill. It is not known if these risks also apply to the mini-pill. It is best to stop smoking anyway.

What to do - If you have side-effects

Any side-effects should be checked but minor side-effects can wait until your next appointment.

What to do - If you have just had a baby

After a birth or abortion, or if advised after a miscarriage, your doctor will advise you about starting the pill and whether another method should be used as well. You can start using this pill immediately after a miscarriage or abortion. If you are breastfeeding you may be given the mini-pill. (The combined pill is not recommended at this time as it can reduce the milk flow.) After childbirth you can start taking this pill from day 21 onwards. If you plan to stop using the mini-pill when you finish breastfeeding, make sure you have decided on another method first.

Suppose you want a baby

If you want to have a baby it is helpful to stop the pill and then have two periods before you try to get pregnant. You can use another method such as a condom for that time. Once you have had two natural periods it is easier to work out when the baby is due. However, if you do get pregnant immediately after stopping the pill, research to date has shown this is not harmful.

Final Word

This leaflet can only outline basic information about the mini-pill based on evidence available and current medical opinion at the time of publication. Most pill manufacturers produce their own instruction leaflets and, in some cases, these give conflicting advice on certain points. If in doubt, seek your doctor's advice in your individual case. DON'T FORGET - ring or visit the clinic or your doctor if you are worried or unsure about anything.

 
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