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What is a progestin-only contraceptive?

A progestin-only contraceptive is one kind of birth control pill. It is often called the “mini-pill.” Regular birth control pills have 2 female hormones: estrogen and progestin (a synthetic version of the naturally-occurring hormone progesterone). The mini-pill has only progestin in it. Because this pill doesn’t contain estrogen, it may not have as many side effects.

How does the progestin-only contraceptive work?

This contraceptive does three things. First, like regular birth control pills, the progestin‑only pill makes your body “think” that you are pregnant and stops your ovary from releasing an egg. Second, the mini-pill causes changes in your uterus (where a baby grows) that make your uterus less likely to let a pregnancy get started, even if an egg is released. And third, the progestin-only pill thickens the mucus between your uterus and your vagina. (The vagina is the passageway from the uterus to the outside of the body.) Sperm have a hard time getting through the thick mucus to reach the egg.

Is the progestin-only pill better than regular birth control pills?

The progestin-only pill is better than regular birth control pills if you are breastfeeding because the mini-pill will not change your milk production (estrogen reduces the quality and amount of breast milk).

The mini-pill may be safer for some women to use than regular birth control pills. This pill is safer for women who are older than 35. It is also safer for women who smoke, have high blood pressure, are overweight or have a history of blood clots.

Regular birth control pills make some women feel sick to their stomach or have severe headaches. The progestin-only pill might not cause this problem.

If I use the progestin-only pill, can I still get pregnant?

No contraceptive method is perfect, even when you use it correctly. 2 or 3 of every 100 women who use the progestin-only pill correctly could still get pregnant. This risk of pregnancy is almost the same as the risk with regular birth control pills. With progestin‑only pills, it’s very important that you take your pills at exactly the same time every day. If you don’t take the pills at the same time every day, your risk of pregnancy increases. Remember that both kinds of birth control pills are better at preventing pregnancy than condoms alone.

Does the progestin-only pill have any disadvantages?

You might have a little bleeding between your periods for several months after you start taking the progestin-only pill. This can be inconvenient, but it is not a health risk. The bleeding will probably go away on its own after you use the mini-pill for a few months. If the bleeding seems heavy or if it bothers you, contact your healthcare provider about it.

A common side effect of the mini-pill is feeling hungry more often, which may result in weight gain. This side effect usually goes away when you stop taking the pill. Tender breasts can also occur.

Like regular birth control pills, the progestin-only pill has to be taken for a whole month before it can protect you from pregnancy. So for the first month, you need to use another kind of contraception, such as condoms, along with the mini-pill.

The mini-pill works best if you take it every day at the same time of day. Timing is much more important for the progestin-only pill than for regular birth control pills. If you are more than three hours late taking the progestin-only pill, you should take your missed dose right away and use a backup method of contraception (such as a condom) for 48 hours.

If you miss a day completely, you have to use a second method of contraception for the rest of the month (until your next period). You can’t take two mini-pills the next day to make up for a missed pill, the way you can with regular birth control pills.

Like all birth control pills, the progestin-only pill does not protect you from getting a sexually transmitted disease.

Sources

Using Progestins in Clinical Practice by BS Apgar, M.D., M.S. and G Greenberg, M.D., M.A. (10/15/00, http://www.aafp.org/afp/20001015/1839.html )