Progesterone only pills (mini pill)

Dr. Babak Ashrafi

Medically reviewed by

Dr Babak Ashrafi

Last reviewed: 05 May 2022

The progesterone only pill is a contraceptive pill that is also known as the mini pill.

The mini pill works by stopping your ovaries from releasing an egg (ovulation) to prevent you from getting pregnant. The mini pill is 99% effective in preventing pregnancy if you use it perfectly. However, you may miss a pill every now and then, which can bring the effectiveness down to around 91%.

You can request the mini pill from ZAVA by filling out our simple questionnaire. We have a range of mini pills and other contraceptive options available, so you can learn more about which one could be right for you.

Contents
Woman looking for progesterone pills on her phone in bed
 

What is the mini pill?

The mini pill is a contraceptive pill that contains only progesterone as the active ingredient. The mini pill is ideal if you cannot take oestrogen. Both progesterone and oestrogen are types of female sex hormones that your body naturally produces.

Mini pills contain synthetic (man made) progesterone, such as desogestrel or levonorgestrel.

How does the mini pill work?

The mini pill works by giving your body a steady dose of progesterone hormone.

Your menstrual cycle is regulated by changing levels of oestrogen and progesterone. By taking a regular dose of progesterone, processes such as ovulation or getting your period comes to a stop. As you are not ovulating, you will not be able to get pregnant.

The mini pill can also thicken your cervical mucus to stop sperm from getting into your womb. It’ll also thin the lining of your womb, making it more difficult for an egg to implant. This can cause you to have much lighter periods.

What is the difference between the mini pill and the combined pill?

The difference between the mini pill and the combined pill is their active ingredients. Combined pills contain both oestrogen and progesterone, whereas the mini pill contains only progesterone.

They both work in a similar way by giving your body a steady dose of hormones. Both pills temporarily stop ovulation to prevent pregnancy. You can get pregnant again if you stop taking the pill.

The way you take a combined pill is different to how you take a mini pill. With a combined pill you take it every day and often have placebo pills, or take a break, for up to 7 days during a 28 day cycle. With the mini pill, you take it every day without any breaks during a 28 day cycle.

With the mini pill you need to take it at the same time each day, within the same 3 hour or 12 hour window. With the combined pill, you need to take it at the same time each day within the same 24 hour window.

Changing from the mini pill to the combined pill

If you are changing from the mini pill to the combined pill, take the first combined pill on the first day of bleeding. This might mean taking a combined pill on the same day you’ve taken a mini pill. If you start on the first day of bleeding you should have contraceptive protection immediately.

If you are switching from a mini pill that contains desogestrel to a combined pill, you do not need to use extra contraception.

If your mini pill contains levonorgestrel or norethisterone and you are switching to a combined pill, you’ll need to use extra contraception (such as condoms) for the next 7 days if you have sex.

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Is the mini pill right for me?

The mini pill might be right for you if you’re looking for a contraceptive method that does not contain oestrogen. You may not be able to take oestrogen if you get side effects from it or if your doctor has told you that you should not take oestrogen based medicines.

You need to take the mini pill every day at around the same time each day. Unlike the combined pill, there’s no pill free break or placebo pills. You’ll take the mini pill continuously.

This might suit you if you prefer to take a pill every day and can remember to do this. If you think you’ll forget to take your pill, you can consider other types of contraception such as a patch, vaginal ring or implant.

The mini pill is more suitable than the combined pill if you:

  • smoke
  • have high blood pressure
  • are breastfeeding
  • are over 35 and need an alternative to the combined pill

What are the different brands of mini pills in the UK?

There are several different brands of the mini pill available in the UK. All mini pills will contain either desogestrel, levonorgestrel or norethisterone, which are all types of the hormone progesterone.

At ZAVA, we offer several contraceptive pill brands that contain these active ingredients. These include:

Other brands of desogestrel mini pills include Lovima and Hana.

Different brands can contain the same active ingredient, such as Cerazette and Cerelle. You may find that you tolerate one brand better than the other. This is because the manufacturer can use different ingredients to make up the pill, while the active ingredient stays the same. You can find all the ingredients that are in a medicine by checking the patient information leaflet for it.

How to take the progesterone only pill

Taking the progesterone only pill can be straightforward if you follow our simple steps. If you’re switching from the combined pill, check the patient information leaflet to make sure you are switching without the risk of getting pregnant. You may need to use extra contraception for up to 7 days, such as condoms, to protect yourself when switching pills.

Starting the first mini pill

Start the first mini pill on the first day of your period. You’ll have contraceptive protection from the first day and do not need to use extra protection.

If you start taking the mini pill within the first 5 days of your period, you’ll be protected straight away too. However, if you start on the sixth day of your period or have a short menstrual cycle, then you’ll have to use protection, such as condoms, for 2 days.

If you’re switching from another mini pill, you can start taking the new pill at any point during the cycle. Make sure you have not missed any pills, and take your new mini pill instead of your old mini pill at your usual time each day. You will not need extra contraception.

If you’re switching from the combined pill and usually take a pill free break, start the mini pill the day after your last active pill and skip the placebo (inactive) pills.

If you’re switching from the combined pill and do not have a pill free break or placebo pills, you can start the mini pill the day after the last combined pill. You will not need to use extra contraception.

Vomiting and diarrhoea can change the effectiveness of the mini pill. If you throw up or have diarrhoea within 2 hours after taking the pill, you’ll need to use extra contraception while you’re sick and for:

  • 2 days after, if you’re on the 3 hour mini pill (levonorgestrel or norethisterone)
  • 2 days after, if you’re on the 12 hour mini pill (desogestrel)

Keep taking the mini pill as normal during this time.

After having a baby

You can start taking the mini pill 21 days after having a baby. You should use extra contraception for the first 2 days if you start later than this.

You should be able to take the mini pill if you are breastfeeding. Your doctor may advise you to delay taking it until a few weeks have passed after birth to ensure your breast milk has no trace of medicines. There’s no evidence to suggest that taking the mini pill while breastfeeding will harm your baby.

After a miscarriage or abortion

If you’ve had a miscarriage or abortion you can take the mini pill straight away and be protected from pregnancy. If you start the mini pill more than 5 days after, you’ll need extra contraception, such as condoms, for at least 2 days.

How long does the mini pill take to work?

If you take the mini pill within the first 5 days of your period starting, the mini pill will work straight away to protect you from pregnancy. If you start the mini pill after this, you’ll need to use condoms for 2 days while you continue to take it. If you miss a mini pill, it will not work as effectively to protect you against pregnancy.

It takes around 7 days for the pill to work to stop you ovulating and around 2 days for it to thicken the mucus in your cervix. Both of these actions prevent you from getting pregnant.

Remember that the mini pill does not protect you against sexually transmitted infections (STIs). Only condoms and abstinence can protect you against STIs.

What to do if you forget to take a mini pill

If you forget to take a mini pill, take the missed pill as soon as you remember. This might mean taking 2 pills in the same day.

You’ll need to check what type of mini pill you are taking. Most mini pills can be taken within the same 12 hours each day, such as desogestrel pills Cerelle, Cerazette, Lovima and Hana. Noriday or Norgeston need to be taken within the same 3 hour window each day.

If you’re more than 3 hours or 12 hours late taking your mini pill, you’ll need to use extra contraception, such as condoms, for the next 2 days.

If you’ve had unprotected sex in the past 7 days and missed a pill, it’s likely that you’ll need emergency contraception. Speak to your pharmacist or sexual health clinic if this happens.

Where to buy the mini pill

In most cases, you can buy the mini pill through getting a private prescription. This applies to online doctor services, such as ZAVA. These mini pills are prescription only medications (POM).

You can also buy certain brands of the mini pill over the counter at your local pharmacy or online through ZAVA. Lovima and Hana are brands of desogestrel mini pills that are pharmacy only medicines. This means a pharmacist will need to ask you a few questions before you can buy the pill.

Buying the mini pill online

You can buy the mini pill through online pharmacy and doctor services. To be safe, make sure the online services you buy from are registered with:

  • the General Medical Council (GMC)
  • the General Pharmaceutical Council (GPhC)

These are the official regulators of medical and pharmaceutical services in the UK.

You can buy the mini pill from ZAVA without needing an appointment. All you need to do is fill out a short consultation questionnaire. One of our doctors will review this questionnaire to make sure the mini pill is suitable for you.

We can then deliver the pill to your home address or you can choose to collect it from your local Post Office.

Getting the mini pill over the counter (Lovima and Hana)

Hana and Lovima are mini pills that are available to buy over the counter. Both Hana and Lovima contain 75 micrograms of desogestrel in each pill.

You can speak to your pharmacist to find out if you can buy Hana or Lovima. Your pharmacist will run through a few questions with you to make sure the mini pill is safe for you to take. This does not require an appointment and should take a short amount of time.

Getting the mini pill through the NHS

If you want to get the mini pill through the NHS, speak to a doctor or sexual health clinic about contraception. They can prescribe the most suitable pill for you and answer any queries you have about taking the mini pill. You can take this prescription to any UK pharmacy.

All contraceptive pills, patches and devices available on the NHS are free of any prescription charges only if they are used for contraceptive purposes. You may need to pay a prescription charge if you are prescribed the contraceptive pill for another reason, such as treating acne.

Side effects of the progesterone only pill

You may experience some side effects when you first take the progesterone only pill, or mini pill. These side effects are usually temporary and will not last very long.

Some side effects will go away after a few days of taking the mini pill as your body gets used to the hormones. Other side effects may take a few weeks or months to get better.

If you’re concerned about any side effects, speak to a doctor or pharmacist.

The common side effects of the mini pill are:

  • headache
  • feeling sick
  • acne
  • mood changes, such as depression
  • reduced sex drive
  • breast tenderness
  • irregular or no periods
  • increased body weight

Uncommon side effects can affect up to 1% of women taking the mini pill. This means if 200 women take the mini pill, less than 2 women will experience these side effects.

The uncommon side effects of the mini pill can include:

  • tiredness
  • vomiting
  • painful periods
  • hair loss
  • vaginal infections such as thrush
  • ovarian cysts

As a biological woman, the risk of blood clots will be higher than men. This risk is increased slightly when you use a method of hormonal contraception. You should have regular pill reviews with your doctor to check your general health.

Women older than 40 have a higher risk of breast cancer than younger women. It’s important to check your breasts regularly and let your doctor know if you notice anything unusual.

The mini pill has a smaller risk of both blood clots and breast cancer compared to the combined pill. This might make it a better choice for you than the combined pill.

You can find out more information about side effects by reading the patient information leaflet that comes in your pack of mini pills.

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Medically reviewed by:
Dr Babak Ashrafi Clinical Lead for Service Expansion

Babak studied medicine at King’s College London and graduated in 2003, having also gained a bachelor’s degree in Physiology during his time there. He completed his general practice (GP) training in East London, where he worked for a number of years as a partner at a large inner-city GP practice. He completed the Royal College of GPs membership exam in 2007.

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Last reviewed: 05 May 2022




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