Let’s Talk Contraception: The Mini-Pill or Progestin-Only Pill

Birth control pills usually contain progestin and estrogen, which are both sex hormones. Progestin-only birth control pills (POPs) are sometimes called the mini-pill because they don’t contain estrogen. If you are concerned about taking estrogens because you have high blood pressure, migraines, heart disease, or a history of blood clots, but still would like to take an oral contraceptive, this may be an option for you. It is also a good choice if you are a new mother and breastfeeding.

Progestin-only pills don’t contain estrogen, making them a good option for some people.

POPs are used in the same way as other birth control pills. They come in packs of 28 pills. You take one pill at the same time each day and after the last pill in the pack is taken, you start a new pack the next day; there is no skipping days. Because there is a slightly greater risk of becoming pregnant on progestin-only pills, you must be very careful to take each pill at the same time each day and never miss a day. If your period is late and you missed one or more pills or took them late, you may need to take a pregnancy test.

The effects of POPs are easily reversible and after stopping these pills your chances of getting pregnant should not be delayed.

The best time to start these pills is the first day of your menstrual period. You need to use a backup method, such as a condom, for at least 48 hours after you start these pills to prevent pregnancy. Optional start times are during the first five days of your period, the next day after stopping another type of birth control pill, within 21 days of giving birth if not breastfeeding, and immediately after a miscarriage or abortion. If you are a nursing mother, you must wait six weeks after you have given birth before starting these pills. And, even though small amounts of hormones may pass into breast milk, POPs are considered safe to use by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists.

The most common side effects are bleeding changes or irregular periods. Other less common side effects are headache, nausea, dizziness, and breast pain. Acne, weight gain, or hair growth are much less common. If you have increased bleeding, no periods, or severe stomach pain, it’s important to tell a health care provider.

Always tell a health care provider or pharmacist about all the medications you take, including over-the-counter items such as vitamins, herbs, or supplements, because they may interfere with birth control pills. If you are allergic to aspirin, tartrazine (yellow food dye), or progestin, tell your doctor before taking these pills. If you have a history of breast lumps or cancer, liver disease, or diabetes, let your doctor know.

As with all birth control pills, smoking may increase your risk of heart attacks or strokes. And POPs used alone do not protect you from getting HIV or sexually transmitted diseases.

You can make an appointment at a Planned Parenthood health center to discuss birth control pills and other contraceptive options with a clinician, and find the option that best serves your needs.

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