Progesterone-Only Oral Contraceptives
What are Mini-Pills?

Mini-Pills are progesterone-only birth control pills. Mini-Pills come in packs of 28 pills and one is taken every day. They have a synthetic form of the progesterone hormone and no estrogen. The Mini-Pill affects the mucus around the cervix and makes it harder for sperm to enter the uterus. It also affects the transport of the egg through the fallopian tubes. In these ways, the Mini-Pill prevents fertilization. Mini-Pills are 87-99.7% effective, slightly less than regular birth control pills. They do not protect against sexually transmitted infections, including HIV/AIDS.


There are hormones in each Mini-Pill; there are no spacer pills. It is important to take a pill every day, preferably at the same time each day. Forgetting a Mini-Pill or taking it late increases the chance of pregnancy more than missing a regular birth control pill.
You can improve the effectiveness of Mini-Pills by adding a backup method, like condoms or spermicide. This is most important during the first three months and days 8-18 of your menstrual cycle after the first three months.

Starting Mini-Pills

Take the first pill on the first day of your period. Take one pill daily, at the same time of day, even during your period.
After the First Pack

As soon as you finish one pack, begin the next one. Start your next pack even if you are still bleeding or have not started your period. Continue taking one pill every day.

If you have problems with the Mini-Pill, call the clinic. DO NOT stop taking the Mini-Pills unless you want to get pregnant or can use another method of birth control.

Your Health

Every woman is different and Mini-Pills are not recommended for all women. Due to the risk of serious health problems, women with the following conditions should not use Mini-Pills:

  • Unexplained vaginal bleeding
  • Known or suspected pregnancy
  • Breast Cancer
  • Mini-Pills may not be recommended for women who are concerned with weight gain, have liver disease, gallbladder disease, heart disease, diabetes, or a history of depression.

Mini-Pills increase the risk of having functional ovarian cysts. They also very slightly increase the risk of ectopic pregnancy. An ectopic pregnancy occurs when a fertilized egg attaches and grows outside the uterus. This can be very dangerous and requires emergency medical attention. To protect your health, watch out for the Mini-Pill’s danger signs.


Women on Mini-Pills have a decreased risk of endometrial cancer and pelvic inflammatory disease. You may have less menstrual cramping and pain, fewer periods, and less chance of anemia.

Side Effects

The most common side effect for women using Mini-Pills is irregular bleeding. While many women on Mini-Pills have normal periods, others may have irregular periods, spotting between periods or no periods at all. If you do not bleed for 60 days, call the clinic to arrange for a pregnancy test but continue taking your pills.
Other possible side effects of the Mini-Pill are mood changes, headaches, and lowered sex drive.
Some of the typical side effects of regular birth control pills, such as nausea, and breast tenderness, usually do not occur with Mini-Pills.

Drug Interactions

The effectiveness of Mini-Pills is lowered when taken with certain medications. These drugs include Rifampin and anti-seizure medications. If you are taking any medications, tell your clinician. When taking medications that may interfere with Mini-Pills, consider adding a backup method of birth control, like condoms and spermicide. As with all drugs, it is useful to inform all your medical providers if you are using hormonal birth control.

Danger Signs
  • Women who experience any of the following symptoms while taking Mini-Pills should call the clinic immediately:
  • Abdominal pains (severe)
  • Chest pain or shortness of breath
  • Headaches (severe)
  • Eye problems, such as blurred vision
  • Severe leg or arm pain or numbness
Missed Pills

3 or more hours late: Take a pill as soon as you remember. Use a backup method for 48 hours.
1 pill missed: Take a pill as soon as you remember and take the next one at the usual time. This may mean taking two pills in one day. If you only miss one pill and make it up, you probably will not get pregnant. Use a backup method for 2 weeks.
2 pills missed: Take 2 pills each day for the next 2 days. Use a backup method for 2 weeks. You may have some spotting or bleeding. If the bleeding is like a period, call the clinic.
3 or more pills missed: Use a backup method and call the clinic for instructions.

Future Fertility

Women who want to become pregnant may stop using Mini-Pills at any time. Fertility may return immediately or after a few months.

  •  Avoids typical side effects of regular birth control pills.
  •  Has no estrogen.
  •  Easy to use.
  •  Does not harm future fertility.
  •  Does not interrupt sex play.
  •  Does not protect against sexually transmitted infections, including HIV/AIDS.
  •  Must be taken every day at the same time.
  •  Less effective when taken with some drugs.
  •  Increased risk of functional ovarian cysts.
  •  Increased risk of ectopic pregnancy.
  •  May cause irregular bleeding.
  •  Requires a prescription.
Further Resources

Feminist Women's Health Center: 404-728-7900
Female Health Company (Manufacturer’s Site):
Our Bodies, Ourselves, for the New Century. Boston Women’s Health Book Collective, new version in 2005.


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