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The mini pill (progestin-only pill) contains a single hormone, a progestin.
The progestin makes it harder for the man’s sperm to get into the uterus by thickening the cervical mucus, and may also affect ovulation and change the lining of the womb so an egg cannot implant.
The mini pill needs to be taken at the same time each day.
It takes seven days of taking the pill every day for it to become effective as a contraceptive.
The pill works reasonably well at preventing a pregnancy as long as it is taken as instructed.
With ‘perfect’ use the mini pill is around 98% effective but this effectiveness falls to 90-97% when more typical irregular use occurs.
There are more effective pills than the mini pills if the woman wants to take a pill and is suitable for it, or more effective progestin contraceptives is she prefers this hormone.
They are safe and suitable for nearly all women.
The few reasons that a woman might not be suitable include breastfeeding a child less than 6 weeks old; the presence of abnormal vaginal bleeding; the presence of severe liver damage or cirrhosis; a history or current deep vein thrombosis; a history of or current breast cancer; or taking some medicines for TB or epilepsy.
According to the WHO, some women prefer the pill because: its use can be controlled by the woman; it can be stopped any time, without the provider’s help; it can be used while breastfeeding; and it does not interfere with sex.
The mini pill can cause side effects.
Common side effects include changes in bleeding pattern, from irregular bleeding to complete absence, headaches, dizziness, mood changes and breast tenderness. It should be made clear in counselling that lighter or absent bleeding may be normal and will not harm future fertility.
Some mini pills have a short ‘window’ in which the woman can take her tablet if she has forgotten to take it at the right time on a given day. If the woman takes her tablet after that window then her mini pill regime may not cover her for the immediate period. Most combined pills, and mini pills containing desogestrel, have a 12 hour window.
By comparison mini pills containing norethisterone or levonorgestrel only have a 4 hour window.
Unlike condoms, pills do not protect against sexually transmitted infections.