Mini Pill

The mini pill is a very effective form of contraception providing near total protection against pregnancy, as well as providing additional benefits especially if you have found the combined pill to be unsuitable for you.

The mini pill – POP pill or progestogen-only pill - is a form of oral contraception used to prevent pregnancy from occurring and is taken in the same way as the combined pill; one pill daily. However, there are some important differences to note. The main difference is that the POP pill has only one hormone in it, a synthetic progestogen. Because it only has one hormone, its side effects are much less severe. In fact, there are very few side effects associated with this treatment and it is suitable for women who smoke and are over the age of 35.

The advantages of the mini pill are that it is a much milder form of contraception as it does not contain oestrogen, and there are other additional benefits as well. For example, associated health risks are much lower than those of the combined version, it can be taken in many circumstances in which the regular pill cannot be taken including if you are breastfeeding, have diabetes, smoke, have high blood pressure or are older than 35. It can also help to ease PMT (pre-menstrual tension).

One of the main disadvantages of this treatment is that it does not control periods in the same way as the combined pill. This means that you could experience spotting when taking the mini pill, and will never be sure when you are going to start your period, how long it will last or how heavy it will be. This is often not a problem for many women, but other may seek further advice or alternative contraceptive treatment.

Mini pill brands

There are multiple brands of the mini pill. Whilst some are more popular than others, discussing your mini pill options with a medical professional such as your GP or doctor can shed further light on which type of contraception to use. At euroClinix, we provide three clinically proven and popular mini brands:

• Cerazette
• Micronor
• Noriday

The mini pill can be split into two types; the three-hour POP pill and the 12-hour POP pill. This refers to the timeframe in which each pill must be taken daily to remain effective as a birth control method. The three-hour mini pills must be taken within three hours a day after the previous pill, whilst the 12-hour pill offers more flexibility. For example, if you have taken one three-hour POP pill at 9pm, the next day you must take the next pill within 9pm-12am.

The mini pill is highly effective when used correctly because it works in a couple of ways to help stop pregnancy.

• It thickens the secretion around the neck of the cervix, making it difficult for sperm to get through and fertilise the mature egg
• It makes the lining of the womb thinner and therefore less receptive to holding a fertilised egg

Most mini pills don't stop ovulation from occurring, which is how most combined contraceptives protect against pregnancy. However, some new versions of the medication can now prevent ovulation as well.

This treatment is not quite as effective as the regular pill. If you had to compare it to another birth control method, it would probably be as effective as an IUD. This still means the mini pill is over 99% effective when used correctly and it is only considered this efficient if it is taken at the same time daily for the duration you are on the pill and want to be protected from pregnancy. If you miss one day, or take it at random times, it will not be effective.

Advantages

The main advantages of the mini-pill is that it is a much milder form of contraception, and has less side effects.

Other advantages of this treatment include:

• It has fewer side effects in comparison with the combined pill
• You can take it at any age, unlike the combined pill, which is commonly phased out after the patient is over 35
• Smokers can use this treatment
• It can be taken by breastfeeding women
• It will not raise your blood pressure
• It can also help to ease PMT (pre-menstrual tension)

Disadvantages

One of the main disadvantages of this treatment is that it does not control periods. This means that regular spotting may occur when using the mini-pill. Another disadvantage, especially for those who are busy, relates to the diligence that must be taken when using the mini-pill, as there is a time frame whereby each pill needs to be used every day to remain effective.

The mini pill is taken over the full course of your 28-day menstrual cycle, in comparison to the combined pill that is taken for 21 days with a seven-day break.

Whilst you should read the instructions of how to take each particular brand of mini pill, many follow the same process:

• Every blister pack is clearly marked with the days
• You must take each pill at the same time everyday
• You won't experience a seven-day break
• Continue the next pack straight after

As women don't have that seven-day pill break, the predictability of when your period will start alters. Some women find they spot, whilst other find that their body needs to adjust to the progestogen before their periods level out.

What to do if you miss a pill

The main disadvantage of the POP (progestogen-only pill) is that you need to be extremely careful about taking each tablet at the same time every day. If you do not do this, it may not be effective. Again, this may depend on which mini pill brand you are taking, but also how long it's been since you've missed said pill.

If you have missed the three-hour or 12 hour window of your pill, even missing just one will affect the efficiency of this contraception. You will need to use barrier contraception such as condoms for up to seven days after.

For the three-hour mini pill, you should take the missed pill as soon as you remember and continue to take the rest of the blister pack. The NHS advises women to seek barrier protection for two days after missing the pill.

Regarding the 12-hour POP pill, again, you should take the last pill as soon as you can and continue with the pack. Whilst 12-hour pills such as Cerazette provides a larger margin for error, if it has exceeded 12 hours, you won't be protected for seven days after the missed pill and will need to use a barrier contraceptive during those seven days to prevent pregnancy.

Vomiting and diarrhoea

Vomiting within 4 hours of taking the mini pill or severe diarrhoea over a course of 24 hours may mean the tablets hasn't been fully absorbed into the bloodstream. Contact the doctor to find out the best course of action if this happens as you may need to take another pill straight away.

As with all prescription medication, the progestogen-only pill may result in side effects, however these are unlikely, especially considering the fact that the mini pill doesn't contain any oestrogen. If you do experience side effects, these will most likely appear during the first three month of taking the new medication and should disappear after this time.

You may also find that you will suffer from:

• breast tenderness
• a change in sex drive
• headaches
• acne
• fluctuations in mood
• upset stomach

Taking the POP pill may also slightly increase the risk of an ectopic pregnancy, which is a dangerous complication of pregnancy where the egg implants itself outside the womb. Despite these side effects, the vast majority of women find the progestogen-only pill to be an ideal form of contraception with no side effects whatsoever, especially if they experience discomfort with the combined pill.

Whenever you take 2 or more treatments at the same time, the effects of one treatment can be altered by the other. This process is known as an interaction. A very small number of treatments interact with the progestogen-only pill and causes them not to work properly. Your doctor should be informed if you are taking the following medication as they may interact wrongly with the mini pill.

The antibiotics rifampicin and rifabutin (which are used to treat illnesses including meningitis and tuberculosis) can decrease the efficiency of the mini pill. Other antibiotics will not have this same effect.

If you're prescribed rifabutin or rifampicin, you might need extra contraception, such as condoms, whilst taking the antibiotic and for 28 days after. For more information, contact your doctor, nurse or healthcare provider.

The mini pill can interact with medications called enzyme inducers. These speed up the breakdown of progestogen by your liver, lessening the efficacy of the treatment. Examples of enzyme inducers include:

• epilepsy drugs - carbamazepine, phenytoin, primidone and topiramate
• St John's wort (a herbal remedy)
• Some antiretroviral medication used to handle HIV

It is possible to order a mini pill blister pack directly online without a face-to-face appointment or hassle booking and attending doctor's schedules. As the mini pill is a prescription medication in the UK, like all hormonal contraceptives, you will need a prescription slip to obtain treatment. We provide a free online consultation with your order which enables one of our partner doctor's to ensure your safety and provide a prescription to the pharmacy where it is dispatched to you.