Mini-Pill

The mini-Pill is a very effective form of contraception. It has been around for over 40 years now, and in that time, it has proved remarkably safe to use. These days, many women choose this medication because they do not want to take the combined pill or cannot do so for medical reasons. This treatment is also commonly knows as the “POP” or the “progestogen-only pill.”

These types of treatments contain only synthetic progestogen and are usually taken by women who smoke and/or are older than 35, who are unable to take them because of the added oestrogen. They also have a lower risk of side effects and are taken for the full 28 days of your cycle. The most popular versions include Cerazette and Micronor.

The mini-pill is a form of oral contraception used to prevent pregnancy from occurring. Often people make the mistake of assuming it is similar to the combined birth control pill, but just a lighter dosage. This is because the name ‘mini-pill' can be a bit misleading.It is a completely different product to the regular combined version. The main difference is that the mini-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

The mini-pill is not as effective as the regular combined version, and needs to be taken strictly at the same time every single day of the year, without a break. It is a common form of contraception for women over 35 and for women who cannot, for whatever reason, take the regular tablet.

OrganonManufactured by
Cerazette
Cerazette (desogestrel) is a mini-pill; a single hormone contraceptive pill. Mini-pills don’t use an oestrogen and are better for women who are sensitive to this hormone, as well older women, those who are breastfeeding, and women who smoke. Cerazette contraceptive pills are taken for the full 28 days of your cycle, without a break between courses. It’s one of the only mini-pills that prevents ovulation, making it almost as effective as combined contraceptives.
Janssen CilagManufactured by
Micronor
Micronor (norethisterone) is a mini-pill. It is different to the combined contraceptive pill, because it is a single hormone contraceptive. Mini-pills do not use oestrogen to prevent pregnancy, which makes them a more suitable birth control pill for women who are sensitive to this hormone. It’s also a better choice for older women, women who are breastfeeding and women who smoke. Micronor is taken for 28 days straight, with no break between courses.
PharmaciaManufactured by
Noriday
Noriday is a progestogen-only contraceptive pill which is proven to help with PMS symptoms. It’s just as effective as the combined contraceptive pill; and it prevents ovulation in some women who use Noriday. The absence of oestrogen reduces the chance of developing side effects associated with oestrogen such as fluid retention, breast tenderness, cramps and irregular bleeding. It can be taken by smokers, women over 35 or those breastfeeding, unlike the combined contraceptive pill.

Advantages

The main advantages of the mini-pill is that it is a much milder form of contraception, and has less side effects. It might be less effective, but the 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 - for example if you are breastfeeding, have diabetes, smoke, have high blood pressure or are older than 35.

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 you could experience constant 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.

Another disadvantage, especially for busy women, is that you need to be extremely diligent about taking the mini-pill at the same time every day. If you do not do this, it will not be effective. You may also find that you will suffer from breast tenderness, and be slightly more susceptible to an ectopic pregnancy, which is a dangerous complication of pregnancy where the egg implants itself outside the womb.

How does it work?

This medications works by doing 2 things:

  1. It thickens the secretion around the neck of the cervix, making it difficult for sperm to get through and fertilise the mature egg
  2. 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.

How effective is it?

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. It is only considered effective 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.

When is it not safe to take the mini-pill?

You should not take the mini-pill if you experience or suffer from:

  • Liver tumours
  • A history of breast cancer
  • Being overweight
  • Not being able to keep a routine or schedule
  • Severe artery disease
  • Diagnosed vaginal bleeding

Taking this treatment with other medications

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.

Antibiotics

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.

Epilepsy and HIV medications, and St John’s wort

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:

  1. epilepsy drugs carbamazepine, phenytoin, primidone and topiramate
  2. St John’s wort (a herbal remedy)
  3. Some antiretroviral medication used to handle HIV