The mini pill, also known as the progestogen-only pill or POP, is one of the most commonly used forms of contraception in the UK. In this guide, you can find out more about what it is, how it works, how effective it is, where to get it and more.

 

Article contents:

  • What is the mini pill (progestogen-only)?
  • How does the mini pill work?
  • How effective is the mini pill?
  • How to take the mini pill?
  • What are the advantages and disadvantages of the mini pill?
  • What are the side effects of the mini pill?
  • Where can I get the mini pill?

 

What is the mini pill (progestogen-only)?

The progestogen-only pill, also known as the mini pill or POP, is a form of contraception for women. As the name suggests, it only contains a synthetic form of the hormone progesterone (such as desogestrel, norethisterone or levonorgestrel) and doesn’t contain oestrogen. Lovima®, a progestogen-only pill, contains 75 micrograms of desogestrel in each tablet, which helps to protect against pregnancy in women of child-bearing age, including adolescents.

 

How does the mini pill work?

The mini pill works to prevent pregnancy by releasing progesterone. This hormone is particularly effective because it thickens the cervical mucus (a viscous fluid) that can be found at the cervix, or the entrance of the womb, making it harder for sperm to enter and fertilise an egg. Progesterone also thins out the lining of the womb, so should an egg become fertilised, it will struggle to implant and therefore is very unlikely to lead to a successful pregnancy.

The mini pill also works by suppressing ovulation. In some POPs, such as Lovima®, the active ingredient desogestrel maintains a high level of progestogen, which prevents the ovaries from releasing an egg.

Therefore, all of these things combined make conception more unlikely for women who don’t wish to become pregnant.

 

How effective is the mini pill?

No form of contraception is 100% effective, but when taken correctly, the progestogen-only pill can be up to 99% effective, meaning that less than one woman will fall pregnant each year for every 100 who take it.

However, ‘perfect’ use is generally different to ‘typical’ use. Typical use refers to when a pill is missed or taken late, whereas perfect use would involve taking it at the same time each day without fail. Not every woman takes her tablet at the same time each day, and there are other factors involved in effectiveness too, such as whether a pill has been missed altogether or whether you’ve had sickness and diarrhoea. You may have taken your pill at the perfect time, but sickness and diarrhoea could prevent a POP from being absorbed, reducing its effectiveness.

The NHS estimates that with ‘typical’ use, the way in which the pill is taken by women in real life, the POP could be around 91% effective. This is why it’s so important to take the pill as laid out by the manufacturer, and also at the same time each day. More information on this can be found in Lovima®’s patient information leaflet.

If you take a desogestrel pill less than 12 hours late, you can take the missed tablet as soon as you remember and you will still be protected. This means that, should you take the POP at 8am every morning, but you forget until 8pm one day, your chances of pregnancy are still low.

If you take a pill more than 12 hours late, you might not be protected so be sure to use other methods of contraception, such as condoms. Take your pill the next time you remember and continue to use condoms for the next seven days while the progesterone gets to work.

 

How to take the mini pill

Taking it for the first time

 

If this is the first time you’ve taken the POP, you should take the first tablet on the first day of your period. This means you will instantly be protected against pregnancy. Take the pill with or without food, and swallow it whole with some water to help it go down.

Then, take one tablet at the same time each day. This means you will go 24 hours between each tablet. Once you’ve gone through the first packet (usually 28 tablets), you can move on to the next pack without taking a break. The combined pill is the one where you have to take 21 tablets and then have a seven day break, but with the POP, you can take a pill every day with no gap in between.

Remember that your progestogen-only pill will be more effective when it’s taken at the same time each day. You could set an alarm to remind you or take it with a certain meal (like at lunchtime). This makes it less likely that you’ll forget or miss a pill.

While you can start the POP on days two to five of your menstrual cycle, you would need to use additional contraception, such as condoms, for seven days to prevent pregnancy.

 

Taking it after pregnancy

 

If you’ve just had a baby, you can start a POP immediately and no additional contraception is needed up to 21 days after childbirth if your periods have not started again.

If you have had a baby more than 21 days ago, you can start taking a POP, however you will need to use other forms of contraception, such as condoms, for the first seven days of taking the tablet.

 

What are the advantages and disadvantages of the mini pill?

 

There are advantages and disadvantages to any contraceptive, and it’s important to weigh these up when choosing which type is right for you.

Some of the advantages of the progestogen-only pill are:

  • It has a high effectiveness
  • It is suitable for women who can’t take oestrogen-containing pills
  • It is suitable for women who smoke
  • It can be taken at any child-bearing age
  • It is safe to use while breastfeeding
  • It is suitable for women who are overweight

 

However, some disadvantages are:

  • It may interrupt your menstrual cycle, resulting in missed periods, spotting or more frequent periods
  • You need to take it at the same time every day for it to be effective
  • You might not be protected if you have sickness or diarrhoea
  • It doesn’t protect against STIs


What are the most common side effects of the mini pill?

Side effects from the mini pill can include:

  • Acne
  • Breast pain
  • Changes in mood/depressed mood
  • Headaches
  • Irregular or no periods
  • Nausea
  • A reduction in sex drive (libido)
  • Weight gain
  • Vaginal bleeding or spotting

Many of these side effects will be temporary and should disappear within the first few months of taking the progestogen-only pill. If you’re concerned about any of the side effects you’re experiencing, you should seek advice from your GP.

 

Where can I get the mini pill?

The mini pill, or POP, can be purchased from a variety of sources.

To purchase Lovima®, you can visit your local pharmacy or buy the pill online. In both instances, you will be asked some questions to determine that you’re suitable to take the POP and, as long as you are, a pharmacist will provide the medication for you. When purchasing online, you can answer the questions immediately so you can get fast delivery.

You don’t need to have your blood pressure checked when purchasing Lovima, however you can request this in a pharmacy if you’d like. You should always read the label that comes with the product before taking it.

Complete the Lovima® Checklist before you go in-store to aid a discussion with your pharmacist.

 

Sources

https://cks.nice.org.uk/topics/contraception-progestogen-only-methods/

https://www.nhs.uk/conditions/contraception/how-effective-contraception/

https://www.nhs.uk/conditions/contraception/the-pill-progestogen-only/

https://www.contraceptionchoices.org/contraceptive-method/mini-pill