Progestin-Only Oral Contraceptive Pill (POP) or Mini-pill

nor-qd pill

The progestin-only pill (POP), also called the “Mini-pill,” is a type of birth control pill (oral contraceptive) that comes in a pack of 28 pills. Instead of containing the hormones progestin and estrogen, it only contains progestin. It’s often called the “Mini-Pill” because it doesn’t contain estrogen. It may be prescribed for young and adult women who can’t take estrogen due to an underlying medical condition, sensitivity or because of an unwanted side effect. POPs are used for birth control but also for treating menstrual period problems, cramps, endometriosis, and other conditions.

How do Progestin-only pills work?

Progestin is a female hormone that works by preventing the release of eggs from the ovaries (ovulation) and by changing the cervical mucus and the lining of the uterus.

How effective are Progestin-only pills?

Progestin-only oral contraceptives are an effective method of birth control, but they don’t prevent the spread of sexually transmitted infections (). If progestin-only oral contraceptives are used perfectly (i.e. every single day at the same exact time) only 1 out of a 100 young women will become pregnant over the year;With typical use (i.e. not taken at the same time every day),  7 out of 100 women become pregnant over a year. . POPs may be slightly less effective than the combined birth control pill which contains both estrogen and progestin because the timing is so important.

Before you take Progestin-only pills, tell your health care provider(s) if you:

  • Have an allergy to progestin or any other medications
  • Are taking any other prescription or nonprescription (over-the-counter) medicine
  • Have ever had breast lumps, liver disease, or diabetes
  • Smoke
  • Are pregnant or want to become pregnant
  • Take anticonvulsant or seizure medicine

How do I take Progestin-only pills?

Take one pill every day, AT THE SAME TIME. Every pill is an “active” pill, meaning that all the pills in the 28 day pack contain progestin, unlike combination pill packs that have inactive pills or “placebo” pills in the last row of the pill pack. It’s best to start the Progestin-only pill on the first day of your period or the first Sunday after your period begins. If you’re sexually active, be sure to use a backup barrier method of birth control (condom) for the first 7 days after starting the Progestin-only pill to prevent pregnancy. You should always use condoms to decrease your risk of getting a sexually transmitted infection (STI).

What should I do if I miss a Progestin-only pill?

  1. Take the missed Pill as soon as you remember, (you can take 2 Pills in one day but spread them apart), and then go back to taking the Pill at the regular time.
  2. If you are more than 3 hours late taking your Pill, either don’t have sex or use a backup method of birth control for the next 48 hours.
  3. If you are not sure what to do about the Pills you have missed, keep taking it. Don’t have sex or use a backup method of birth control (condom) until you can talk with your health care provider.
  4. If you become sick with vomiting or severe diarrhea within three hours after taking the Progestin-only Pill, keep taking the Pill every day. Do not have sex, or use a back-up method (condom), until 2 days after the vomiting has stopped. Call your health care provider if you have any concerns.

Benefits of progestin-only oral contraceptives (Mini-pill):

  • Progestin-only pills are an effective birth control pill and a substitute for girls/women who cannot take combined (progestin and estrogen) oral contraceptive pills.
  • Progestin-only pills may be effective in treating endometriosis.
  • Progestin-only pills, taken every day, help to protect against uterine cancer.

Possible side-effects:

  • Spotting or break-through bleeding can last for a few days until your body gets used to the medicine, or for as long as you are taking it.
  • Not having a period is also common.
  • Other side effects, such as acne, mood swings, nausea, dizziness, bloating, weight gain, headache, and/or hair thinning are rare.

Most of the time side effects are mild. However, if you have heavy bleeding that lasts longer than usual and/or severe pain in your belly, call your health care provider right away. Most women have no periods while taking POPs. If you are sexually active and have no periods, talk to your provider, they may recommend taking a pregnancy test every 2 to 3 months, just to be sure you are not pregnant.

Types of progestin-only pills: There are many brands of Progestin-only Pills (POP) but they are all the same dose and contain the same active ingredient – norethindrone, 0.35 milligrams (mg)  daily.

Some Brand Names:

  • Camila®
  • Errin®
  • Heather®
  • Jolivette®
  • Nor-Q.D.®
  • Norethindrone®