Progesterone-only pill (mini pill): A guide

The mini pill is a daily hormonal contraceptive pill that is mainly used to prevent pregnancy. It contains a synthetic version of the hormone progesterone. The mini pill does not contain oestrogen, making it a better option for some people. It can also be used to help treat heavy, painful periods and endometriosis.

The mini pill is called many names, but they all mean the same thing – a contraceptive pill containing a synthetic version of progesterone.

Other names for the mini pill include:

• progesterone-only pill
• progestogen-only pill
• progestin-only pill
• POP (an abbreviation for progesterone-only pill)

The progesterone-only pill works to prevent pregnancy by:

• thickening cervical mucus to make it more difficult for the sperm to reach the egg
• thinning the womb lining to make it more difficult for a fertilised egg to securely attach

Depending on which pill you are taking, the progesterone-only pill can also stop ovulation by preventing the egg from being released from the ovary. This can happen in:

• up to 60% of people who take levonorgestrel
• up to 97% of people taking desogestrel

There are a few different types of mini pills that can be characterised by the hormone they contain and their window of effectiveness, which is the period of time in which you need to take the pill each day to still be effective.

Types of mini pill include:

• desogestrel – such as Cerazette, Cerelle, Hana, Zelleta, or Desomono, these have an effectiveness window of 12 hours
• levonorgestrel – such as Norgeston, these have a smaller 3-hour effectiveness window
• drospirenone – such as Slynd, which has a 24-hour effectiveness window
• norethisterone – such as Noriday, which has a 3-hour window of effectiveness

The mini pill should be taken at the same time every day. It’s taken by swallowing 1 pill whole with water. Most mini pills have a 3-hour or 12-hour window that you need to take them in for them to be most effective. So, it’s important that you pick a time that is best for you.

Progesterone-only pills come in a pack of 28 pills. When you have finished a pack, you should start a new pack the next day with no break in between.

When can I start taking the mini pill?

Generally, you can start taking the pill at any time, but it’s best to start on days 1 to 5 of your menstrual cycle, as you will be protected against pregnancy straight away. If you start after day 5, you will need to use another contraceptive method, such as condoms, for 2 days. If you have irregular cycles, you should also use condoms for 2 days.

The only exception to this is drospirenone mini pills: you must start it on day 1 of your menstrual cycle for it to be effective straight away. Otherwise, you should use condoms or another barrier contraception for the first 7 days if you have sex. If you have irregular cycles, you should also use another contraceptive for 7 days.

After giving birth

You can start the progesterone-only pill whenever you want after giving birth. However, if you start it within the first 20 days, you’ll be protected from pregnancy straight away.

If you start it on day 21 or after, you’ll need to use additional protection for 2 days, or 7 days if you’re using a drospirenone pill.

After an abortion or miscarriage

You can start taking the progesterone-only pill straight away. It’s best to take it on days 1 to 5 after the abortion or miscarriage, as you will be protected against pregnancy straight away. If you start after day 5, you will need to use another contraceptive method, such as condoms, for 2 days.

The exception to this is drospirenone mini pills. You must start it on day 1 after an abortion or miscarriage for it to be effective straight away. If you start it after day 1, use barrier contraception for 7 days.

What happens if I miss a progesterone-only pill?

If you miss a progesterone-only pill, you should take it as soon as you remember, even if it means taking 2 pills on the same day. The type of pill you are taking and how long it has been will affect how protected you will be.

3-hour window mini pills

If you are taking a pill with a 3-hour window, and you take it more than 3 hours late, you may not be protected against pregnancy and should use extra protection, such as condoms, for 2 days.

If you take it within 3 hours, it will still be effective, and you do not need to use additional contraception.

12-hour window mini pills

If you are taking a pill with a 12-hour window, and it has been less than 12 hours since you should have taken the pill, you should take the missed pill as soon as you remember.

If it has been more than 12 hours, you should take the missed pill as soon as you remember. If you have missed more than 1 pill, you should only take 1 pill and then continue to take your next pills as normal.

You should use condoms for 2 days to make sure you are protected.

24-hour window mini pills

For drospirenone mini pills, which have a 24-hour window, you should take it within 24 hours for it to remain effective.

If it’s been longer than 24 hours, you should take the missed pill as soon as you remember. If you have missed more than 1 pill, you should only take 1 pill and then continue to take your next pills as normal.

You should use condoms for 7 days to make sure you are protected.

How to stop taking the mini pill

You can stop taking the mini pill whenever you want. As soon as you stop taking it, there’s a chance of pregnancy, so if you still want to be protected, you’ll need to use another form of contraception. You can find out more about changing contraceptive pill in our guide.

After stopping the mini pill, any benefits and side effects will also stop. If you are still getting side effects after stopping, speak to your doctor. Your chances of pregnancy typically return to normal around 1 month after you stop.

The mini pill may cause some side effects, but not everyone will experience them. Some side effects of the progesterone-only pill include:

• changes to your period
• acne
• mood swings
• weight gain
• changes to your sex drive
• headaches
• breast tenderness
• feeling sick

Side effects are most common during the first few months of taking the pill as your body adjusts to the hormone changes and will usually wear off on their own. If they do not go away or start to get worse, you should speak to your doctor about changing to a different contraception.

There are some small risks associated with taking the mini pill, but they are not common. These include:

• ovarian cysts, small fluid-filled sacs that appear on your ovaries and are not usually dangerous and do not normally need to be removed, and often disappear without treatment
• increased risk of breast cancer, there is a possible link between breast cancer and the mini pill, but the risk is very small

You should not take the mini pill if you:

• are allergic to any of its ingredients
• have had a stroke
• have or have had breast cancer
• have severe liver disease
• take certain medications that are used to treat HIV, hepatitis C, or bacterial infections
• take some herbal remedies, such as St John’s wort

Speak with your doctor about choosing the right contraceptive pill for you if you are unsure about the mini pill.

There are many benefits of taking the progesterone-only pill, it:

✓ is an effective way to prevent pregnancy

✓ does not interfere with sex

✓ can help to regulate painful, heavy, or irregular periods

✓ can be used to treat endometriosis

✓ can be used by people with a higher body mass index (BMI)

✓ can be taken if you’re breastfeeding and straight after birth (if started in the first 20 days after birth, it’s immediately effective)

✓ does not increase the risk of developing a blood clot, compared to the combined pill

✓ is still suitable if you’re over 35 and smoke, while the combined pill is not

The mini pill may not be suitable for everyone, but it can be taken by people:

• who cannot take oestrogen
• who are over 35 and smoke
• who are breastfeeding
• over 50
• with health conditions such as high blood pressure or who have a history of blood clots

The main difference between the mini pill and the combined pill is the hormones they contain and how they’re taken:

As the combined pill contains oestrogen, it can have more benefits, such as lighter periods and improvements to acne. However, this also means it may lead to more side effects and is not suitable for people who are sensitive to oestrogen, are at risk of blood clots, or who are over 35 and smoke.

You can get the mini pill online from a trusted pharmacy, on the NHS, and sometimes over the counter.

Can I buy the mini pill online?

Yes, you can buy the mini pill online with Asda Online Doctor. To buy with us online, you will first need to complete a short online health assessment for one of our doctors to review. You will then:

1. Place your order.
2. If approved, your order will be dispatched and sent to your home address in discreet packaging, or you can choose to collect it from your local Asda Pharmacy 4 hours after a doctor’s approval.
3. If your order is not approved, one of our doctors will contact you via your account with alternative treatment options.

Our service is simple, discreet, and fully confidential. Our doctors will use the information you provide to determine if the pill you are requesting is safe and suitable for you to take. If it is, we’ll dispatch your medication in plain, unmarked packaging.

Can I buy the mini pill over the counter?

Yes, you can buy some brands of mini pill over-the-counter, such as Hana or Lovima, but most are prescription-only.

Can I get the mini pill on the NHS?

Yes, you can get a prescription for the mini pill from the NHS, but you will need to make an appointment with your doctor first.