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Types of Birth Control Pills

Yesterday we took a look at the question “what are the different types of birth control pills?” by discussing combination birth control pills. Today in Part Two of our article we will progestin only pills or “mini pills.” Continue reading for more information on the differences between these contraceptive options.

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Oral contraceptives are both popular and effective. If you are considering starting to take birth control pills or changing your contraceptive method, read on for further information. Yesterday’s article discussed how birth control pills work and specifically focused on combination pills and their effects. Today we’ll be discussing progestin-only pills, commonly referred to as “mini pills.”

What are Progestin-Only Pills?

The second of the two types of birth control pills, Progestin-only pills, are sometimes referred to as “mini-pills.” These contain no estrogen. The dose of progestin in these pills is less than the amount in a combination pill. Like the combination pill, the progestin-only pill (POP), or minipill, works by thickening cervical mucus to impede the motility of the sperm and to thin the endometrium (the uterine lining), to keep a fertilized egg from implanting. It is more inconsistent than the combination pill in inhibiting ovulation. The minipill may be slightly less effective than the combination pill. With typical use of the minipill, 13 of 100 may experience unintended pregnancy in a year of use.

Minipills come in 28-day packs only, and are to be taken at the same time each day. Depending on the woman, a menstrual period may occur in the last week of the cycle, there may be spotting throughout the month, or there may not be a period at all. A new pack and a new cycle begins at the end of 28 days. If pill is taken over three hours later than usual on any day, backup contraception should be used for at least two days. Check with a doctor for situations where a changing work schedule or other factors may make it difficult to take the pill at the same time every day.

Some women have concerns about possible side effects from birth control pills containing estrogen. For these, the minipill may be preferable. The minipill may be recommended for women who suffer from migraines, have a history or higher than normal risk of blood clots in the legs or the lungs, or high risk of heart disease. Additionally, it can be used by women who are breast-feeding. As with the combination pill, the progestin-only pill is not recommended for women who have unexplained uterine bleeding, history or risk of breast cancer or liver disease, or who are taking anti-seizure or anti-tuberculous medications.

Like the combination pill, the progestin-only pill is easily reversible; it can be discontinued at any time. Ovulation will begin again about two weeks after stopping the pill for most women. It’s possible to become pregnant in the first cycle after ending use of a birth control pill, before even experiencing one period. For some women, however, it may be a couple of months until their regular ovulation cycle returns.

In addition to consulting with a doctor about which pill would be the best option for you, be sure to get direction as to when in your cycle you should begin to take the pill, and whether or when back up contraception is advisable.

Important notes for use of birth control pills:

  • Do not stop taking the pill, even if you feel nauseous. This can increase the risk of becoming pregnant.To lessen the incidence of nausea, a possible side effect when taking birth control pills, take them in the evening after dinner or at bedtime.
  • Side effects such as nausea, vomiting, or bleeding between periods should end after the first 2 to 3 months. If they continue past three months, talk with a doctor about changing pill brands or levels of hormones in the pill.
  • Neither of the types of birth control pills provides protection against sexually transmitted infections including HIV. If this is a concern, use a condom or abstain from sex.
  • Due to the risk of cardiovascular disease, a woman who is a smoker past the age of 35 should not take birth control pills.

What about the morning-after pill?

The morning-after pill is not a type of birth control pill. It is an emergency contraceptive designed to keep a woman from becoming pregnant after a single incident of unprotected sex or the failure of another form of birth control. Do not confuse it with a regular birth control pill or use it in place of routine methods of contraception. Even when used correctly, the morning-after pill may not be successful in preventing pregnancy.

We hope these articles have helped address your questions regarding the differences in birth control pills. If you have been taking birth control pills or are considering an oral contraceptive for the first time and think you might be pregnant, contact us today. For a free medical-grade pregnancy test or for assistance in navigating a suspected or confirmed unplanned pregnancy, Avenue Women’s Center is here for you. Please reach out to us by call, text, email or chat. It will be our honor to serve you.


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Reviewed by Patricia Kuenzi, APN-CNP, MSN, ANP, PNP.

The information provided here is general in nature.  It is not a substitute for a consultation with a medical professional. Before any medical procedure, it is imperative that you discuss your personal medical history, risks, and concerns with your doctor. If you have questions during or after a procedure, your doctor should be immediately contacted. Avenue Women’s Center is not an emergency center.  If you are experiencing severe symptoms, such as bleeding and/or pain, seek immediate medical attention.  Contact your physician, go to an emergency room, or call 911.