For the majority of women, the mini pill is a safe and well-tolerated drug. Because of this, in 2021, it was announced that two progestogen-only pill brands, Hana and Lovima, would be available as pharmacy medications (P) in the UK, meaning you do not need a prescription to take them. Though a pharmacist or prescriber will still have to ask you some questions to ensure that they’re suitable for you.
However, all medications have the ability to cause side effects and this is also true of mini pills. The most common side effects associated with progestogen-only pills include, but aren’t limited to, nausea, headache, low libido, tender breasts, depression and fatigue.
The mini pill isn’t always safe for everyone to take. You can’t take progestogen-only pills if you:
- have cirrhosis or liver tumours,
- have or have had breast cancer,
suffer with liver disease,
- have arterial disease or heart disease or stroke,
- have unexplained bleeding in between your periods,
take medications which affect the pills effectiveness,
- think you might be pregnant.
If you take the mini pill and you’re sick within two hours, you may not have properly absorbed it. Take another pill after you vomit to ensure contraceptive protection is not affected.
Mini pill effectiveness
Just how effective are progesterone only pills? Well – mini pills are highly effective, even when not taken perfectly. ‘Perfect use’ describes remembering to take them every day, at the right time, and never missing a single pill. If you use the mini pill perfectly, you’ll have over 99% protection from pregnancy.
With ‘typical use’, which takes into account the average use of the mini pill including missed pills and incorrect timings, it still remains around 91% effective.
If you do forget to take a pill, but you remember within your three or 12 hour window – take it as soon as you remember and then take your next pill at the regular time. This should not impact your protection.
If you forget to take a pill and it’s been longer than three or 12 hours (depending on the type of mini pill you take) – you will no longer be protected from pregnancy. Regardless of how many pills you’ve missed, take one pill as soon as you think to. Take the next pill at the usual time – this might mean taking two pills in a single day. Then resume taking your daily pills at the same time each day. Refrain from having sex, or use condoms, for 48 hours after you remember to take a pill again.
You may need to seek emergency contraception or take a pregnancy test if you had sex after your forgot to take a pill and before two days have passed since you remembered to take it.
Coming off the mini pill
You can stop taking the mini pill at any time, it’s safe to stop taking it whenever you like and your ability to become pregnant will not be affected.
However, just as starting the pill can cause a number of noticeable changes in the body – coming off the pill can do the same. Some women who stop taking the progestogen-only pill experience flare-ups with acne, and they’ll likely see their periods return to how they were before taking the mini pill.