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Mini pill pregnancy

Minipill Progestin-Only Birth Control: Usage and Side-Effects

Written by Paige Fowler

Medically Reviewed by Nivin Todd, MD on February 05, 2022

In this Article

  • How It Works
  • Why Take It
  • Who Should Avoid the Minipill?
  • How to Take It
  • Dangers and Side Effects

The minipill is a type of birth control pill. It’s made with progestin, a man-made form of the hormone progesterone your body makes.

Regular birth control pills have progestin and a second female hormone called estrogen. They’re known as combination birth control pills. The minipill has a lower dose of progestin. And because it doesn’t have estrogen, the minipill may have fewer side effects.

How It Works

The minipill prevents pregnancy in several ways. It thickens the mucus inside the cervix. This makes it hard for sperm to travel to the egg. It also thins the lining of the uterus. This helps keep the fertilized egg from implanting itself. Like regular birth control pills, it also helps prevent ovulation. This is when the ovary releases an egg. But the minipill doesn’t block eggs as well as combination pills. So it’s slightly less effective in preventing pregnancies.

Why Take It

You may want to go with the minipill if you:

Breastfeed. With estrogen in combination birth control pills, you may not make as much breastmilk. Your doctor may recommend the minipill if you plan to nurse your baby.

Are over 35 and smoke, have high blood pressure, or have a history of blood clots. The minipill may be safer for you to take than combination birth control pills.

Want to avoid estrogen. The hormone may interact with other medicine you take. Estrogen also can give some women stomach pain or bad headaches.

Have dermatitis. The minipill may help treat this skin condition. Dermatitis causes red, swollen, sore skin. It may be linked with your menstrual cycle.

Who Should Avoid the Minipill?

The minipill isn’t right for every woman. Your doctor may suggest you avoid it if you have:

  • Breast cancer or had it before
  • Liver disease
  • Had weight loss surgery
  • Any trouble taking the pill at the same time every day
  • Uterine bleeding and don’t know why
  • To take drugs for conditions like tuberculosis, HIV or AIDS, or seizures

How to Take It

The minipill comes in a pack of 28. Unlike combination birth control pills, there’s no row of inactive, or placebo, pills. It’s important to take the minipill every day and at the same time each day. Your body clears progestin more quickly than the hormones in combination birth control pills. If you take the minipill more than 3 hours outside of your usual time, it may not work as well to prevent pregnancy. If you miss the 3-hour window, use a condom or don't have sex for the next 2 days.

If you forget to take a pill, take one as soon as you remember. That may mean you take two pills in one day. Take them a few hours apart. Then take the next pill at your regular time.

When you first start the minipill, take it within 5 days of when your period starts. It takes time for the minipill to work. Use a condom every time you have sex in the first week after you start the minipill.

Dangers and Side Effects

If you get pregnant while taking the minipill, it can cause problems. You’re more likely to have an ectopic pregnancy. This is when a fertilized egg implants outside of the uterus, such as in a fallopian tube. You won’t be able to continue with your pregnancy, and you may need surgery to remove the fetus.

Possible side effects of the minipill include:

  • Acne
  • Nausea
  • Fatigue
  • Headaches
  • Depression
  • Lower sex drive
  • Tender breasts
  • Cysts on the ovaries
  • Weight gain or loss
  • Bleeding between periods
  • Skipped periods
  • Mood swings
  • Dizziness
  • Thinning hair

The minipill doesn’t protect you from sexually transmitted infections. Always use condoms to reduce your chance of disease.

Minipill (Progestin-Only) - How It Works, How Effective, & More

Minipill (Progestin-Only) - How It Works, How Effective, & More | Kaiser Permanente
  • 91% effective
  • Take daily
  • Prescription required
  • Contains hormones
  • No STI/STD protection
  • Lighter periods

What is it?

  • The minipill (also called the progestin-only pill) is a small tablet with the hormone progestin that you take daily to prevent pregnancy. 
  • Minipills come in a pack, and you swallow 1 pill every day.
  • The minipill has a lower dose of hormones than the birth control pill.
  • You must take minipills within the same 3 hours every day to be protected from pregnancy.
  • If used perfectly, the minipill is 99% effective in preventing pregnancy. But people aren’t perfect. So, in reality, the minipill is 91% effective.1

How it works

  • The minipill contains the hormone progestin to stop you from getting pregnant. 
  • The hormones in the minipill work by:
    • Stopping your ovaries from releasing eggs. When eggs aren’t released, you can’t get pregnant.
    • Making the mucus in your cervix too thick for sperm to pass through. This prevents sperm from meeting an egg.

How to get it

  • You can get a prescription for minipills at your medical facility. 


  • Because of the Affordable Care Act, Kaiser Permanente members can get certain types of birth control methods at low or no cost. Check with Member Services or your provider for details. 

How to use it

  • Swallow 1 minipill each day at the same time.  
  • After you finish the pack of minipills, immediately start a new pack the next day.
  • Make sure you fill your prescription for the minipill on time, so you don’t miss a day. Getting a full 12-month supply of your prescription may help you continue your birth control without running out and having a risk of unplanned pregnancy.2 So be sure to ask your pharmacist about a 12-month supply. Depending on your coverage, you may be eligible to get a 12-month supply when filling your prescription.
  • If you forget to take 1 minipill, take it as soon as you can. If you take the pill more than 3 hours late, use condoms as a backup for the next 2 days. 
  • If you forget to take 2 minipills, take 1 as soon as you can and take your next pill at the usual time. You should also use condoms for the next 2 days.


  • The minipill is 91% effective in preventing pregnancy. That’s because people don’t always use it correctly or take it on time.
  • You may have more regular, lighter, shorter, and less painful periods.
  • The minipill is temporary. You can stop using it whenever you want to try getting pregnant.
  • The minipill can be used after you have a baby and while you’re breastfeeding.


  • The minipill doesn’t protect against sexually transmitted infections (STIs/STDs), including HIV. Even if you take the minipill, you should use a condom every time you have sex to reduce your chances of getting or spreading STIs.
  • If you don’t take the minipill on schedule every day, you’re more likely to get pregnant.
  • The minipill may cause spotting.
  • Some people may experience headache or nausea. 

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