The Mini Pill Risk Factors
We explore the most common risk factors associated with taking contraceptive pills:
Can the mini pill causes breast cancer?
There has not been any clear link proven between using the mini pill and developing breast cancer. There may be a small increased risk but if it exists it is small and likely to reduce when the mini pill is stopped.
Can the mini pill cause ovarian cysts?
While taking the mini pill, some women develop ovarian cysts which are follicles filled with fluid. These are small and tend to disappear on their own and dont need any treatment. Very occasionally they may cause pelvic pain or discomfort.
There has not been any clear link proven between using a POP and developing breast cancer.
Does the mini pill affect heart health?
So far there has been no proven association between taking the mini pill and cardiovascular disease such as heart attacks or strokes. More studies are being done to confirm this.
Can the mini pill cause ectopic pregnancies?
The mini pill is an effective contraceptive but in the small number of women who do become pregnant while taking them there is a 10 per cent risk that the pregnancy will be ectopic. Ectopic pregnancies grow outside of the uterus and cant continue. They can be life threatening to the mother.
Summary Of Important Points About The Mini Pill
- No contraceptive option is 100% effective, though taken correctly the mini pill is extremely reliable
- Vomiting or diarrhoea when taking the pill, or a missed pill, can lead to pregnancy
- The mini pill does NOT protect against sexually transmitted infections
- If you take your mini pill more than 3 hours later than yesterdays dose, you may become pregnant
- There are no inactive sugar pills in a mini pill pack- you take an active pill EVERY day, with no breaks
- Irregular vaginal bleeding is a common side effect of the POP, but you should have it checked out by your doctor to rule out other causes
If you have further questions about contraception or the mini pill, speak to your doctor.
If You’re Less Than 3 Or Less Than 12 Hours Late Taking The Pill
If you’re taking a 3-hour progestogen-only pill and are less than 3 hours late taking it, or if you’re taking the 12-hour progestogen-only pill and are less than 12 hours late:
- take the late pill as soon as you remember, and
- take the remaining pills as normal, even if that means taking 2 pills on the same day
The pill will still work, and you’ll be protected against pregnancy you do not need to use additional contraception.
Do not worry if you’ve had sex without using another form of contraception. You do not need emergency contraception.
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How To Avoid Sexually Transmitted Infections
Condoms are the only contraceptive method which protect against sexually transmitted infections. To ensure protection from both pregnancy and infection, we recommend “dual protection”. This means using a male or female condom in addition to the contraceptive method of your choice to prevent pregnancy.
Path To Improved Health
Second, like regular birth control pills, the progestin-only pill makes your body think youre pregnant and stops your ovary from releasing an egg. This doesnt happen as often as with combination birth control pills. Forty percent of women taking the progestin-only pill will continue to ovulate.
Third, the mini-pill causes changes in your uterus that make it less likely to let a pregnancy get started, even if an egg is released.
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At A Glance: Facts About The Progestogen
- If taken correctly, it’s more than 99% effective. This means fewer than 1 in 100 who uses the progestogen-only pill as contraception will get pregnant in 1 year.
- With “typical use” of the progestogen-only pill , it’s only about 91% effective.
- You take a pill every day, with no break between packs of pills.
- The progestogen-only pill can be used if you cannot use contraception that contains oestrogen.
- You can take the progestogen-only pill if you’re over 35 and you smoke.
- You must take the progestogen-only pill at the same time each day. If you take it more than 3 hours late or 12 hours late it may not be effective.
- If you’re sick or have severe diarrhoea, the progestogen-only pill may not work.
- Some medicines may affect the progestogen-only pill’s effectiveness ask your doctor for details.
- Your periods may stop or become lighter, irregular or more frequent.
- Side effects may include spotty skin and breast tenderness these should clear up within a few months.
- You’ll need to use condoms as well as the progestogen-only pill to be protected against sexually transmitted infections .
How Do I Use The Mini
In your first appointment with a doctor or clinician, you will discuss a range of contraceptive methods to find the one that suits you. Often, you will talk about your lifestyle, preferences, needs and medical history, and the clinician will assess the risks and benefits of contraceptive methods for the individual, considering all alternatives.
When taking your first pill, choose a convenient time to take it. This can be any time of the day. Once you’ve chosen a time you must then take one progestin-only pill at this same time every day
After you finish all the pills in the pack start a new pack the next day so there are no breaks between packs.
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What Does It Mean If You Miss Periods Or Get Irregular Bleeding On The Mini Pill
- Some women dont get periods when they take the mini pill. If you have missed a period, but you have taken all your tablets correctly and have not taken any medications that interfere with your mini pill, then it is very unlikely that you are pregnant- continue to take the mini pill as usual. If you have further concerns consult your doctor or pharmacist.
- If you miss two periods in a row, you may be pregnant even if you have taken your pill correctly do a pregnancy test, and/or seek advice from your doctor.
- Irregular vaginal bleeding between periods is common in the first few months of taking the mini pill. Its usually advised to continue to take your tablets as usual. The bleeding often stops after a few months, once your body has adjusted to the
- If you have unexpected bleeding which is repeated, continuous, heavy or not settling after the first 2-3 months, you should see your doctor. If there is abdominal pain or abnormal vaginal discharge with the bleeding, you should also seek prompt medical attention.
Will The Pill Make My Periods Late
On the combined pill you bleed in the fourth week of each cycle, which is when youre taking a break from taking the pill each day. This may shorten or extend your cycle, affecting the time and length of your period.
You can start taking the pill at any time in your cycle. The time of the month you start will affect when you get your next period as well as how long until youre protected from pregnancy.
As your body adjusts to the pill your periods may take a while to become regular, and they could come late. If this doesnt go back to normal again after several months, see your doctor.
Delayed or missed periods arent always due to the Pill, or being pregnant. A lot of things can affect your periods, including:
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When Starting The Combined Pill
It is common to have irregular bleeding within the first three months of starting the combined pill. This is because the body is adjusting to the increased amount of oestrogen and progesterone. Each persons womb reacts differently to this initial fluctuation in hormone level. In some people the womb lining thickens excessively, which means there would be shedding of the lining when there are temporary dips in progesterone and oestrogen levels, such as before the next tablet is taken the next day.
Mini Pill Contraceptive Effectiveness
The effectiveness of the mini pill depends on when you start it and how consistently you take it.
If you start it within the first five days of starting your period, its immediately effective.
If you start it more than five days from the first day of your period, you should use a backup method, such as a condom, for at least the first two days, according to the Centers for Disease Control and Prevention.
Taking your mini pill at the same time each day increases its effectiveness. Overall, the risk of pregnancy is about two percent to three percent while on the mini pill.
However, taking it regularly can reduce this risk, while forgetting a pill or taking it at inconsistent times can increase this risk.
Oral contraceptives, including the mini pill, do not prevent the spread of sexually transmitted infections.
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Do Other Medicines Interfere With The Progestogen
Some medicines may interfere with the POP and make it less effective. Tell the doctor or pharmacist that you take the POP if you are prescribed or buy another medicine. Medicines which interfere with the POP include:
- Some medicines for epilepsy – for example, carbamazepine, oxcarbazepine, eslicarbazepine, phenytoin, phenobarbital, primidone and topiramate. Some of these pills are used for other problems – for example, migraine or pain.
- The antibiotics rifampicin and rifabutin.
- Some medicines used to treat HIV and AIDS – for example, nevirapine and ritonavir.
- St John’s wort. This is a treatment bought over the counter and sometimes used for depression. Your doctor may not know you are on it, so you should mention it. The POP may not work if you are taking St John’s wort.
- Ulipristal acetate. This is a medicine which comes in two forms – as ellaOne® for emergency contraception, and Esmya® for fibroids. If you take the POP after using ellaOne®, you should not take a POP for five days. This is because the POP can stop the ellaOne® from working. You will need to avoid sex or use a barrier contraceptive for seven days from the day you took ellaOne®. If you take Esmya® you should not use the POP. You should also not take it for 12 days after finishing it.
Questions To Ask Your Doctor
- How can I know which birth control pill is best for me?
- If I take progestin-only birth control pills, am I less likely to gain weight as a side effect?
- Is one birth control pill more effective than another at preventing pregnancy?
- Does one birth control pill have fewer side effects than another?
- Can I use birth control pills to skip having a period altogether?
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At What Age Should You Stop Taking Birth Control Pills
I recommend that most women stop taking birth control pills in their early 40s. Birth control pills, sometimes called combination birth control pills, contain estrogen and progestin. Estrogen increases your risk of developing blood clots, high blood pressure or other heart conditions. Other factors like your weight, pre-existing conditions, medical history and whether you smoke can also increase your risk of complications from birth control pills that contain estrogen.
If youre on the pill, consider talking to your primary care doctor or OB-GYN when you turn 40 to make sure its still a safe option for you. If combination birth control pills arent recommended, the mini pill might work best it only contains the hormone progestin, making it safer for women during perimenopause.
Whats Inside The Pill
There are two main types of contraceptive pills: combined oral contraceptives and so-called progestogen-only pills, or POPs . Both types contain synthetic analogs of female sex hormones. COCs have both synthetic estrogens and synthetic forms of progesterone , while the POPs contain progestogens alone.
Female sex hormones influence the body at different levels. Thats why, apart from preventing unintended pregnancy, birth control pills can treat hormonal imbalance or mitigate symptoms related to the menstrual cycle.
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Does The Pill Stop Your Period
Oral contraceptive pills or birth control pills or the pillis a hormonal pill that is used to prevent pregnancy. The hormones estrogen and progestin in the pill alter the hormone levels that must be maintained to conceive. OCPs are prescription tablets that are taken once a day and at the same time every day for best results. It is important to note that OCPs do not prevent the transmission of sexually transmitted diseases .
Because the pills alter your hormone levels, it is possible to temporarily stop or prevent your period with continuous use of any birth control pill. Skipping periods for some women would mean skipping debilitating cramps, bloating and moodiness that regularly arise at that time of the month. This can make a difference in the quality of life for many women and relieve the stress of anticipating these symptoms. Once the OCPs are discontinued, the menstrual cycle returns to normal. The pill wont stop the period permanently. Risks associated with the continuous use of the pill are the same as those with regular use with a slightly increased risk of blood clots and stroke. You must consult with a doctor for an appropriate regimen.
How To Control Or Stop It
If you smoke, quitting smoking can help control breakthrough bleeding.
If youre on the pill, the best way to stop breakthrough bleeding is to take your pill at the same time every day.
For most people, breakthrough bleeding stops 3 to 6 months after starting hormonal birth control. If youre still experiencing breakthrough bleeding related to birth control after that point, talk with your doctor.
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How To Take The Progestogen
There are 2 different types of progestogen-only pill:
- 3-hour progestogen-only pill must be taken within 3 hours of the same time each day
- 12-hour progestogen-only pill must be taken within 12 hours of the same time each day
Follow the instructions that come with your pill packet missing pills or taking the pill alongside other medicines can reduce its effectiveness.
There are 28 pills in a pack of progestogen-only pills. You need to take 1 pill every day within either 3 or 12 hours of the same time each day, depending on which type you’re taking.
There’s no break between packs of pills when you finish a pack, you start the next one the next day.
Why Am I Bleeding On The Mini Pill
The bleeding that women can experience on the progestogen-only pill is caused by the synthetic hormone progestogen, which mimics the progesterone our bodies naturally create. However, its hard to say why some women get frequent bleeding and others have none at all.
If you are experiencing any unexplained bleeding when you start taking the POP, you should speak to your doctor to check it out and to make sure they rule out pregnancy or STIs.
Bleeding is a relatively common side effect in women who take the POP. In fact, almost half of POP takers experience bleeding and seven in 10 women report breakthrough bleeding or spotting in more than one cycle. The good news, however, is that prolonged bleeding and frequent bleeding decrease the longer a woman is on the pill for.
Over 12 months of use:
- 5 in 10 women can expect to be amenorrhoeic or have infrequent bleeding, such as irregular periods
- 4 in 10 women will experience between three and five bleeding episodes
- 2 in 10 women will experience prolonged bleeding
- 1 in 10 women will experience more than six bleeding episodes
Bleeding usually isnt an issue, but some women just dont like it. Therefore, if its unmanageable, you could look at switching to another type of pill, or you could try one of the solutions listed below.
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Effectiveness At Preventing Pregnancy
The effectiveness of a contraceptive method can be measured for perfect use and typical use.
- Perfect use is when instructions are followed precisely. The failure rate for perfect use of the mini pill is about one per cent. So if used perfectly, about one woman in every 100 will become pregnant in a year.
- Typical use is what tends to happen in reality. Typical use failures include failures due to incorrect use. The failure rate for the mini pill is about 8-9 per cent in a year of typical use.
The mini pill tends to be less effective in younger, more fertile women than in older women.
When Can I Get Pregnant After Coming Off The Pill
Theoretically, you can get pregnant as soon as you come off the pill and from the day you stop, you are no longer protected against pregnancy. We suggest using a barrier method of contraception if youre coming off the pill and not looking to get pregnant, because everyone is completely different and your fertility should return quickly, if not straight away .
Every body is completely different, and so could react to the pill differently. You may have heard that the contraceptive pill can have lasting effects on your fertility, but there is no evidence to suggest this is true.
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Disadvantages Of The Mini Pill
One of the disadvantages of the mini pill is that the pill has to be taken once per day, at the same time. Forgetting to take the pill on a daily basis could make it fail. It is important to consider whether you would be able to take the pill at the same time each day when choosing the right contraceptive method for you.
Other disadvantages of the mini pill include:
- Some users develop more frequent or irregular bleeding while taking the mini pill.
- Some users may experience headaches, breast tenderness and acne, but these symptoms generally get better within the first few months of using the pill.
- The pill may not work if you have vomiting and diarrhoea.
- Use of some medications, such as those for seizures , HIV or for tuberculosis, can make the pill less effective. Check with your medical provider if your medications are compatible with use of the pill.
- It is possible that some users may experience weight gain as a side effect of the mini pill, although there is little causal evidence to suggest this.