Progestogen-only pill (mini pill)

The progestogen-only pill is a daily pill you swallow at the same time each day to prevent pregnancy. It’s also called the mini pill.

If taken correctly, it can be more than 99% effective. This means that fewer than 1 in 100 people who use the progestogen-only pill as contraception will get pregnant in one year.

In real life use about 8 in 100 people will get pregnant in a year because they forget to take it (92% effective).

It does not protect you against sexually transmitted infections (STIs).

Cerelle progestogen-only pill

How the progestogen-only pill works

The mini pill prevents pregnancy by releasing progestogen which:

  • prevents you from releasing an egg (ovulating)
  • makes it difficult for sperm to get to an egg
  • thins the womb lining, so there’s less chance an egg will attach to it

There are 2 different types of mini pill.

3-hour progestogen-only pill

This type of mini pill must be taken within 3 hours of the same time each day. Norgeston and Noriday are examples of this type of pill.

12-hour progestogen-only pill

This type of mini pill must be taken within 12 hours of the same time each day. Cerazette is an example of this type of pill.

Follow the instructions that come with your pill packet. Missing pills or taking the pill alongside some other medicines can reduce its effectiveness.

There are 28 or 35 pills in a pack of mini pills. You need to take 1 pill every day. There’s no break between packs of pills. When you finish one pack, you start the next one the next day.

When it starts to work

You can start the mini pill at any time during your menstrual cycle, as long as you’re not pregnant.

If you take it during the first 5 days of your period, you’ll be immediately protected against pregnancy.

If you take it on any other day of your period, you should use additional contraception such as condoms until you’ve taken the mini pill for 2 days.

After giving birth

You can usually take the mini pill between 1 to 21 days after giving birth. You’ll be immediately protected against pregnancy.

If you start the progestogen-only pill on any other day of your cycle, you’ll need to use additional contraception such as condoms for 2 days

The mini pill is safe to use if you’re breastfeeding. Small amounts of progestogen may pass into your breast milk. This is not harmful to your baby. The mini pill does not affect the way your breast milk is produced.

After a miscarriage or abortion

You can take the mini pill 5 days after having a miscarriage or abortion. You’ll be immediately protected against pregnancy.

If you take the mini pill 5 days after a miscarriage or abortion, you’ll need to use additional contraception until you’ve taken the mini pill for 2 days.

What to do if you miss a pill

If you forget to take a progestogen-only pill, what you should do depends on:

  • the type of mini pill you’re taking
  • how long ago you missed the mini pill
  • how many mini pills you have forgotten to take
  • whether you’ve had sex without using another form of contraception during the previous 7 days

3-hour progestogen-only pill

If you’re taking the 3-hour progestogen-only pill and have taken it:

  • less than 3 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
  • more than 12 hours late – take the late pill as soon as you remember (if you have missed more than 1, take only 1) and take the remaining pills as normal, even if that means taking 2 pills on the same day

Use extra contraception such as condoms for 2 days. If you had sex around the time you missed your pill, you may need emergency contraception.

12-hour progestogen-only pill

If you’re taking the 12-hour progestogen-only pill and have taken it:

  • 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
  • more than 12 hours late – take the late pill as soon as you remember (if you have missed more than 1, take only 1) and take the remaining pills as normal, even if that means taking 2 pills on the same day

Use extra contraception such as condoms for 2 days. If you had sex around the time you missed your pill, you may need emergency contraception.

Vomiting and diarrhoea

If you vomit or have diarrhoea within 2 hours (or 4 hours for the 12-hour pill) of taking the mini pill, it may not have been fully absorbed into your bloodstream. Take another pill straight away and the next pill at your usual time.

If you don’t take the replacement within 3 hours (or 12 hours for the 12-hour pill) of your normal time, use additional contraception, such as condoms, for 2 days.

If you continue to be sick, keep using another form of contraception while you’re ill and for 2 days after recovering.

Very severe diarrhoea may also mean that the pill doesn’t work properly. Keep taking your pill as normal. You should use additional contraception, such as condoms, while you have diarrhoea and for 2 days after recovering.

Who can use the mini pill?

Most women can use the mini pill, however it might not be suitable for some people. Your doctor or nurse will talk about this with you.

You should not use the mini pill if you:

  • think you might be pregnant
  • do not want your periods to change
  • take certain medicines
  • have unexplained bleeding in between periods or after sex
  • have breast cancer or have had it in the past
  • have severe liver disease

You can take the mini pill until you reach the menopause or until you’re 55.

Pregnancy

There is a very small chance that you could become pregnant while taking the mini pill. This is not common.

If this happens, there is no evidence that the pill will harm your unborn baby.

Speak to your GP practice or nurse if you:

  • think you may be pregnant
  • have sudden or unusual pain in your tummy (abdomen)

Side effects

Some people may experience side effects from using the mini pill.

Some side effects can include:

  • acne
  • a change in your bleeding pattern (your periods may become less regular or may stop, this isn’t harmful)
  • breast tenderness and breast enlargement
  • an increased or decreased sex drive
  • mood changes
  • headache and migraine
  • nausea or vomiting
  • cysts on your ovaries (these are usually harmless and disappear without treatment)

What if I’m taking other medicines?

Some medicines can stop the mini pill from working.

These include:

  • medication for HIV
  • medication for epilepsy
  • complementary remedies, such as St John’s Wort
  • some antibiotics, such as rifabutin or rifampicin

If you’re taking any of these medicines, you’ll need additional contraception. You may wish to change your form of contraception that isn’t affected by your medication.

Always tell your doctor you’re using the pill if you’re prescribed any medicine.

Risks of taking the mini pill

There are some risks of using the mini pill, but they are not common.

A very small number of women may experience some serious side effects.

These may include:

The benefits of the mini pill outweigh the possible risks. You should speak to your doctor or nurse about this before starting the mini pill.

Where can you get the mini pill?

You can get the mini pill from:

If you’re under 16

Anyone can get contraception for free in Scotland, even if you’re under 16.

Contraception services are confidential so the person won’t tell anyone else about it. You can ask them any questions you may have.

If you’re under 16, they might encourage you to tell your parents, but you do not have to.

The only time a professional might need to tell someone else is if they think you’re at risk of harm, such as abuse. The risk would need to be serious. They’d usually talk about it with you first.

Last updated:
30 December 2022