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| |    The Mini-Pill: Progestin-Only Oral Contraceptives by Marjorie Greenfield, M.D. reviewed by Marjorie Greenfield, M.D. Progestin-only birth control pills (also called the Mini-Pill) are available in the United States and include Nor QD, Micronor, and Ovrette. The main benefit of these pills over combination oral contraceptives is that they do not contain estrogen, so women who cannot take estrogens because of medical risks or side effects can often take the Mini-Pill. The Mini-Pill is slightly less effective than regular pills and much less forgiving if you are late in taking a pill. How the Mini-Pill works Progestin is the class of female hormones that includes the natural hormone progesterone. Unlike combination pills, the Mini-Pill doesn't completely prevent ovulation. Rather, the progestin in the pills thickens the cervical mucus to help prevent sperm from getting through. The fallopian tubes also don't function properly under the influence of progestins, and the uterine lining cannot support implantation. Every pill in the pack contains the same dose of progestin--there are no placebos--so unlike with combination pill use, the menstrual period occurs whenever the woman would typically menstruate, which may or may not be during the last week of the pack. Since the Mini-Pill does not offer perfect protection from pregnancy, you should keep track of your menstrual periods and run a pregnancy test if you are more than a week late. How to take the Mini-Pill Your practitioner will give you instructions on how to start the Mini-Pill. Usually the first pack of Mini-Pills is started on the first day of your period. A backup barrier method of birth control is recommended for the first month, and any time that you are late taking a pill. Once started, a pill must be taken every day; you don't have the leeway with the Mini-Pill that you do with regular oral contraceptives. To be effective, each pill must be taken within three hours of when it was due. If you are more than three hours late, you need to use a backup barrier method of birth control for 48 hours. If the Mini-Pill is your choice of birth control, it's wise to always have a barrier method on hand to provide that added protection when necessary. Many couples who use the Mini-Pill also use condoms protect against sexually transmitted infection as well as pregnancy. Because the Mini-Pill pack does not contain placebos, it's crucial that women who are used to standard combination pills remember that the last week of pills in the Mini-Pill pack is just as important as the other three weeks. Do not skip the last week of pills! Effectiveness of the Mini-Pill While standard combination oral contraceptives are 99.9 percent effective when used perfectly, the Mini-Pill is more like 98 percent effective, meaning two women out of a hundred will get pregnant in a year of perfect use. Irregular usage dramatically decreases this effectiveness--even being late by as little as 12 hours on the Mini-Pill can allow the sperm to do their job! Advantages:
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