What Is the Minipill?

Medically Reviewed by Brunilda Nazario, MD on May 17, 2024
Written by WebMD Editorial Contributors
4 min read

The minipill is a type of birth control pill made with progestin. That's a man-made version of the hormone progesterone, which your body already makes. It's also known as the progestin-only pill (POP). Your doctor can write a prescription, or you can get it over the counter.

Minipills contain either the progestin norethindrone or the progestin drospirenone.

 

Both are types of low-dose birth control pills. But minipills have only one type of hormone, progestin. Combination pills contain a second female hormone called estrogen. 

Combination birth control pills prevent pregnancy by stopping ovulation. That's when your ovaries release an egg. They also slow the speed at which an egg travels through your fallopian tubes, which makes it harder for sperm to reach it. Combination birth control pills do this by thickening the mucus inside your cervix and thinning the lining of your uterus. 

There are many options to choose from, depending on how often you want to have a period and the amount of hormones best for you. Packs include 21 active pills and seven inactive pills, or 24 active pills and four inactive pills.

Minipills also thicken the mucus in your cervix and thin the lining of your uterus. But unlike combination pills, minipills only stop ovulation sometimes. There aren't as many choices for minipills. In each pack, all minipills contain the same amount of progestin, so you must take one every day.

It's a good idea to weigh the pros and cons of the minipill and other forms of birth control with your doctor.

When you talk about the dose of birth control pills, you're talking about the amount of hormones they contain. Most combination pills and all minipills are low-dose.

With combination pills, the more estrogen they have, the more side effects they may cause. These can include: 

  • Breast tenderness 
  • Nausea 
  • Headaches
  • Fatal blood clots (rare) 

Birth control pills had 150 micrograms of estrogen when they first became available in the 1960s. Most combination pills today have 10-35 micrograms. Ultra low-dose combination birth control pills have 20 micrograms or less. Minipills have no estrogen.

Your doctor may recommend the minipill if you:

Breastfeed. Because of the estrogen in combination birth control pills, you may not make as much breast milk. 

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 trigger stomach pain or bad headaches in some people.

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

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

  • Breast cancer (or had it before)
  • Liver disease
  • Had weight loss surgery
  • 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

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 additional birth control like 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 begins. Backup contraception is recommended for those who start the minipill more than 5 days after their period begins. 

 

 

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

You might also have:

  • Tender breasts
  • Cysts on the ovaries
  • Bleeding between periods
  • Skipped periods
  • Mood swings
  • Dizziness
  • Thinning hair

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