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THE MINI PILL (progestin-only
oral contraceptives)
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| What is
"the Mini Pill"? |
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Progestin-only
oral contraceptives are commonly known as
"the mini pill". They differ from combined
birth control pills in that they contain
only one hormone (progestin) instead of
two (estrogen and progestin).
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| How does
the Mini Pill work? |
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The
mini pill prevents pregnancy in several
ways. Their main action is to cause thickening
of the cervical mucus; this blocks sperm
from entering the cervix to reach and fertilize
the egg. They can also prevent ovulation,
which is the release of eggs from the ovaries
as well as cause changes in the lining of
the uterus preventing implantation of the
pregnancy.
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| How effective
is the Mini Pill? |
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Among
perfect users (women who miss no
pills and follow instructions perfectly),
only about 1 in 200 women (0.20) is expected
to become pregnant over one first year of
use. Among typical users, about 5
to 7 in 100 women will become pregnant over
one year of use. The mini pill is generally
less effective than the combined pill.
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| Am I a
good candidate for the Mini Pill? |
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Women who are unable to
take estrogen containing birth control pills
or are not interested in injectable progestin-only
birth control (Depo-Provera) may be good
candidates for the mini pill. This includes
if you are over 35 who smoke, if you have
a history of high blood pressure, if you
are at increased risk forming blood clots,
if you experience vascular migraine headaches,
and if you are currently exclusively breastfeeding.
You must be very motivated
to take the mini pill because if you are
more than 3 hours late in taking the mini
pill you must use a backup method of birth
control (such as condoms) for the next 48
hours
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| What
are the common side effects of the Mini Pill? |
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irregular bleeding
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Mini Pill users often
have spotting or breakthrough bleeding
(bleeding in the middle of the cycle)
and irregular cycles (shorter or longer
times between periods). Menstrual cycle
effects usually lessen over time. |
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mood changes |
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Some women experience
mood changes on the mini pill-depression,
anxiety, or irritability. Although
depression may become worse on the mini
pill, it is more likely to improve. |
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| What are
the benefits of the Mini Pill? |
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immediately reversible
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can be used by women
who are unable to take estrogen-containing
birth control pills |
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can be safely used
by breastfeeding women |
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less side effects such
as nausea, headache, changes in blood
pressure, and depression |
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no associated weight
gain as compared to the Depo-Provera
injection |
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| When do
I start the Mini Pill? |
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You must wait for your next
period to start the mini pill. This ensures
that you are NOT pregnant when you start
the mini pill. Start the mini pill on the
first day of your next period.
The mini pill may also be
started after pregnancy. You may start
the mini pill on the same day as a termination
of pregnancy. You may also start the mini
pill after a fullterm delivery. The mini
pill is safe for breastfeeding mothers and
can be started six weeks after giving birth.
Women who are not breastfeeding can begin
the mini pill 3 weeks after delivery.
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| How do
I take the Mini Pill? |
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You must take one mini pill
every day. Unlike the combined pill, each
mini pill has the same hormone content and
there is NOT a hormone free week (week of
reminder pills); you must take one mini
pill every day. Do NOT skip the last week
of pills. It is even more important to
take the mini pill at the same time every
day as varying the time even by a few hours
greatly increases the risk of getting pregnant.
The mini pill works by causing the cervical
mucus to thicken and create the most effective
barrier against sperm and it takes about
four hours for this effect to be optimum.
Therefore, the best time to take the mini
pill is four hours before the most likely
time of intercourse. Given that bedtime
is the most frequent time of sexual intercourse,
taking the mini pill several hours earlier
may provide the greatest protection against
pregnancy.
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| What
If I miss a Mini Pill? |
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If you miss a mini pill:
Missed 1 mini pill.
Take the missed mini pill NOW and the next
mini pill at the usual time (this may entail
taking 2 pills now). If the forgotten pill
is more than 3 hours late, use a backup
method of birth control (such as condoms)
for at least 48 hours. You may have some
breakthrough bleeding or spotting for the
remainder of the pill pack.
Missed 2 or more mini
pills. Take 2 pills NOW and 2 pills
a day. There is an increased chance that
you could become pregnant. Start using
a backup method of contraception immediately.
If you have unprotected sex after forgetting
your mini pill, ask your doctor about emergency
contraception.
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