Mini pills (also called progestogen-only pills or POPs) are contraceptives with only one type of progestogen hormone. As they don’t contain oestrogen, they’re a more suitable option for those who are sensitive to oestrogen or who have an increased risk of side effects.
Just like with any other form of birth control, not all women taking a mini pill will have the same experience. While it works well for some, it may cause some side effects for others. Mini pills and weight gain have been linked, and this may play a part in how you choose your contraceptive. Some women have also reported bleeding on the mini pill. The good thing about mini pill side effects is that they are often mild and easy to manage.
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Mini pill side effects
In most cases progesterone-only pill side effects occur when you start taking a pill. They are mostly subtle and go away on their own in time as your body gets used to the change in hormone levels.
The most common progesterone mini pill side effects include headache, nausea, acne, vomiting, irregular bleeding, hair thinning, mood fluctuations, weight gain or loss, changes in libido and ovarian cysts.
If you get side effects which bother you too much or that start to affect your day-to-day activities, you should speak to your doctor.
Though serious progesterone contraception side effects are rare, it is good to know about the symptoms in case they occur.
If you notice signs like chest pain, fatigue, sudden weakness on one side of your body, vision problems in one of your eyes, seek immediate medical attention and stop using the POP pill as these may be indicating a heart attack or stroke.
You should also be cautious of symptoms such as difficulty breathing, cramping pain or coughing up blood, these can be an indication of blood clots. Symptoms of deep vein thrombosis (DVT) include pain in the calf or thigh, typically in one leg, swelling and redness of the skin. Seek advice from a doctor immediately regarding these serious progestogen side effects.
If you’ve any pre-existing conditions or are taking medication, let your doctor know during the consultation. Some medications may not be suitable to work alongside the mini pill. It’s possible to develop progestin-only pill side effects because of an interaction between two medications.
Why am I bleeding on the mini pill?
Spotting or breakthrough bleeding (between periods) is the most common mini pill side effect. It happens to women because the hormones in their body aren’t consistent and are adjusting to the new birth control method.
Menstrual disturbances like long periods or heavy bleeding on the mini pill are also possible. But you shouldn’t stop taking the pill thinking that it isn’t working for you. It can take a bit of patience for your body to fully adjust to the mini pill.
Bleeding on the mini pill may also occur if you aren’t taking the pill as you should — at the same time every day. Missing your pill or not taking it at the right time can impact the effectiveness of the mini pill. You are then at a greater risk of getting pregnant as well as of breakthrough bleeding.
If your mini pill bleeding is constant even after a couple of months of starting it, or you have no period on the mini pill and you’re concerned you could be pregnant due to a missed or late pill, speak to your doctor.
How common is spotting on the mini pill?
Spotting on the mini pill is quite common. According to a study, around 70% of users reported spotting or breakthrough bleeding on mini pill in one or more cycles.
Besides this, women also experienced disturbances in menstrual flow such as long periods, heavy bleeding and prolonged menstrual cycles. Irregular bleeding on the mini pill was the main reason for up to 25 percent of women stopping this form of contraception.
Can the mini pill cause weight gain?
Mini pill weight gain is one of the main concerns among women when they’re thinking of trying this type of contraceptive. This limits the use of mini pills by many women.
Though rare, some women report weight gain while taking mini pills. It is usually a temporary side effect which happens due to bloating or fluid retention in the body and goes away in two to three months.
Some studies have provided limited evidence to prove that use of mini pills cause changes in body weight or composition.
But if you notice that the mini pill and weight gain coincide then speak to your doctor. They might suggest an alternative contraceptive that works better for you.
Can the mini pill cause spots?
The mini pill and acne symptoms are more likely in women who are already prone to the condition. Mini pills contain progesterone which may cause fluctuations in your androgen levels, make your skin oilier and increase the risks of developing hormonal acne.
Male hormones, like androgens have been noted as a reason for acne breakouts. They increase the production of sebum (oily substance) which then blocks pores and causes blackheads, whiteheads or pimples.
So, if you’re looking for birth control which will help you with your acne and not worsen it, there are some combined oral contraceptives that may be able to help. The levels of oestrogen and progesterone hormones in them help stabilise the hormone levels and reduce androgen activity. This can prevent flare ups and clear up acne spots.
Mini pill and blood clots: what are the risks?
Blood clots are dangerous but rare with mini pills. The progesterone-only pills do not contain oestrogen — a key hormone in other combined contraceptives such as the pill, vaginal rings and contraceptive patches.
Oestrogen alone doesn’t cause blood clots by itself but it increases the clotting factors and risks that can trigger blood clotting.
We cannot be certain of the impact of progesterone on the incidence of blood clots. Further research into the area is required.
But if you have a history of blood clots or have had problems related to it, make sure you let your doctor know when you’re consulting them about contraception. This will help them prescribe you the contraception that’s safe and works best for you.
Mini pill side effects on your mood
The mini pill initiates hormonal changes in your body which can affect your mood. Women taking the mini pill sometimes experience unpleasant changes in mood like anxiety, depression, feeling low, being irritated, getting annoyed or angry easily. But this isn’t the same for everyone. You may not have any of these symptoms while others notice them frequently.
Mini pills side effects normally occur when you start taking the pill and your body is adjusting to the changes in your hormone levels. These side effects are normally mild and go away after a few weeks.
In case the changes to your mood are intolerable, speak to your doctor. They’ll be able to suggest the best alternatives.
Taking the mini pill when breastfeeding
The mini pill contains only progesterone and is a safer option for breastfeeding mothers. A small amount of the hormone present in the mini pill passes into the breast milk, but it has no harmful effects on the breastfeeding baby.
But does the mini pill affect milk supply?
Most mothers don’t have any problems with their milk production when they use progestin-only contraceptive methods after the sixth to eighth week postpartum. There may be only a few rare cases when women have faced issues while using such methods.
Progestin-only methods like the mini pill don’t reduce breast milk supply and may even increase it. You may see a drop in your milk production if you take birth control pills containing oestrogen, like combined pills, though they aren’t usually recommended during breastfeeding.
The American Academy of Paediatrics has approved only low dose hormonal contraceptives for breastfeeding women.
Though the progesterone-based pill is well tolerated by most women, it may not be the best option for you. Consult with your doctor and let them know about your complete health history before taking a mini pill. Your doctor may not encourage you to take mini pills while breastfeeding if you’ve a history of low levels of milk supply, preterm birth, multiple births (twins, triplets) or breast surgery.
What are the side effects when you stop the mini pill?
Your menstrual cycle should return to normal once you stop the mini pill. However, it can take some women a bit more time to have a period. In case your period doesn’t come after three months of stopping the mini pill, let your doctor know.
In the first week of stopping the pill, you may also have withdrawal bleeding. This usually continues for around a week. You may also experience longer and heavier periods and changes in frequency.
If you had taken the pill to help with premenstrual symptoms (PMS) like abdominal cramps, nausea or bloating, you may start having them again. But that’s not always so. Your body may react differently to the hormonal changes that occur when going off the pill.
Acne, mood swings, vaginal discharge and unwanted hair can be some other side effects of stopping the progesterone-only pill.
What should I do about mini pill side effects?
Mini pill side effects are normally mild and usually go away over time. If you’re getting side effects for too long and they are affecting your daily activities, speak to your clinician.
To get the best results out of the mini pill, take it at the same time everyday. If you’re late by more than three hours in taking your pill or have missed a pill, take your missed dose immediately and follow the steps for what to do when you miss a pill.
Though the mini pill is a safe contraceptive, some precautions will help you keep side effects at bay. Let your doctor know if you’re taking any prescription or non-prescription medications or are allergic to progestins or any other ingredients. If you’re pregnant, have tumors, jaundice, hepatitis, unexplained vaginal bleeding, breast cancer or severe cirrhosis, you shouldn’t take mini pills. Avoid smoking while you’re on the pill.
If you have a severe headache, stomach ache, late periods, no periods, long bleeding cycles or an accidental overdose, consult your doctor.
The mini pill: where to start?
The mini pill is just one of many contraceptive options available through Treated. Our experts are here to guide you through finding the best contraceptive for you. Our mini pill subscription options mean that your contraception is taken care of each month.
Norethindrone (Camila, Errin, Heather) side effects
Norethindrone is a mini pill that contains just one hormone, norethindrone. There are branded versions of it called Camila, Errin and Heather.
Norethindrone pill side effects are usually mild and may occur after you start taking Noriday. These usually disappear after a month or two of use. But if side effects concern you, let your doctor know. You may benefit from switching to an alternative pill.
Irregular periods are the most frequently reported side effect of Norethindrone. Other side effects of the Norethindrone mini pill that you might have include:
Progestin-only methods safe during lactation. (1993)
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