Mini-Pills (Progestin-Only)
How does it work?
Read the sections below for details about Mini-Pills (Progestin-Only), including how well it works and how to use it.
Compare this method with others, or view the full list of birth control methods using the links below.
More about Mini-Pills (Progestin-Only)
The mini pill has one type of hormone in it: progestin. Because hormones can affect the growth of breast cancer cells, we generally recommend against using the mini-pill and other hormonal birth control after a breast cancer diagnosis.
Unfortunately, there is limited high-quality research on the safety of hormones after breast cancer. Because of this uncertainty (and because hormone exposure may increase the risk of breast cancer coming back), we and most medical experts recommend avoiding birth control with hormones after breast cancer - especially for those with hormone receptor (HR) positive breast cancer.
For those who are within 5 years of a breast cancer diagnosis, hormonal birth control, including the mini-pill, should not be used. During this time, the risk of breast cancer coming back is higher, and being exposed to hormones can increase that risk.
For those who are more than 5 years out from diagnosis and in remission, hormonal birth control is still generally discouraged. While the risk of breast cancer coming back decreases over time, it does not go away completely. There is also not enough evidence to confirm that hormonal birth control is safe – even for people whose cancer was not hormone-sensitive.
In some situations, birth control that contains hormones, including the mini-pill, may be considered to treat severe bleeding or pain when options without hormones have not worked. In these cases, decisions should be made carefully and in collaboration with your oncology and primary care teams. These decisions should also be revisited over time as your health and priorities change.
With perfect use, fewer than 1 out of 100 people who use mini pills will get pregnant over a year. Perfect use means that no pills are missed.
Most people forget to take one or more mini pills each month. This is called typical use. With typical use, 7 out of 100 people will get pregnant over a year.
Note: There is a special mini pill called Slynd, which works slightly better than other mini pills. With typical use, 5 out of 100 Slynd users will get pregnant. With perfect use, 1 out of 100 Slynd users will get pregnant.
You can also use a birth control method at the time of sex. We call this a Method Boost because it prevents pregnancy better than the mini pill alone. Method Boost options include outer condom (penile), inner condom (vaginal), pull out, spermicides, the vaginal gel (Phexxi), the cervical cap, and the diaphragm.
You can also use these as a Method Backup when you forget to take one or more mini pills.
The mini pill has the progestin hormone only. Progestin makes the mucus in the cervix thicker. This makes it harder for sperm to reach the egg (fertilization). The mini pill can also stop an egg from being released (ovulation).
There are two types of mini pills.
1) The most common mini pill has norethindrone, which is a progestin hormone. These include OrthoMicronor, Nora-Be, Camila, Errin, and others. These pill packets have 28 "active" hormone pills that should be taken every day. There are no inactive (sugar) pills.
There is a NEW mini pill called the OPill®, which you can buy at a pharmacy without a prescription! Science shows that the mini-pill is very safe, which is why the U.S. Food and Drug Administration approved it to be sold over the counter.
2) The mini pill Slynd has drospirenone, which is a progestin hormone. Slynd has 21 active hormone pills and 4 inactive (sugar) pills. Slynd works better than other mini pills at preventing pregnancy. This means there is more "wiggle room" if you miss a pill or are late taking a pill.
Irregular bleeding is more common with mini pills than the regular pill. Usually, the bleeding gets lighter and happens less often. The bleeding may stop completely while taking mini pills. This is safe and for some, very wanted because they do not have to deal with bad periods.
People who cannot use estrogen can safely take mini-pills since they do not contain estrogen.
The mini pill Slynd can also improve mild acne.
You might have nausea, mild headache, or breast tenderness for the first 2-3 months. These are annoying but not serious symptoms and usually go away.
Irregular bleeding gets better for some, but not all people.
Some people worry that the mini pill will affect their weight, mood, or sex drive. Studies show that the mini pill is not linked with these side effects.
If you ever have concerns about side effects, you should tell your health care provider. Your concerns should be taken seriously.
Beyond the breast cancer concerns discussed in the section "Special considerations for breast cancer survivors and thrivers," the mini pill is very safe. In fact, pregnancy has a higher risk of health problems than the mini pill.
Mini pills do not have estrogen hormone. People who have higher risk for blood clots, stroke, or heart attack can safely take mini pills.
No. However, correct use of condoms can prevent HIV and STIs.
Mini pills need a prescription. The only exception is OPill®, which can be bought at a pharmacy or online.
Note: The Slynd mini pill is hard to find in most retail pharmacies. It may be easier to get Slynd online.
Mini pills can cost up to $50 a month. If your insurance covers the pill, you may pay $0-$20.