Contraception - the progestogen only (mini) pill

About oral contraception

There are 2 types of oral contraception available in Australia – the combined pill, known as ‘the pill’, and the progestogen only pill, sometimes known as the mini pill.

The combined pill contains the hormones oestrogen and progestogen. The progestogen only pill contains only progestogen.

Both are taken daily, and are available on prescription. They are very effective forms of contraception if used correctly.

About the progestogen only pill

The progestogen only pill contains the hormone progestogen. Progestogen is similar to a hormone produced by the ovaries.

There are 2 types of progestogen only pills in Australia:

• Traditional pills (sometimes known as the mini pill) are very low dose and to remain effective must not be taken more than 3 hours late.
• The drospirenone only pill is a low dose pill and was released in Australia in 2021. It remains effective even if a pill is up to 24 hours late.

Effectiveness of the progestogen only pill

Taken correctly, the progestogen only pills are at least 99% effective at preventing pregnancy. Allowing for mistakes, they are 93% effective.

What stops the progestogen only pill from working

The progestogen only pill might not work if:

• you miss a pill
• you vomit within 3 hours of taking it
• you have very severe diarrhoea
• you are taking some medications or natural remedies (check with your doctor, nurse or pharmacist).

How to use the progestogen only pill

You take it by swallowing one pill around the same time every day. The pack contains 28 pills.

The traditional progestogen only pill has no sugar pills. The new drospirenone only pill has 4 sugar pills.

How the progestogen only pill works

Both progestogen only pills works by thickening the fluid around the cervix (opening to the uterus or womb). This helps to prevent the sperm from entering.

The drospirenone progestogen only pill also stops the ovaries from releasing an egg. This can sometimes also happen with traditional progestogen only pills also.

When you are starting the progestogen only pill for the first time, or after a break, it can take up to 7 days to start working.

Ask your doctor, nurse or pharmacist about the best way to get started.

Where to get the progestogen only pill

Your doctor can provide a script which you can take to the pharmacy.

The traditional progestogen only pills will be cheaper if you have a health care card. The drospirenone progestogen only pill is by private script only and there is no discount for health care card holders.

Benefits of the progestogen only pill

The progestogen only pill:

• starts working quickly
• has a low dose of hormone
• is another choice if you have difficulty taking or are unable to take the hormone oestrogen. ‘The pill’ (combined pill) and vaginal ring contain oestrogen and progestogen. The progestogen only pill only contains progestogen
• can be used while breastfeeding.

Once you stop using the progestogen only pill your fertility quickly returns to normal.

Side effects of the progestogen only pill

Possible side effects for a small number of users can include:

• irregular vaginal bleeding
• headaches
• sore or tender breasts
• changes to your skin
• mood changes.

These side effects often settle with time. The progestogen only pill has not been shown to cause weight gain.

Progestogen only pill and serious health problems

There are no known serious health risks from taking the progestogen only pill.

When the progestogen only pill is not a good option

The progestogen only pill might not be a good option for you if you:

• find taking a tablet at the same time each day difficult
• have been treated for breast cancer
• have severe liver disease
• are taking certain types of medication which might stop the progestogen only pill from working (check with your doctor, nurse or pharmacist).

If you miss a progestogen only pill

If you miss a traditional progestogen only pill:

• Take the missed pill as soon as you notice (this may mean taking 2 pills on the same day), and continue to take your pills as normal.
• Use condoms for the next 3 days.
• If you have had unprotected sex since you missed your pill, you may need emergency contraception.

If you miss a progestogen only pill with drospirenone:

• Take the missed pill as soon as you notice (this may mean taking 2 pills on the same day).
• Continue to take your pills as normal.
• Use condoms for the next 7 days.
• If you have had penis in vagina sex without a condom in the 7 days before missing a pill, you may need emergency contraception or you may need to skip your next sugar pills and start a new pill pack in the hormone section. This depends on where you are up to in the pill packet (check with your doctor, nurse or pharmacist).

If you get pregnant while taking the progestogen only pill

The pill won’t harm the pregnancy. It is safe to continue the pregnancy (and stop the progestogen only pill) or to have an abortion.

Progestogen only pill after having a baby

You can start the progestogen only pill straight after you give birth, even if you are breastfeeding.

Progestogen only pill and pregnancy

You can stop the progestogen only pill at any time and your fertility will quickly return.

Further information about the progestogen only pill

The progestogen only pill:

• does not protect you from sexually transmissible infections (STIs). The best way to reduce the risk of STIs is to use barrier protection such as external and internal condoms with all new sexual partners
• can be obtained in small quantities from your pharmacist. If you run out of pills and cannot see a doctor for a new script, speak to a pharmacist. They can often give you a small supply of pills without a script. If possible show them your old pill packet.

Where to get help

• 1800 My Options Tel. 1800 696 784 – for information about contraception, pregnancy options and sexual health in Victoria
• Your GP (doctor)
• Pharmacist
• Community Pharmacist Program – receive some treatments at a local pharmacy without needing to see a doctor for a prescription in Victoria
• Many community health services and some public hospitals will have a family planning clinic, a sexual health clinic or women’s health clinic providing contraception
• Private clinics offering abortion also offer contraceptive services
• Sexual Health Victoria (SHV) – book an appointment online or call Melbourne CBD Clinic: (03) 9660 4700, Box Hill Clinic: (03) 9257 0100 or (free call): 1800 013 952. These services are youth friendly