Progesterone Only Pill

[55]

Hi I'm wondering if you could please help out with some questions about the mini pill (Cerelle), which I was recently prescribed (I've never been on the pill before) by my GP.
I am unable to go on the combined pill due to migraines. However I am slightly concerned about the progesterone only pill because I already have acne. I know this type of pill can make acne worse so I'm just wondering if this is a definite thing or just possible? Also I'm concerned about the weight gain. How does the pill make somebody gain weight? Is it water retention or does it increase your appetite? Thirdly, is it less effective than the combined pill (is pregnancy more likely with progesterone only than combined if I take it at the same time every day)?
I'd really appreciate some advice. Thank you!

[Sam W]

Hi Holly,

In terms of effectiveness, the minipill and the combination pill are at about the same level (around 90/91% effective with typical use).

When thinking about side effects, the thing the keep in mind is that even if a side effect is common, it's not necessarily a guaranteed thing you'll experience. All you can do is wait and see how your body responds to the pill. When weight gain does occur on the minipill, it's due more to things like water retention than the pill causing a change in your eating habits.

[55]

Hi Holly,

In terms of effectiveness, the minipill and the combination pill are at about the same level (around 90/91% effective with typical use).

When thinking about side effects, the thing the keep in mind is that even if a side effect is common, it's not necessarily a guaranteed thing you'll experience. All you can do is wait and see how your body responds to the pill. When weight gain does occur on the minipill, it's due more to things like water retention than the pill causing a change in your eating habits.

Hi Sam.

Thank you for clearing this up. I have read that the progesterone only pill doesn’t always actually stop ovulation. This sounds a bit worrying to me. Does that mean, unlike the combined pill, it’s a bit of a gamble as to whether or not it will stop me releasing an egg? Am I therefore more likely to fall pregnant on it?

Moreover, if I do get bad side effects and I stop the pill. How quickly will my body return to normal?

Thank you!

[Sam W]

You're welcome!

So, minipills work two ways. The main way is by thickening cervical mucus so sperm can't reach the uterus. They also sometimes suppress ovulation. This is different from the combination pill, which does those two things plus making the uterine lining less hospitable to a fertilized egg (this is why, although the typical use rates for each method are close, the combination pill is slightly more effective). You can read more about how the minipill works here: https://www.scarleteen.com/birth_contro ... _minipills. Too, if you have concerns about the minipill's effectiveness, a simple option is to back up with condoms is you are sexually active.

With side effects, it depends on what they are and the quirks of your body, but in most cases it's somewhere around a week or two or a month.

[55]

You're welcome!

So, minipills work two ways. The main way is by thickening cervical mucus so sperm can't reach the uterus. They also sometimes suppress ovulation. This is different from the combination pill, which does those two things plus making the uterine lining less hospitable to a fertilized egg (this is why, although the typical use rates for each method are close, the combination pill is slightly more effective). You can read more about how the minipill works here: https://www.scarleteen.com/birth_contro ... _minipills. Too, if you have concerns about the minipill's effectiveness, a simple option is to back up with condoms is you are sexually active.

With side effects, it depends on what they are and the quirks of your body, but in most cases it's somewhere around a week or two or a month.

Thank you for clearing this up! I really wanted to go on the combined pill so I’m pretty gutted I can’t at the moment due to other health issues (migraine related).

I can now understand how the mini pill works differently to the combined pill. However, it sounds from your description like the combined pill is three times more effective because it definitely stops ovulation plus it does that third extra thing to prevent pregnancy! If, compared to that, the mini pill only thickens the mucus and sometimes stops ovulation, why is it that they’re both about 99% effective? I can’t understand how they could both be pretty much the same effectiveness when the combined pill sounds like a lot more ‘armour’, to use a metaphor?!

Can I basically put my faith in the minipill when it does so much less than the combined :/

Thanks again

[Alice M]

I understand where you are coming from here -- however, it does not work quite like that. The 1% typical use difference between the minipill and the combination pill is a significant difference in efficacy. Putting your faith into the minipill would require you to always take it within that 3 hour window. The combination pill gives you a 12 hour grace period before the pill is late.

Does that make sense?

[55]

Hi,

I see the difference between the grace period, but if I took it at the same time every day without fail (give or take the 3 hours allowed) would it be as effective in efficacy as the combined pill? I’m just quite frustrated at not being allowed the combined pill and feel I now won’t be as protected as I could have been
Thanks

[Sam W]

If you're taking it within the three hour window every time, then that would help you have the typical effectiveness rate or higher . It may help to think of it this way: those effectiveness rates for birth control methods are figured over the course of a year, and a figured based on a group of people, rather than on a single person. So while the combination pill has a slightly higher average effectiveness compared to the minipill, if you're careful in taking your pill you're unlikely to become pregnant, which would mean the effectiveness rate for you was 100%.

All that aside, if you're nervous about the difference in effectiveness, backing up with condoms is the simplest way to remove any remaining pregnancy risk.