Progestin Only Pills

How do progestin-only pills work?
The progestin only pill thickens the mucous in the cervix to block sperm. It also sometimes stops ovulation (the release of an egg). It only has progestin – it does not have estrogen like the combined hormonal pill. Progestin-only pills are 91 percent effective in actual use (9/100 users get pregnant per year) and can have higher effectiveness if you always take your pills on time. This makes them the same as the combined hormonal birth control pill, patch, and ring.

How do I take the progestin-only pill?
With the progestin-only pill, it is very important to take it very close to the same time every day. If you miss a pill by 3 hours or more it is considered a missed pill. Pick a time of day that is easy to remember. Keep the pills by your toothbrush, in your makeup bag, put a reminder on your phone or use an app to send text reminders.

It is also important to take a pill every day with no breaks. Start by taking the first pill in the pack and take one a day until the pack is finished. Then start your next pack the next day.

When can I start my pills?

  • After an aspiration abortion you can start the pill the same day or the day after. If you do, it will protect you right away.
  • With a medication (medical) abortion, you can start the pill the day after using the misoprostol. If you do, it will protect you from pregnancy right away.
  • If you start the pill on the first day of your period, it will also start working right away to protect you.
  • If it is not the first day of your period or right after an abortion, then back up with condoms or don’t have intercourse until 48 hours after your first pill. After that you can rely on it for protection.

What should I do if I miss a pill?
Take the pill as soon as you remember and then go back to your regular schedule. If your pill was 3 or more hours late, back up with condoms or do not have sex for 48 hours after you take the late pill (in which time you should have taken that missed pill and two more). If you’ve had unprotected sex in the last week, you can use emergency contraception methods such as Plan B, Ella, or the copper IUD to reduce the chance of pregnancy. See our website at www.ewhc.ca for more information.

If you throw up or have severe diarrhea within 4 hours of taking a pill, take another pill as soon as possible and then go back to your regular schedule. Back up with condoms or do not have sex until 48 hours after the vomiting or diarrhea has stopped. If you have had unprotected sex in the five days before the vomiting occurred, consider using emergency contraception such as Plan B, Ella or the copper IUD. 

Where can I get progestin-only pills?
You need a prescription from a health care provider in order to get progestin-only pills. You can get one from your family doctor or from a youth, sexual health, walk-in or abortion clinic. Once you have a prescription, you can buy the pills from a pharmacy. The progestin-only pills currently available in Canada are Micronor and Movisse. They are sometimes free at youth clinics or sold for less at clinics and they may be covered by extended health plans.

How will progestin-only pills effect my periods?
The most common side effect of progestin-only pills is irregular bleeding and changes to periods. Unpredictable bleeding is most common in the first few months of use. Your period may become irregular and may stop altogether over time. This is safe and normal – not something to worry about. Many people who continue to have periods find that they become lighter and less crampy.

If you have irregular bleeding, keep taking your pills. If the bleeding lasts for more than 8 days or is very heavy, it is recommended to see your health care provider. It is also recommended to get a pregnancy test if a) your period is late and you have not taken all your pills on time and had sex without a condoms or other back up method or b) you have not had a period for 2 months in a row.

What side effects can the progestin-only pill have?
Many people have no side effects at all. Some report headaches, nausea, weight gain or loss, breast tenderness, depression, fatigue, decreased libido (sex drive), acne, or increase in body hair growth.

What are benefits of the progestin-only pill?
It only contains progestin, so it is safe to use for those who cannot use estrogen. For some, the possibility of having fewer, lighter or no periods is a strong benefit.  Progestin-only pills can also help lessen cramps with periods, and can endometriosis and migraines.

Who should not use the progestin-only pill?
There are very few people who cannot use the progestin-only pill. You should not use it if you have current breast cancer, and should talk to your doctor about whether it is the best choice for you if you have a history of breast cancer, serious liver problems or if you are on certain anti-seizure medications.

Frequently Asked Questions

Why are progestin-only pills uncommon in Canada?
Because the progestin-only pill has to be more carefully taken at around the same time each day, they are not prescribed as widely as combined hormonal birth control pills, which are a bit more flexible. However, progestin-only pills are considered as effective in actual use as other birth control pills.

Will the progestin-only pill make me gain weight?
Most people do not gain weight on progestin only pills.

Will the progestin-only pill make it harder for me to have a baby in the future?
No. When you stop taking the progestin-only pill your fertility returns very quickly.

Does the progestin-only pill cause blood clots, heart attack or stroke?
No. Because they do not have estrogen, progestin-only pills are not associated with increased risk of these.

Does the progestin-only pill protect me against sexually transmitted infections (STIs)?
No. Using condoms with pills will provide you with protection against STIs as well as increased protection against pregnancy. It is also recommended to get tested regularly for STIs, which you can do at our clinic.

Questions? Contact the Sex Sense Line at 604-731-7308 (1-800-739-7367) or www.sexsense.org

To contact our clinic call 604-322-6692 from 9:30 am to 4:00 pm from Monday to Friday. Donate Now Through CanadaHelps.org!\