Progestogen-only pill (mini pill)

What is the progestogen-only pill (mini pill)?

• The progestogen-only pill is a pill you take once a day to prevent pregnancy.
• It’s often called the mini pill or POP.
• When it’s taken correctly, it’s more than 99% effective.
• In everyday life, the pill may not be taken perfectly all the time. This typical use lowers its effectiveness to 93%.
• It can help improve heavy or painful periods for some people.
• It may also help improve premenstrual syndrome (PMS) symptoms.
• It’s useful if you can’t use contraception with oestrogen in it.

How does the mini pill work?

The mini pill (POP) contains the hormone progestogen.

• The 12-hour and 24-hour types of POP stop the ovaries releasing an egg each month (ovulation).
• All types thicken the mucus in the cervix (entrance to the womb) so sperm can't get to an egg to fertilise it.
• All types thin the womb lining so it’s hard for a fertilised egg to implant there.

There are 3 types of mini pill (POP):

• 3-hour POP. Must be taken within 3 hours of the same time every day. It has a progestogen called norethisterone or a progestogen called levonorgestrel. There are 28 active pills in each pack. All the pills are the same and can be taken in any order.
• 12-hour POP. Must be taken within 12 hours of the same time every day. It has a progestogen called desogestrel. There are 28 active pills in each pack. All the pills are the same and can be taken in any order.
• 24-hour POP: Must be taken within 24 hours of the same time every day. It has a progestogen called drospirenone. There are 24 active pills and 4 placebo (dummy) pills in a pack. You take the active pills first and then the placebo pills.

For more information on POP brands available from SHL, please see: SHL.UK Contraceptives Ingredients

How effective is the mini pill?

• The mini pill is over 99% effective when always taken correctly.
• Not everyone takes the pill correctly all the time. People might forget pills or take the wrong one. This is called ‘typical use’ and can mean the pill is less effective. Around 7 in 100 typical pill users will become pregnant in a year.

Taking the mini pill

The mini pill (POP) is taken every day, with no break between packs.

Try to take your pill at the same time every day. This helps you remember it and gives it the best chance of being effective.

After you finish a pack, start a new pack the next day.

Starting a 3-hour or 12-hour POP

• If you start taking a 3-hour or 12-hour POP during the first 5 days of your period, you’ll be protected from pregnancy straight away.
• If you start taking a 3-hour or 12-hour POP after the 5th day of your period, you won’t be protected from pregnancy for the first 2 days. Use condoms if you have sex during this time.

Starting a 24-hour POP

• If you start taking a 24-hour POP on the first day of your period, you’ll be protected from pregnancy straight away.

If you start taking a 24-hour POP after the first day of your period, you won’t be protected from pregnancy for the first 7 days. Use condoms if you have sex during this time.

Common mini pill brands

There are different brands of mini pill (POP). Some of the most common are:

• 3-hour POP (norethisterone or levonorgestrel): Norgeston, Noriday
• 12-hour POP (desogestrel): Cerelle
• 24-hour POP (drospirenone): Slynd

For more information on POP brands available from SHL, please see: SHL.UK Contraceptives Ingredients

Things to consider when taking the mini pill

• The mini pill (POP) doesn’t prevent you from getting sexually transmitted infections (STIs) so, you may want to use condoms too.
• If you’re sick (vomit) within 2 hours of taking a 3-hour POP or within 3 to 4 hours of taking a 12-hour or 24-hour POP, the pill might not have been absorbed properly. Take another pill of the same type. If you take the replacement pill more than 3, 12 or 24 hours after your usual pill-taking time, act as if you had missed a pill. See below: Missing a mini pill. If you continue to vomit, keep taking your pill as usual, but use condoms until you’ve had 2 days without being sick (3-hour and 12-hour POPs) or 7 days without being sick (24-hour POP).
• Severe watery diarrhoea soon after taking a mini pill may mean it hasn’t been absorbed properly. Take another pill of the same type as soon as possible. If you take the replacement pill more than 3, 12 or 24 hours after your usual pill-taking time, or if you have diarrhoea again, act as if you had missed a pill. See Missing a pill. If your severe diarrhoea continues, keep taking your pill as usual, but use condoms until you’ve had 7 days without diarrhoea.
• You’ll need a clinical consultation before being prescribed the mini pill. This is to make sure it’s medically suitable for you. This can be done at your GP surgery, at many pharmacies, at a sexual health service or through the SHL.UK online contraception service. During your consultation, give as much information as possible about your health and any medication you take.
• The mini pill might not be suitable for you if you take certain medications, including some types of weight-loss medication, the herbal medicine St John’s Wort, some medicines used to treat epilepsy, and a medicine called lamotrigine.
• The mini pill might not be suitable for you if you’ve ever had certain health conditions including breast cancer or liver disease.
• The 12-hour POP is not usually suitable if you’ve ever had a type of brain tumour called meningioma. You can use other types of POP.
• The 24-hour POP is not suitable if you use potassium sparing diuretics or some types of potassium supplement. It’s also not suitable if you have kidney disease, Addison’s disease, have high potassium levels or are at risk of high potassium levels. You can use other types of POP.
• If you develop some types of heart condition or have a stroke while you’re using the POP, you may be advised to stop using it.
• Some people get ovarian cysts while taking the mini pill. There’s not enough evidence to say if these are caused by the mini pill. Ovarian cysts are also common in people not using hormonal contraception. They’re usually harmless and will not usually need treatment.

Benefits of the mini pill

• It can improve heavy or painful periods.
• It can help with premenstrual symptoms.
• It’s safe to use if you’re breastfeeding.
• It can be a good option for people who can’t use or don’t get on well with contraception with oestrogen (combined pill, patch, vaginal ring).
• Your fertility will return to whatever is normal for you once you stop using the mini pill.

Possible side effects and risks of the mini pill

Some people experience side effects when taking the mini pill (POP).

• Your bleeding pattern is likely to change. Bleeding can vary and be unpredictable, especially if you’re using the 3-hour or 12-hour POP. It can be lighter, shorter, regular or irregular. It may be more or less frequent or infrequent or may stop altogether while you’re using the mini pill.
• If you’re using the 24-hour POP, you’re more likely to get regular bleeding during days you’re taking the placebo pills.
• You may get spotty skin (acne), mood swings, breast tenderness and headaches. These side effects usually settle within a few months as your body gets used to the mini pill.

There are some risks to be aware of:

• Current or recent users of any hormonal contraception, including the mini pill, may have a small increase in their risk of developing breast cancer. The overall risk is still very small. Everyone is advised to check their breasts or chest regularly.
• The type of progestogen in the 12-hour POP can slightly increase your risk of meningioma (a type of brain tumour). The overall risk remains small. If you’ve ever had meningioma, tell your pill provider.

Missing a mini pill

3-hour POP

If you’re less than 3 hours late taking your 3-hour pill, take it immediately. Take your next pill as usual. You’ll still be protected against pregnancy.

If you’re more than 3 hours late, take a pill as soon as you remember.
Only take 1, even if you've missed more than 1 pill.
Take your next pill at the usual time even if this means taking 2 pills on the same day. From then on, take the rest of your pills at your usual time.

Use condoms if you have sex during the 2 days (48 hours) after taking your missed pill.

If you had any unprotected sex from the time you first missed a pill(s) until 2 days after you started taking the pill properly again, you may need emergency contraception.

12-hour POP

If you’re less than 12 hours late taking your 12-hour pill, take it immediately. Take your next pill as usual. You’ll still be protected against pregnancy.

If you’re more than 12 hours late, take a pill as soon as you remember.
Only take 1, even if you've missed more than 1 pill.
Take your next pill at the usual time even if this means taking 2 pills on the same day. From then on, take the rest of your pills at your usual time.

Use condoms if you have sex during the 2 days (48 hours) after taking your missed pill.

 If you had any unprotected sex from the time you first missed a pill(s) until 2 days after you started taking the pill properly again, you may need emergency contraception.

24-hour POP

If you’re less than 24 hours late taking your 24-hour pill, take it immediately. Take your next pill as usual. You’ll still be protected against pregnancy.

If you’re more than 24 hours late, take a pill as soon as you remember.
Only take 1, even if you've missed more than 1 pill.
Take your next pill at the usual time even if this means taking 2 pills on the same day.

If you missed an active pill, use condoms if you have sex during the 7 days after taking your missed pill.

If you missed any of the last 7 active pills in your pack, finish your active pills but do not take the placebo pills. Start a new pack of pills the day after you finish the active pills.

You may need emergency contraception if:

• You had any unprotected sex from the time you first missed a pill(s) until 7 days after you started taking the pill properly again.
• You missed 1 or more of the first 7 active pills in the pack and you had unprotected sex during this week and/or during the 4 days of placebo pills before you started your latest pack.

Where can I get the progestogen-only mini pill?

Free progestogen-only mini pills online from SHL

If you’re 16 or over and your London borough is part of our contraception service you can have a consultation and order free progestogen-only pills from SHL.

1.    Register or Log in

2.    Take our online consultation

3.    If the mini pill is right for you, we’ll post it to you or you can collect it from selected pharmacies or ParcelShops

Free progestogen-only mini pills from London health services

You can get the mini pill for free from these places, even if you’re under 16:

• All London sexual health clinics
• Many London pharmacies
• Many GP surgeries (if you’re registered with them)
• Many young people’s services

Buy progestogen-only mini pills

• You can buy the mini pill from many online and high street pharmacies
• Prices vary depending on the type and brand of pill and any delivery charges
• You still need to have a consultation to check the pill is right for you

How often will I need a review?

When you first start taking the mini pill, your pill provider will check that the pill is ok for you.
You’ll need a review at least once a year to check everything is ok. Some services may ask you to have a review sooner or more often than this.
Your review may be done online, by phone or at a face-to-face appointment. This depends on what your pill provider offers.

But you can contact your GP, a sexual health clinic, a pharmacist, or your pill provider at any time if you have any questions or concerns. You don’t need to wait until your review.

Is the progestogen-only pill (mini pill) right for me?

• The mini pill could suit you if you’re happy to make contraception part of your daily routine and can remember to take your pill every day. It’s great if you can’t use oestrogen for any reason.
• An added benefit is that it may help make your periods lighter and less painful – but they can be unpredictable and may last longer for some people.
• Most mini pill users only need to have a review once a year. You can often have this online or over the phone.
• If you need STI protection or sometimes forget your pill, you’ll need to be happy using condoms too. You may sometimes need emergency contraception too. It’s helpful to have a few places you know you could get this quickly. This could include ordering the emergency pill online from SHL.
• Like any hormonal contraception the mini pill can have side effects that may be positive or negative for you. If you’re unhappy with any side effects, talk to your healthcare professional. They may be able to help or they can support you to change to a different method of contraception. Your pill provider will also talk to you about any risks associated with the progestogen-only mini pill. Some people may have conditions that mean they can’t use the mini pill.
• If the mini pill is not right for you, you might be interested in long-acting reversible contraception. This is more effective and protects against pregnancy for longer. This includes the implant (lasts 5 years), the hormonal coil (lasts 3 to 8 years) and the injection (lasts 3 months). Periods usually become lighter, shorter or less painful when using these methods. They can stop completely for some people – but bleeding patterns can sometimes be unpredictable.
• The copper coil is a non-hormonal, long-acting option that lasts for 5 or 10 years. This may not be suitable if you have heavy or painful periods as it can make periods longer, heavier or more painful for some people.
• Flexible options that you need to remember more regularly include the combined pill, the contraceptive patch or the vaginal ring (NuvaRing). These are all available by post from SHL.

This Brook tool can help you consider the best contraception for you.

Helpful links

• Progestogen-only pill - NHS
• Mini Pill | Contraception Choices
• Progestogen-Only Pill - Brook

Sources

FSRH Clinical Guideline: Progestogen-only Pills (August 2022, amended April 2026) | CoSRH

FSRH CEU Statement: Drospirenone Progestogen-only Pill (DRSP POP) (Jan 2024) | CoSRH

CoSRH Statement: Meningioma and Progestogens | CoSRH

UK Medical Eligibility Criteria for Contraceptive Use (UKMEC) | CoSRH