Combined pill vs the mini pill

What you need to know about the different types of pills.


The contraceptive pill is a popular method for women to avoid pregnancy. If used correctly, the pill is 99% effective in preventing pregnancy. The pill is the most commonly used oral contraceptive and 25% of U.S. women between the ages of 15 to 44 are currently using it.

There are different types and hundreds of brands offering oral contraceptives, which can make the process of choosing the right pill confusing. You may have heard of the combined pill and the mini-pill. But what exactly are the differences?

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The combined contraceptive pill

The combination pill is the most commonly prescribed form of hormonal pill. It contains estrogen and progesterone as active ingredients. The pill works by preventing ovulation - the process of an egg being released for fertilization by the ovaries. The hormones also disrupt th lining of the womb, which prevents a fertilized egg from attaching.

Typically, the combined oral contraceptive comes in a pack of 21 active pills and 7 placebo pills. The placebos are included so patients don’t forget to pills or get off schedule. Oral contraceptives should be taken consecutively around the same time each day. You can avoid forgetting to take a pill by establishing a routine. For example, take the pill with your breakfast every morning or after brushing your teeth.

Most combined contraceptive pills are taken on the first day of your period and are effective immediately. But it’s important to check the packaging content as effectiveness may vary depending on brand and ingredients.


The progesterone-only pill (mini-pill)

As the name suggests, the progesterone-only pill does not contain estrogen. It prevents pregnancy in a similar manner to a combined oral contraceptive: by thickening the cervical mucus and preventing sperm from reaching the uterus.

The mini-pill is usually taken on the first day of your period and consecutively according to the package instructions. Many mini-pills are taken for the full month without a 7-day break. It is just as effective (99%) as the combined contraceptive if taken correctly.

The progesterone-only pill is prescribed to women who are sensitive to estrogen or cannot take estrogen because of prior medical conditions. Women who breastfeed, have migraines with aura, smokers and women over the age of 35, may also be recommended the mini-pill as opposed to the combined oral contraceptive.


Other reasons to take the contraceptive pill

Some patients take the contraceptive pill as a treatment to ease symptoms of endometriosis. Both the combined pill and mini-pill have been shown to be effective in reducing pain in sufferers of endometriosis. The mini-pill however, may provide better long-term relief even after it is discontinued.

You can also take hormonal pills to lessen cramps experienced during menstruation or to shorten your periods. The combination pill has been associated with a reduction of ovarian and endometrial cancer. Speak to your doctor if you’re concerned or would like to find out more about avialable contraceptive pills.



  1. Cooper DB, Adigun R, Mahdy H. Oral Contraceptive Pills. [Updated 2019 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from:
  2. Carey, M., & Allen, R. (2012). Non-contraceptive uses and benefits of combined oral contraception. The Obstetrician & Gynaecologist, 14/4: 223-228.
  3. Weisberg, E., & Fraser, I. S. (2015). Contraception and endometriosis: challenges, efficacy, and therapeutic importance. Open access journal of contraception, 6, 105–115.

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