Combined pill vs the mini pill

The contraceptive pill is a popular method for women to avoid pregnancy. If used correctly, the pill is 99% safe 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 its main active ingredients. The pill works by preventing ovulation - the process of an egg being released for fertilization by the ovaries. The hormones also cause the womb lining to be thinner which prevents a fertilized egg from attaching.

Typically, the combined oral contraceptive comes in a pack of 21 pills and 7 placebo pills. The placebos are included so patients don’t forget to take a pill. Oral contraceptives must be taken consecutively around the same time each day. To help you avoid forgetting to take a pill, you can establish 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 active 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 or those who smoke and are over the age of 35 years 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 their symptoms of endometriosis. Both the combined pill and mini-pill have been shown to be effective in reducing pain experienced by sufferers of endometriosis. But the mini-pill may provide better long-term relief even after the contraceptive method is discontinued.

You can also take the hormonal pill to lessen cramps experienced during your 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 contraceptive pills available.

References

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: https://www.ncbi.nlm.nih.gov/books/NBK430882/
Carey, M., & Allen, R. (2012). Non-contraceptive uses and benefits of combined oral contraception. The Obstetrician & Gynaecologist, 14/4: 223-228. https://doi.org/10.1111/j.1744-4667.2012.00126.x
Weisberg, E., & Fraser, I. S. (2015). Contraception and endometriosis: challenges, efficacy, and therapeutic importance. Open access journal of contraception, 6, 105–115. https://doi.org/10.2147/OAJC.S56400