Conditions and Management

Several effective hormonal birth control options contain progestin but no estrogen. These progestin-only contraceptives include injections, implants, pills, and certain intrauterine devices (IUDs).

Let’s look at the unique benefits of progestin-only birth control pills, sometimes termed “mini-pills.”

What Are Progestin-Only Pills?

Progestin-only pills are oral contraceptives that contain progestin without estrogen. They come in 28-day packs. These pills are termed “mini-pills” because the amount of progestin in each active pill is lower than in combination birth control pills, which contain estrogen and progestin. The mini-pill contains only the hormone progestin at a relatively low dose.

How Do Mini-Pills Prevent Pregnancy?

Mini-pills prevent pregnancy through three key mechanisms:

• They thicken the mucus in the cervix to block and trap sperm, preventing passage through the cervix into the uterus.
• They provide inconsistent ovulation prevention – around 4 out of 10 mini-pill users will still ovulate sometimes. However, the thick cervical mucus prevents sperm from meeting and fertilizing the eggs.
• They thin the uterine lining, making implantation of an embryo extremely difficult or unlikely.

Taking the mini-pill at precisely the same time daily helps ensure the cervical mucus remains thick. Taking it more than 3 hours late, or missing pills altogether, allows the mucus to thin out. This could permit ovulation and sperm passage into the uterus to occur.

What Are the Benefits of Mini-Pills?

When taken exactly in line with the recommendations, mini-pills prevent pregnancy effectively, with less than 1% of women getting pregnant in the first year of ideal mini-pill use.

Mini-pills do not affect breastfeeding or harm infants in any way. This makes them a good birth control choice for postpartum women, allowing new mothers to prevent pregnancy without interrupting breastfeeding.

Some women experience much lighter menstrual periods or no periods when taking mini-pills. For those who normally have heavy, painful monthly bleeding, this relief can be substantial. Mini-pills may help make periods lighter, shorter, and more manageable. Some women also appreciate eliminating monthly bleeding for convenience.

Mini-pills are safe for those who cannot use contraceptives containing estrogen due to health risks. Some conditions where estrogen poses dangers include:

• History of blood clots: The estrogen in combination pills increases clotting factors in the blood, which can be hazardous for women already prone to blood clots. Progestin has a lower clot risk than estrogen.
• Migraines with aura: Estrogen can exacerbate migraine headaches. In women who have migraines with neurological aura symptoms, taking estrogen may significantly increase stroke risk.
• High blood pressure: Mini pills are considered safe for women with hypertension.
• Liver tumors: Estrogen may cause or worsen the growth of tumors in the liver. Mini-pills are a safe oral contraceptive choice for these women.

Because they lack estrogen, mini-pills do not raise clotting factors or cardiovascular disease risk for users. This makes them a safer contraceptive choice for those who cannot take estrogen for medical reasons.

You can start mini-pills right after pregnancy without delaying the return of your fertility. You can get pregnant quickly after stopping mini-pills, as progestin has no lingering effect on ovulation.

What Are the Potential Side Effects?

Unpredictable spotting or bleeding between periods is the most common side effect women report with mini-pill use. You may experience frequent spotting or irregular bleeding that is difficult to predict. This abnormal bleeding pattern could persist over time.

Other potential side effects include nausea, headaches, and breast tenderness. These are usually minor and often resolve after a few months of mini-pill use.

With mini-pill packs containing four inactive pills, you may get your withdrawal bleeding during those inactive pill days. This allows for more predictable monthly menstruation.

Who Should Avoid Using Mini-Pills?

Certain women with particular medical conditions should avoid using mini-pills:

• Women with active liver disease: Progestin gets metabolized by the liver, so impaired liver function can be problematic.
• Those diagnosed with breast cancer: Progestin may adversely affect the growth of certain types of breast cancer.
• Women with unexplained uterine bleeding: The cause of bleeding should be investigated before progestin use.

You should thoroughly discuss your complete medical history with your doctor before using mini-pills. Women over age 35 who smoke should use caution with mini-pills, as the risks likely outweigh the benefits.

Consult Raleigh Gynecology & Wellness for Progestin-Only Guidance

Progestin-only contraceptives such as mini-pills can provide effective birth control and unique benefits for many women. If you think this progestin-only pill option may suit your needs, schedule a consultation with Raleigh Gynecology & Wellness.

Our team of experts can review your health history, discuss your preferences, and determine if mini-pills or other progestin methods are a good match for you. Contact us today at (919) 636-6670 or schedule an appointment online so we can help you take charge of your reproductive health with confidence.

The vaginal ring offers a convenient, effective birth control option for many women. This discretely worn ring provides monthly hormone release to prevent pregnancy. Learning proper use of the vaginal ring is key for reliability.

Here are some tips to achieve the best outcomes with this approach to birth control.

How Does the Vaginal Ring Work?

The vaginal ring is a flexible, transparent ring about two inches wide. It releases steady levels of estrogen and progestin once in place. These hormones stop ovulation and thicken your cervical mucus to block sperm from meeting an egg.

The ring stays comfortably in place, with most women and partners unable to feel it during intimacy. One ring worn for three weeks prevents pregnancy, and then you replace it with a new ring after a one-week break.

When You’re Protected with the Vaginal Ring

You can begin using the vaginal ring any time, as long as you’re sure you aren’t pregnant. Suppose you insert it within the first five days of your period. In that case, you’ll be protected immediately from getting pregnant, so you don’t need a backup.

If you start the ring any other time, use an alternative as a backup for the first week. Your healthcare provider can advise on the best approach if switching from another birth control method to the ring.

Inserting and Removing the Vaginal Ring

Inserting the vaginal ring is easy. Get comfortable and gently push the ring into your vagina until it feels stable and secure. The exact positioning is not important. Most women do not feel the ring once inserted correctly.

Hook your finger under the ring’s rim and pull down and out to remove it. Make sure to be gentle. It might also help to engage your pelvic muscles and bear down. Place the used ring in its case and throw it out (don’t flush!).

Remember to remove the ring after wearing it for three weeks on the same day you inserted it. Allow ring-free time for your period, then insert a new ring in 7 days even if bleeding continues.

Tips for Proper Vaginal Ring Use

With consistent, proper use, the vaginal ring is over 99% effective at preventing pregnancy. However, incorrect use can reduce reliability. Here are tips for success:

• Do not spend more than a week without a ring inserted to avoid ovulation.
• If the ring comes out, rinse and reinsert it within 48 hours to stay protected.
• If it’s out over 48 hours, use backup birth control for a week. Take emergency contraception if needed.
• Mark your calendar to remind yourself of ring insertion and removal dates each month.

Who Shouldn’t Use the Vaginal Ring?

The vaginal ring is safe for most women. But some circumstances make it less ideal. Your healthcare provider may recommend against the vaginal ring if you:

• Smoke and are over age 35.
• Have a history of blood clots, heart disease, high blood pressure, or stroke.
• Have had breast cancer.
• Have diabetes, high cholesterol, or other medical conditions.
• Weigh over 198 pounds.
• Take certain medications that might interact with your ring.

The Pros and Cons of Vaginal Ring Birth Control

There are many benefits to using the vaginal ring:

• It doesn’t prevent you from having sex since most can’t feel it.
• No daily pill to remember.
• Vomiting/diarrhea doesn’t impact its effectiveness.
• It may result in lighter periods and help menstrual symptoms.
• It doesn’t require a procedure to start or stop.
• Some potential disadvantages include:
• Side effects such as discharge or headache, especially in the first 1-2 months.
• You must remember to replace it every month.
• It doesn’t protect against STDs, so you still need condoms.
• Risks, such as blood clots, are possible.

Side Effects and Health Risks to Know

All hormonal birth control carries some health risks. On the vaginal ring, these may include:

• Increased chance of dangerous blood clots, especially if you are a smoker or are overweight.
• High potassium levels.
• Rare liver tumors, gallstones, or jaundice.

More common side effects usually resolve within 1-2 months. They include discharge, headaches, breast tenderness, nausea, or mood changes. Discuss your full health history with your doctor before using the ring. Report any concerning symptoms after you begin using it.

Getting Your Vaginal Ring

The vaginal ring requires a prescription, which your healthcare provider can write after a discussion. Pick it up at your local pharmacy, where it may be covered by your insurance in part or in full.

You may also be able to get low-cost or free birth control, including the ring, through Medicaid or similar government programs.

Trust Raleigh Gynecology & Wellness for Personalized Reproductive Care

The vaginal ring can be an excellent contraceptive option when used properly. With its steady hormone release and low maintenance, it provides monthly pregnancy prevention without daily effort. However, correct and consistent use is imperative.

Raleigh Gynecology & Wellness team of expert healthcare providers has extensive experience helping women find the best birth control method for their needs. We keep up with the latest vaginal ring recommendations and research to provide the most up-to-date guidance and ensure you feel empowered in your choice.

Contact us today at (919) 636-6670 or schedule an appointment online to discuss whether the vaginal ring may be a good fit for you.

Combination contraceptive pills are composed of two synthetic hormones: estrogen and progestin. Regular intake of these pills prevents pregnancy by inhibiting ovulation and thickening the cervical mucus to obstruct sperm from reaching an egg.

Various formulations and schedules of combination contraceptive pills are available, making consultation with your healthcare provider crucial to determine which suits your requirements.

However, having basic knowledge of these contraceptive pills can be advantageous. Here is some essential information about these birth control methods.

Types of Combination Contraceptive Pills

Combination contraceptive pills come in different formulations, including monophasic, multiphasic, and extended-cycle pills, each with distinct proportions of estrogen and progestin.

Monophasic Pills

In monophasic pills, each active pill contains identical amounts of estrogen and progestin, providing consistent dosing that helps to minimize side effects caused by varying hormone levels. Monophasic pills are available in both 21-day and 28-day cycles.

Multiphasic Pills

Multiphasic combination pills alter the estrogen and progestin doses throughout the monthly pill cycle, mimicking the body’s natural hormonal fluctuations. These pills may reduce side effects such as breakthrough bleeding and headaches that can occur with monophasic pills. Most multiphasic pills adhere to a 28-day cycle.

Extended-Cycle Pills

Extended-cycle combination pills decrease the frequency of withdrawal bleeding. Instead of monthly periods, you experience a period every three months or less. This can alleviate menstrual symptoms, cramps, and anemia. Extended-cycle pills come in 13-week packs, with active pills for 12 weeks and inactive pills for the following week.

Advantages of Combination Contraceptive Pills

When administered as directed, combination pills proffer numerous advantages:

• Efficient Pregnancy Prevention: Exhibiting nearly 99% efficacy under perfect use, they offer reliable protection against unintentional pregnancies.
• Regulation of Menstrual Cycles: Combination contraceptive pills can aid in managing heavy or irregular menstrual cycles.
• Management of Hormonal Conditions: These pills effectively control hormonal health conditions such as endometriosis, premenstrual syndrome, ovarian cysts, and other related conditions.
• Potential Reduction in Certain Cancer Risks: Combination contraceptive pills may assist in reducing the risks related to ovarian and endometrial cancer.
• Effective in acne management: These pills, by curtailing the production of androgens (sex hormones associated with puberty), can potentially lessen acne breakouts.
• Support in maintaining bone health: The estrogen in these pills helps preserve bone mineral density, hence aiding in the prevention of bone loss.

Potential Side Effects and Risks

Combination pills have been shown to be safe for most women. However, as with any form of medication, side effects are possible. Common side effects encompass nausea, tender breasts, migraines and headaches, mood changes such as depression, anxiety, irritability, and spotting or breakthrough bleeding between periods.

A more serious concern is an increased risk of blood clots, potentially leading to stroke, heart attack, or pulmonary embolism. This stems from how estrogen impacts the clotting system.

The risk depends on your medical history and factors such as smoking, obesity, age, etc. Your healthcare provider can determine if combination pills are safe for you. Be sure to report any worrying symptoms promptly.

Who Should Avoid Combination Contraceptive Pills?

Combination pills may not be appropriate if you have specific health conditions or risk factors. You should avoid taking combination birth control if you:

• Are older than 35 and a smoker.
• Have experienced blood clots, a heart attack, or a stroke.
• Have uncontrolled high blood pressure.
• Experience migraines with aura.
• Have liver disease or breast cancer.
• Take medications that may interact with combination birth control, such as Rifampin, certain seizure meds, and St. John’s Wort.

Choosing the Right Pill for You

There is a wide array of combination pill brands and formulations. The ideal choice for you depends on aspects such as:

• Your menstrual symptoms: Extended-cycle pills can reduce heavy bleeding.
• Your health conditions: If you can’t take estrogen, you may need a progestin-only pill.
• Other medications you take: Some may negatively interact with combination pills.

Confer with your doctor about your medical history and preferences to ascertain which combination birth control pill is optimal.

How to Use Combination Pills

Combination pills must be taken daily around the same time. Here are some guidelines for proper usage:

• Start a new pack the Sunday after your period begins for immediate pregnancy protection.
• If starting mid-cycle, use a backup form of birth control, such as a condom, sponge, or diaphragm, for a week.
• Take your pill at the same time daily, but if not possible, do not exceed a three-hour window.
• If you miss a contraceptive pill, take it the moment you remember. If two or more are missed, use backup protection for seven days.
• Begin each new pack on time, as delays can increase pregnancy risk.
• Some medications can make the pills less effective, so discuss possible drug interactions with your provider.

Take Charge of Your Reproductive Health with Raleigh Gynecology & Wellness

Finding the optimal birth control method is vital to manage your reproductive health effectively. Combination birth control pills can provide an effective, convenient, customizable way to prevent pregnancy when taken correctly. However, combination birth control isn’t suitable for everyone.

Raleigh Gynecology & Wellness is here to help. Our expert healthcare providers have extensive experience and can help you make an informed decision about your reproductive health. Contact us today at (919) 636-6670 or schedule an appointment online, and let us help you find the best birth control solution.

Birth control is a personal choice. There are a few things to consider to decide whether the pill or another form of contraceptive care is right for you. The best contraceptive care option is the one that fits with your body and lifestyle. By consulting with your physician about your contraceptive care needs, you can make a healthy choice about pregnancy prevention.

Read about how to maximize the benefits of contraceptive care with tips and tricks for effective, combined birth control approaches to pregnancy prevention.

The Pill

Prescription birth control pills work by interrupting the ovulation cycle and by introducing hormones to the cervix, which causes a thickening of the mucus and the blocking of egg fertilization by sperm.

When taken as directed, the pill is up to 99% effective for pregnancy prevention. However, failure to adhere to a daily dosage schedule as directed increases pregnancy risk. There are currently two different types of birth control pill prescription:

• Minipill – Single hormone: progestin.
• Combination pill – Dual hormone: estrogen and progestin.

A secondary form of contraception should accompany the initiation of birth control pill use. Minipill initiation should be used with a back-up birth control method such as condoms for 48 hours.

Combination pill plan use should be combined with a secondary form of contraception for seven days unless the pill was initiated during the first five days of the menstrual period.

Both birth control pills are prescribed to be taken daily at the same scheduled time. Dosage time is crucial for minipill use, which is why the combination pill is often preferred.

Tip 1: Know The Facts

Using birth control as prescribed provides pregnancy prevention. The pill’s effectiveness is determined by type and dosage schedule. Here are tips for understanding birth control pill variants and their use by type.

The Minipill

• Effective after ingestion for two consecutive days.
• Flexible start to the cycle schedule of initiation.
• Use backup contraception for the first two days after treatment is initiated.
• It can be taken immediately post giving birth, miscarriage, or abortion.

The Combination Pill

• Effective immediately if initiated within five days from the start of menstruation. In this situation no backup birth control method is required.
• If initiated at an alternate point in the menstrual cycle, use of a condom for seven days is needed
• It can be used six weeks after giving birth if breastfeeding; and three weeks if not breastfeeding.
• It can be used immediately following an abortion or miscarriage.

Tip 2: Schedule a Time

Birth control pill packs were designed for the 28-day menstrual cycle. Combination pill packs commonly consisted of 21 hormone pills and seven sugar pills with no active ingredients.

The menstrual cycle period is active during the 7-day sugar pill phase of the combination pill pack. Minipill packs contain an entire cycle of a single hormonal dose tablet taken daily. An irregular menstrual period is a common effect of minipill use.

The trick to effective pregnancy prevention is proper contraceptive use. The timing of dose ingestion will determine if the pill can be relied on without extra protection. Schedule a convenient time. Use your mobile phone to set the alarm at the scheduled dosage time to avoid pregnancy risk and costly pack replacement.

Tip 3: What to Do If You Skip

The pill is 99% effective when used properly. The efficacy of birth control pill prescription corresponds with the dosage schedule and its continuity. Therefore, attention to timing of the daily dosage is key. Here are the guidelines following a skipped dose:

• 1 missed pill – ingest a single dose immediately.
• Two missed pills – ingest a single dose, with resumption of the regularly scheduled ingestion time with a single dose, even if falling on the same day.
• 3+ missed pills – dispose of the existing pack and restart the treatment schedule with a new pack.
• Use a backup birth control method or avoid intercourse for seven days after a skip.

Tip 4: Prevention Alternatives

There are several other forms of contraception available. The Centers for Disease Control and Prevention (CDC) recommends long-acting reversible contraception (LARC); the most effective birth control methods are procedurally implemented implant and intrauterine devices (IUDs) with <1% risk of pregnancy, Typical use failure rate of birth control pills is around9%.

Condoms are the only proven method of preventing the spread of sexually transmitted infections (STIs). Combining prescription birth control or LARC with condom use affords the flexibility of multi-contraceptive prevention and additional protection from STIs. Find out more about contraceptive care options available to you from a licensed physician.

Tip 5: Contraceptive Care Services

Raleigh Gynecology & Wellness is a licensed provider in North Carolina. Our practice specializes in routine care and contraceptive care services, including procedural methods.

Schedule an appointment to speak with a physician specialist about pregnancy prevention planning, and the benefits of the available contraceptive options.

A physician-prescribed oral contraceptive, the “minipill,” is a birth control tablet medication composed of a single hormone (progestogen) pharmaceutical compound for suppressing ovulation in women.

Excepting compound differentiation and a few discretionary details for use, progestin pills offer the same pregnancy prevention benefits as combined pill (progestogen and estrogen) prescriptions.

The following is a breakdown of contraceptive care facts dispelling the misconceptions and myths about prescription progestin pill use.

Misconception: Oral contraceptive treatment is a hassle

Instructions for using progestin pills are daily oral ingestion at the same time for 28 days before initiating a new cycle. For maximum effectiveness, birth control tablets should be taken at the same time each day.

The pill can be used safely continuously, without a periodic break in treatment. Taking a break from oral contraceptive prescription use has the potential to lead to pregnancy.

Misconception: The pill is an ineffective form of birth control

Birth control contraceptives are 92% to 99% effective and function by inhibiting ovulation and causing a thickening of the cervix’s mucus, blocking sperm penetration during sexual intercourse. A common effect of oral contraceptive use is menstrual regulation, usually accompanied by reduced episodic cramping.

Misconception: Birth control pill contraception causes cancer

Birth control pills are proven protection from endometrial and ovarian cancer, ectopic pregnancy, and fallopian tube infections. The clinical record shows the incidence of cervical cancer associated with oral birth control use to be low.

Untreated human papillomavirus is a commonly diagnosed sexually transmitted infection (STI) connected to cervical cancer in women. Oral birth control pill use does not protect against the transmission of viral STIs.

Misconception: Taking the pill has no secondary health benefits

The health benefits of oral birth control contraception use for long-term duration are reduced incidence of anemia, cancer, ovarian cysts, and pelvic inflammatory disease.

Birth control pills are also thought to reduce menstrual bleeding, cramps, ovulatory pain, and the symptoms and onset of endometriosis and polycystic ovarian syndrome.

Myth: Birth control pill ingestion leads to short-term health problems

Some patients taking the pill may experience short-term health problems from oral contraceptive prescription drug use. Breast tenderness, headaches, and nausea are commonly cited symptoms of oral contraceptive treatment. Short-term side effects are not generally signs of severe illness and usually cease within the first two to three months of progestin pill treatment.

Myth: Oral contraception causes infertility in women

The notion that oral contraceptive care causes infertility is a myth. Depending on the patient’s age, the number of pregnancies, and the length of time taking oral contraceptive care, there may be variations in a patient’s ability to get pregnant after pill use has ceased.

Myth: The pill induces sexual promiscuity

Contraceptive care physicians reject the fallacy that oral birth control contraceptives are medically linked to increased libido, or the induction of sentience leading to sexual promiscuity. There is no evidence that oral contraceptive care is directly connected to sexual behavior, including any increase or decrease in sexual activity or performance.

Myth: Contraceptive birth control pills absorb unevenly

Concern that oral birth control pill ingestion leads to excess accumulation or uneven distribution in the body thus increasing the potential for disease and tumor growth, is false.

There is no evidence that oral contraceptives accumulate in the stomach, ovaries, and uterus. Instead, once ingested, the pill dissolves in the digestive system, causing the hormones to be absorbed by the bloodstream and metabolized by the liver and gut before discharge.

Myth: There are zero negative side-effects

Potential side effects include breast tenderness, headaches, nausea, and weight fluctuation. Less common side effects are vascular-related conditions such as blood clots, heart attack, or stroke. There is a higher risk of cancer and vascular disorders for women over the age of 35 years who smoke.

Myth: The pill is protection from STI risk

Birth control pills are not adequate protection against STIs (i.e., HIV/Aids). Condoms are the only proven effective birth control method for protection from STIs.

Myth: The pill leads to birth defects

There is no clinical evidence linking birth control pill use with birth defects or in vitro fetal immortality. In the rare circumstance that a pregnancy occurs during birth control pill contraceptive use should be ceased immediately with physician notice to determine the next steps for family planning and future contraceptive care.

Prescription Contraceptive Care

Raleigh Gynecology and Wellness is a licensed medical provider of gynecology and wellness services in Raleigh, North Caroline. Our healthcare practice specializes in routine care and contraceptive care, including progestin-only birth control pill prescriptions.

Find out more about family planning and pregnancy prevention by scheduling an appointment to speak with a specialist about your contraceptive care options.