Minipill

image001 The fertilization of male sperm with female egg results in conception commonly referred as pregnancy. In order to prevent pregnancy from occurring, drugs such as progesterone only pills (POP) are used. The aim of using these pharmacological preparations is to prevent the availability of egg for the sperm in order to prevent fertilization. These minipills are safe to use and are easily available in the form of oral tablets.

What Are Minipills?

Minipills are oral formulation that contains synthetic form of the hormone progesterone (also known as progestin). It is the hormone that is responsible for thinning of uterine lining and preventing ovulation. These tablets are available in a pack of 28 pills and are designed for one pill per day. Besides progesterone only formulations, these contraceptive pills are also commercially available in the form of combination pills (such as estrogen and progesterone oral preparations). One must keep in mind that combination tablets cannot be used without prescription and proper physical checkup. Oral contraception is the preferred method of preventing unwanted/ unplanned pregnancy in women who don’t want to opt for permanent methods such as tubal ligation or other complicated procedures/ protocols such as intrauterine devices.

Advantages

Disadvantages

Lesser risk of side effects than combination pills.

These pills should be consumed every day, at approximately the same time.

Breast feeding women can have these tablets without side effects.

Minipills are not effective or recommended in women above 70 kg in weight.

Is not contraindicated in smokers.

These are less effective than other available pills.

These pills can be taken at any age and can also help in the management of PMT (premenstrual tension).

Minipills cannot prevent ectopic pregnancies in which the fertilized zygote may implant anywhere but the uterus.

There are no issues of blood pressure fluctuations in patients with positive hypertensive patients.

These pills do not control the menstrual cycle.

How Does the Minipill Work?

Minipills work via three primary mechanisms. First main action is the thickening of the cervical mucus, the region which receives the semen containing sperms. With thick mucus, the sperms are unable to pass through to the fallopian tube and fertilization is prevented.

Next important action is the thinning of uterine lining. As the lining gets thinner and fragile, conception becomes difficult since the embryo cannot implant itself, thereby preventing pregnancy. But this does not prevent extra uterine pregnancy.

Another important action of progesterone is the suppression of ovulation, which is the process of release of egg from ovaries every month.

What Is the Success Rate of the Minipill?

Minipills are about 90% reliable if taken properly; the dose should not be skipped or delayed excessively and should not be self-prescribed. If doses are missed or not taken on proper timings, then chances of pregnancy increases substantially. The effectiveness of these drugs increase to almost a hundred percent if the mother is six months into breast feeding.

Newer drugs come in combination with estrogen, allowing reduction in dosing frequency and a success rate of ninety-nine percent.

What Are the Side Effects of the Minipill?

  • One out of nine users likely to get pregnant in the first year
  • Increase in acne
  • Higher risk of ectopic pregnancy
  • Unpredictable and irregular menstrual bleeding
  • Irregular weight gains
  • Frequent nausea and headache
  • Increased breast tenderness

Who Can Take the Minipill?

1. Those Who Can Take

Breastfeeding mothers can use progesterone pills, since these are generally considered safe. These pills do not alter the amount of milk produced nor do these pills are expressed/secreted in breast milk, thereby no risk of exposing the baby to progesterone.

2. Those Who Cannot Take

POP pills should be avoided in females with a potential of vaginal bleeding, it should be carefully managed in patients with a positive history of liver diseases, especially chronic liver disease. Also, management is needed in patients of hypertension and atrial diseases. Breast cancer patients should avoid such drugs, as the risk of complications is fairly higher in this group.

Warning: During the course of therapy with minipills, if you experience excessive vaginal bleeding, abdominal pain, nausea or pain in lower abdominal region, consult a healthcare professional immediately.

How to Take the Minipill

When starting with minipills, one must consult a doctor and give complete details of any family disorder or past diseases in connection with mensuration or pregnancy. Your doctor will help you with the following:

  • Directions on how to consume the drug, prevention scenarios and simple dosing rules that must be followed strictly.
  • Time yourself the first time you take a pill and stick to that time every day. A range of three hours early or late is generally acceptable.
  • Talk to your doctor about a backup method, since maintaining a schedule every day is difficult for many women because of busy lives.
  • It is important to remember that the effects of POP pills last for about 24 hours, therefore missing a single dose may increase the risk of pregnancy. Hence if a dose is missed, it must be taken as soon as the female remembers. Again, a physician should be consulted in case of any confusion.

Sometimes after taking the medication, irregular menstrual bleeding, lower abdomen pain, pelvic pain and vaginal bleeding may occur. These indicate that the female is pregnant in most cases. A physician should be consulted to rule out any other conditions such as ectopic pregnancy or endometrium cancers.

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