Mini Pill vs Combination Pill: Understanding the Differences

Birth control pills are effective and one of the popular methods in preventing pregnancy, regulating menstrual periods, and reducing period cramps.

According to the United Nations 2019 report, approximately 151 million women rely on birth control pills to prevent pregnancy.

There are two kinds of birth control pills such as combined pills and mini pills. 

The pills are taken orally every day and are convenient to use.

But what is the difference between a mini pill and a combination pill?

This comprehensive article will elaborate on mini pill vs combination pill, their effectiveness, and considerations.

Overview of the difference between mini pill and combination pill

The table below differentiates between mini pills and combined pills depending on their distinct characteristics. 

Mini pill vs combination pill

Combination pills and mini pills are a type of oral hormonal birth control that has an effectiveness of 99% when taken regularly.

Combination pills contain Estrogen and Progestin, whereas mini pills contain Progestin.

Therefore, mini pills are also called Progestin-only birth control pills.

Action of mechanism

The mini pill has Progestin and works in the following ways:

• It makes the uterine walls thinner
• It makes the cervical mucus thicker
• The mini pill may also prevent ovulation. However, about half of the people using these pills still ovulate

On the other hand, combination birth control pills contain both hormones and work in the following ways to prevent pregnancy:

• Estrogen prevents ovaries from releasing an egg, also called ovulation
• Progestin thickens the cervical mucus to make it harder for sperm to reach the egg
• Progestin results in the thinning of the uterine lining to prevent implantation (attachment of fertilized egg to the uterus)

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Dosage

Mini pills contain Progestin-only and are taken orally every 24 hours

It is a reliable hormonal birth control pill for women who cannot tolerate combined pills and women who breastfeed.

Further, mini pills are also safe for people with risks of venous blood clotting.

The pills should be taken daily at the right time without delay. If a woman misses one dosage, she must take it within three hours.

However, combination pills are available in different forms, such as one-phase, two-phase, and three-phase.

In the case of one-phase pills, each pill contains the same hormone level in the same proportions. 

In two and three-phase pills, the pills have different proportions of hormones based on the phase of the cycle.

The dosage of hormones in each phase is present in the following manner, 

• One-phase pills contain a consistent amount of Estrogen and Progestin in each active pill.

• Two-phase pills alter the Progestin amount once during the cycle, dividing it into two parts. In a 21-day pack, the first half has less progestin than the second half, while the Estrogen level remains constant throughout.
• Three-phase pills, split the cycle into segments through hormonal changes. In triphasic pills, these changes occur twice, dividing a 21-day cycle into three equal, seven-day phases.

When mini pill vs combination pill fail

Generally, mini pills and combination pills fail when a woman misses her pills more frequently. 

To reduce the chances of missing pills, women can take pills at a regular time every day.

Protection against STDs

Though mini pills and combination pills are effective in preventing pregnancy, they cannot reduce the risk of transmission of Sexually Transmitted Diseases (STDs).

To bring effective birth control that can prevent pregnancy with the risk of STDs, people can use condoms.

Pros

The mini pills include the following pros:

• Easy to reverse if a woman wants to get pregnant
• Effective in women susceptible to Estrogen-containing birth control pills
• Effective for women with blood clots, heart problems, high blood pressure, Migraines, and who breastfeed
• Lowers the risks of Endometrial Cancer

The following are the pros of combination pills:

• COCs can be stopped with minimal side effects  if a women wants to get pregnant
• Reduces acne
• Regular periods with no heavy bleeding
• Low risks of Ovarian, Endometrial, and Colon Cancers
• Reduce PMS symptoms
• Reduction in heavy menstrual bleeding and cramps
• Reduces unwated hair growth due to Polycystic Ovary Syndrome (PCOS)

Cons

Some cons of mini pills are as follows:

• It should be taken daily at the same time
• These pills do not protect against STDs
• It can slightly increase the risk of Ectopic pregnancy
• Side effects, such as low sex drive, acne, weight gain, breast tenderness, and irregular menstrual bleeding

There are some cons of combination birth control pills as follows:

• People must remember to take them daily at the same time
• It can increase the risk of heart problems
• Skipping pills can reduce their effectiveness
• It can increase blood clots in women who smoke and are above 35
• Bleeding in between periods
• It does not protect against STDs
• Side effects like nausea, vomiting, headache, mood swings, and weight gain
• It can increase the risk of Breast and Cervical Cancer

Who cannot take a mini pill vs a combination pill

For birth control pills, the risk factors are higher for people who have:

• Marked 35 or above
• A history of heart problems and blood clots
• Currently have or had a history of Uterine Cancer
• High blood pressure, blood cholesterol level, or Diabetes
• A habit of smoking

People with these medical conditions or age factors must consult a healthcare practitioner before taking birth control pills. 

How do you know which birth control pill is right for you

Most women can take birth control pills safely to prevent pregnancy. 

However, certain medical histories or medications can concern people about which birth control is suitable for you.

People can consult their healthcare practitioner and seek prescribed birth control pills depending on their medical history and senstivity to Estrogen-containing pills.

Conclusion

There are two types of birth control pills, i.e., combination birth control pills and mini pills.

Combination pills contain hormones Estrogen and Progestin, whereas mini pills contain Progestin-only.

The combination pills prevent ovulation, thickening cervical mucus, and preventing implantation.

On the other hand, a mini pill can thicken cervical mucus and prevent implantation.

These pills are taken every day depending on the dosage prescribed by the doctor. However, they may fail if a woman misses her daily pill.

There are many pros of combination pills, such as reducing PMS and lowering the risks of Ovarian Cancer. 

However, both types of birth control pills can have certain cons, such as nausea, vomiting, and risks of blood clots.

Therefore, some people should consult their healthcare practitioner before taking birth control pills to prevent consequences.

Frequently Asked Questions

• ncbi.nlm.nih.gov
• mayoclinic.org