Table of ContentsView AllTable of ContentsWhat Is Progestin-Only Birth Control?Why Use It?Side Effects and RisksBefore You StartTypesFAQ

Table of ContentsView All

View All

Table of Contents

What Is Progestin-Only Birth Control?

Why Use It?

Side Effects and Risks

Before You Start

Types

FAQ

Progesterone-only birth control is a type of hormonal birth control that does not contain synthetic estrogen. Instead, it uses synthetic forms of progesterone called progestins.

The oral form of this type of birth control is also called the minipill. Because it does not contain estrogen, the minipill may have fewer side effects than other forms of hormonal birth control.

Progestin-only birth control is considered a safer form ofbirth controlfor those who are over the age of 35 and smoke, or are at risk for heart attack or stroke. It is between 93% and 99% effective in preventing pregnancy.

Here’s what to know about who should consider progestin-only birth control, what the options are, and the potential risks.

How Progestin-Only Birth Control Works

Progestin-only birth control contains onlyaprogestin, a synthetic form of the hormone progesterone. In the body, progesterone is a sex hormone produced in the ovaries. It plays a role in the menstrual cycle and the early stages of pregnancy

Progestin-only birth control is considered safer for certain people, and it may have fewer side effects than birth control pills that contain estrogen.

What Is the Most Effective Birth Control?

Progestin-only vs. Combination Birth Control Pill

In comparing these two types of hormonal birth control, there are some differences:

Why Use Progestin-Only Birth Control?

Your healthcare provider may recommend a progesterone-only birth control method if:

Who Shouldn’t Use Progestin-Only Birth Control

Progestin-only contraception may not be appropriate for you if:

Common Side Effects

Progestin-only birth control pills share common side effects, some of which will resolve over time. They may include:

Side effects of the progestin injection include:

Risks

Serious side effects are rare, but they include:

Combined estrogen and progestin oral contraceptives may increase the risk of getting breast cancer, endometrial cancer, and liver tumors. It is not known whether progestin-only oral contraceptives also increase the risks of these conditions.

When to Call a Healthcare ProviderAlthough these symptoms are uncommon, call your healthcare provider right away if you experience:Menstrual bleeding that is unusually heavy or that lasts a long timeNo menstrual periodsSevere headachesSevere stomach pain

When to Call a Healthcare Provider

Although these symptoms are uncommon, call your healthcare provider right away if you experience:Menstrual bleeding that is unusually heavy or that lasts a long timeNo menstrual periodsSevere headachesSevere stomach pain

Although these symptoms are uncommon, call your healthcare provider right away if you experience:

A 2016 review of the use of progestin and breast cancer risk concluded that, unlike other oral contraceptives, studies indicate that progestin-only formulations do not increase the risk of breast cancer.The researchers noted that the six studies reviewed had small sample sizes, so larger-scale clinical studies are needed.

Advantages and Disadvantages of Progesterone-Only Birth Control Pills

AdvantagesHighly effectiveContains a smaller dose of progestinSafe during lactationCan be used when estrogen in not recommendedSafe for people over 35 years oldDisadvantagesDoesn’t prevent ovulation as effectively as the combination pilIMust be taken daily and at the same time each dayMay cause menstrual irregularities

AdvantagesHighly effectiveContains a smaller dose of progestinSafe during lactationCan be used when estrogen in not recommendedSafe for people over 35 years old

Highly effective

Contains a smaller dose of progestin

Safe during lactation

Can be used when estrogen in not recommended

Safe for people over 35 years old

DisadvantagesDoesn’t prevent ovulation as effectively as the combination pilIMust be taken daily and at the same time each dayMay cause menstrual irregularities

Doesn’t prevent ovulation as effectively as the combination pilI

Must be taken daily and at the same time each day

May cause menstrual irregularities

Before you begin taking a progestin-only medication, your healthcare provider will want to assess your overall health. You should tell them if you take any other medications or supplements as well and if you smoke.

Your healthcare provider will advise you on when your chosen method will become effective against pregnancy. For example, the minipill needs to be taken for a week before it becomes effective. Therefore, you will need to use a barrier method of birth control if you are sexually active during that time.

An injectable will be immediately effective if it is given within the first seven days after your period has started; if it has been longer than that, you will need a backup method for the first week after the injection.

An IUD becomes effective immediately upon insertion.

Things to Keep in Mind

If you opt for the minipill, it is very important that you take it at the exact same time every day. The Depo-Provera shot must be given every four months. Another thing to consider before starting a progestin-only method is whether you hope to become pregnant in the future. Fertility returns right away after you discontinue some of these methods (such as the minipill), while it may take several months with others (such as the Depo-Provera injection).

Types of Progesterone-Only Birth Control

Progestin-only birth control comes in many different forms. Here’s a rundown:

Birth Control Pills

As their name suggests, progestin-only birth control pills do not contain any estrogen. They are available in 28-day packs which you take every day during your four-week cycle. All 28 pills contain progestin; there are no placebo pills.

The progestin-only pill comes in three formulations in the United States, including norethindrone, which comes in a generic form, or with brand names including:

In July 2023, the Food and Drug Administration (FDA) approved Opill (norgestrel), a progestin-only oral contraceptive, to be sold over the counter (OTC). Opill is the first and only birth control pill available without a prescription.

What to Know About Progestin-Only Birth Control Pills

Depo-Provera Injections

Depo-Provera is a birth control injection that slowly releases progestinmedroxyprogesteroneacetate into your body, providing protection from pregnancy from 11 to 14 weeks. If you opt to use Depo-Provera, you will need four injections each year.The injection also comes in a generic form.

Depo-Provera injections offer the added benefit of reducing thepain associated with endometriosis.

Depo-Provera has aboxed warningthat cautions against possible bone loss and the increased risk ofosteoporosis.For this reason, Depo-Provera should never be used for more than two years and should be entirely avoided in teenagers.

Common side effects include weight gain,irregular bleeding, spotting, and prolonged bleeding. Once stopped, it may several months to a year tostart ovulating againand become pregnant.

What to Know About Depo-Provera

Mirena IUD

The Mirena IUD is an intrauterine device (IUD) that continuously releases a small amount of progestin for up to seven years; it is more than 99% effective at preventing pregnancy. The Mirena IUD has also been approved to helptreat heavy periods.

What to Know About Getting an IUD for Endometriosis

Skyla IUD

Skylais another progestin-only IUD option. It is a bit smaller than Mirena and is typically easier for a healthcare provider to insert. Once inserted, the Skyla slowly releases a form of progestin (calledlevonorgestrel) over a three-year period.

The complications of use are the same as for the Mirena IUD, which may include uterine perforation, infection, and expulsion.

Which Type of IUD Should You Use?

Nexplanon Subdermal Implant

Nexplanon is the newer version of the Implanon subdermal implant. This is a progestin-only birth control device that contains the progestinetonogestreland consists of a flexible plastic implant about the size of a matchstick.

After implantation, you may experience bruising, pain, itching, burning, numbness, bleeding, scarring, or infection at the insertion site.

What to Know About Nexplanon

Noristerat Injection

The Noristerat injection is a birth control delivery system containing progestinnorethisterone enanthate. It is not available in the United States but is commonly used in the United Kingdom, Europe, Africa, and Central America.

The Noristerat injection is designed to be a short-term birth control method. Women may choose it after being immunized against rubella (to prevent pregnancy while the virus is active) or while awaiting their partner’svasectomyto become effective.The Noristerat injection will continuously release progestin into your system for up to eight weeks.

What to Know About Noristerat

Which Type Is Right for You?

When deciding which form of progesterone-only birth control method to choose, you should take into account the convenience factor, among other things. Can you reliably take the minipill at the same time every day, or are you better off with the injection, IUD, or implant, which you don’t have to think about for months or years?

Also, if you know if or when you might like to become pregnant, consider whether a method that is instantly reversible (the minipill, for example) is preferable to one that may not restore fertility for months once you stop it (such as the injection). The best way to make an informed decision is to discuss these pros and cons with your gynecologist.

Frequently Asked QuestionsNo. Progesterone-only birth control isnotrecommended as a treatment for acne. Combination birth control, which contains estrogen and progesterone, is the only form of birth control that has been found tohelp control and clear up acne.No, progesterone-only birth control does not increase the risk of blood clots. Many women choose progesterone-only birth control specifically for this reason. Combination birth control pills have been shown to increase the risk of blood clots. Women at increased risk of stroke or heart disease are advised to choose progesterone-only birth control methods.Yes, progesterone-only pills are often recommended for breastfeeding mothers. Some research has suggested that the estrogen in combination birth control pills may inhibit breast milk production. Progesterone alone does not have this effect.

Frequently Asked Questions

No. Progesterone-only birth control isnotrecommended as a treatment for acne. Combination birth control, which contains estrogen and progesterone, is the only form of birth control that has been found tohelp control and clear up acne.

No, progesterone-only birth control does not increase the risk of blood clots. Many women choose progesterone-only birth control specifically for this reason. Combination birth control pills have been shown to increase the risk of blood clots. Women at increased risk of stroke or heart disease are advised to choose progesterone-only birth control methods.

Yes, progesterone-only pills are often recommended for breastfeeding mothers. Some research has suggested that the estrogen in combination birth control pills may inhibit breast milk production. Progesterone alone does not have this effect.

15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Contraception and birth control methods.American College of Obstetricians and Gynecologists.Long-acting reversible contraception (LARC): Intrauterine device (IUD) and implant.Sridhar A, Salcedo J.Optimizing maternal and neonatal outcomes with postpartum contraception: Impact on breastfeeding and birth spacing.Matern Health Neonatol Perinatol. 2017;3:1. doi:10.1186/s40748-016-0040-yCarlton C, Banks M, Sundararajan S.Oral contraceptives and ischemic stroke risk.Stroke. 2018;49(4):e157-e159. doi:10.1161/STROKEAHA.117.020084American Academy of Family Physicians. Familydoctor.org.Progestin-only birth control pills.Merch LS, Skovlund CW, Hannaford PC, et al.Contemporary hormonal contraception and the risk of breast cancer.N Engl J Med. 2017; 377:2228-2239. doi:10.1056/NEJMoa1700732National Institute of Diabetes and Digestive and Kidney Diseases.LiverTox: Clinical and research information on drug-induced liver injury.Reimers A, Brodtkorb E, Sabers A.Interactions between hormonal contraception and antiepileptic drugs: Clinical and mechanistic considerations.Seizure. 2015;28:66–70. doi:10.1016/j.seizure.2015.03.006Schlatter J.Oral contraceptives after bariatric surgery.Obes Facts. 2017;10(2):118-126. doi:10.1159/000449508Medline Plus.Progestin-only (norethindrone) oral contraceptives.Samson M, Porter N, Orekoya O, et al.Progestin and breast cancer risk: a systematic review.Breast Cancer Res Treat. 2016;155(1):3-12. doi:10.1007/s10549-015-3663-1U.S. Food & Drug Administration.Physician information: Depo-provera.American College of Obstetricians and Gynecologists.Progestin-only hormonal birth control: Pill and injection.Parker C.Injectable contraceptives: Underused and undervalued?Prof Care Mother Child. 1997;7(4):95-7.Trivedi MK, Shinkai K, Murase JE.A review of hormone-based therapies to treat adult acne vulgaris in women.Int J Womens Dermatol. 2017;3(1):44-52. doi:10.1016/j.ijwd.2017.02.018

15 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Contraception and birth control methods.American College of Obstetricians and Gynecologists.Long-acting reversible contraception (LARC): Intrauterine device (IUD) and implant.Sridhar A, Salcedo J.Optimizing maternal and neonatal outcomes with postpartum contraception: Impact on breastfeeding and birth spacing.Matern Health Neonatol Perinatol. 2017;3:1. doi:10.1186/s40748-016-0040-yCarlton C, Banks M, Sundararajan S.Oral contraceptives and ischemic stroke risk.Stroke. 2018;49(4):e157-e159. doi:10.1161/STROKEAHA.117.020084American Academy of Family Physicians. Familydoctor.org.Progestin-only birth control pills.Merch LS, Skovlund CW, Hannaford PC, et al.Contemporary hormonal contraception and the risk of breast cancer.N Engl J Med. 2017; 377:2228-2239. doi:10.1056/NEJMoa1700732National Institute of Diabetes and Digestive and Kidney Diseases.LiverTox: Clinical and research information on drug-induced liver injury.Reimers A, Brodtkorb E, Sabers A.Interactions between hormonal contraception and antiepileptic drugs: Clinical and mechanistic considerations.Seizure. 2015;28:66–70. doi:10.1016/j.seizure.2015.03.006Schlatter J.Oral contraceptives after bariatric surgery.Obes Facts. 2017;10(2):118-126. doi:10.1159/000449508Medline Plus.Progestin-only (norethindrone) oral contraceptives.Samson M, Porter N, Orekoya O, et al.Progestin and breast cancer risk: a systematic review.Breast Cancer Res Treat. 2016;155(1):3-12. doi:10.1007/s10549-015-3663-1U.S. Food & Drug Administration.Physician information: Depo-provera.American College of Obstetricians and Gynecologists.Progestin-only hormonal birth control: Pill and injection.Parker C.Injectable contraceptives: Underused and undervalued?Prof Care Mother Child. 1997;7(4):95-7.Trivedi MK, Shinkai K, Murase JE.A review of hormone-based therapies to treat adult acne vulgaris in women.Int J Womens Dermatol. 2017;3(1):44-52. doi:10.1016/j.ijwd.2017.02.018

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Centers for Disease Control and Prevention.Contraception and birth control methods.American College of Obstetricians and Gynecologists.Long-acting reversible contraception (LARC): Intrauterine device (IUD) and implant.Sridhar A, Salcedo J.Optimizing maternal and neonatal outcomes with postpartum contraception: Impact on breastfeeding and birth spacing.Matern Health Neonatol Perinatol. 2017;3:1. doi:10.1186/s40748-016-0040-yCarlton C, Banks M, Sundararajan S.Oral contraceptives and ischemic stroke risk.Stroke. 2018;49(4):e157-e159. doi:10.1161/STROKEAHA.117.020084American Academy of Family Physicians. Familydoctor.org.Progestin-only birth control pills.Merch LS, Skovlund CW, Hannaford PC, et al.Contemporary hormonal contraception and the risk of breast cancer.N Engl J Med. 2017; 377:2228-2239. doi:10.1056/NEJMoa1700732National Institute of Diabetes and Digestive and Kidney Diseases.LiverTox: Clinical and research information on drug-induced liver injury.Reimers A, Brodtkorb E, Sabers A.Interactions between hormonal contraception and antiepileptic drugs: Clinical and mechanistic considerations.Seizure. 2015;28:66–70. doi:10.1016/j.seizure.2015.03.006Schlatter J.Oral contraceptives after bariatric surgery.Obes Facts. 2017;10(2):118-126. doi:10.1159/000449508Medline Plus.Progestin-only (norethindrone) oral contraceptives.Samson M, Porter N, Orekoya O, et al.Progestin and breast cancer risk: a systematic review.Breast Cancer Res Treat. 2016;155(1):3-12. doi:10.1007/s10549-015-3663-1U.S. Food & Drug Administration.Physician information: Depo-provera.American College of Obstetricians and Gynecologists.Progestin-only hormonal birth control: Pill and injection.Parker C.Injectable contraceptives: Underused and undervalued?Prof Care Mother Child. 1997;7(4):95-7.Trivedi MK, Shinkai K, Murase JE.A review of hormone-based therapies to treat adult acne vulgaris in women.Int J Womens Dermatol. 2017;3(1):44-52. doi:10.1016/j.ijwd.2017.02.018

Centers for Disease Control and Prevention.Contraception and birth control methods.

American College of Obstetricians and Gynecologists.Long-acting reversible contraception (LARC): Intrauterine device (IUD) and implant.

Sridhar A, Salcedo J.Optimizing maternal and neonatal outcomes with postpartum contraception: Impact on breastfeeding and birth spacing.Matern Health Neonatol Perinatol. 2017;3:1. doi:10.1186/s40748-016-0040-y

Carlton C, Banks M, Sundararajan S.Oral contraceptives and ischemic stroke risk.Stroke. 2018;49(4):e157-e159. doi:10.1161/STROKEAHA.117.020084

American Academy of Family Physicians. Familydoctor.org.Progestin-only birth control pills.

Merch LS, Skovlund CW, Hannaford PC, et al.Contemporary hormonal contraception and the risk of breast cancer.N Engl J Med. 2017; 377:2228-2239. doi:10.1056/NEJMoa1700732

National Institute of Diabetes and Digestive and Kidney Diseases.LiverTox: Clinical and research information on drug-induced liver injury.

Reimers A, Brodtkorb E, Sabers A.Interactions between hormonal contraception and antiepileptic drugs: Clinical and mechanistic considerations.Seizure. 2015;28:66–70. doi:10.1016/j.seizure.2015.03.006

Schlatter J.Oral contraceptives after bariatric surgery.Obes Facts. 2017;10(2):118-126. doi:10.1159/000449508

Medline Plus.Progestin-only (norethindrone) oral contraceptives.

Samson M, Porter N, Orekoya O, et al.Progestin and breast cancer risk: a systematic review.Breast Cancer Res Treat. 2016;155(1):3-12. doi:10.1007/s10549-015-3663-1

U.S. Food & Drug Administration.Physician information: Depo-provera.

American College of Obstetricians and Gynecologists.Progestin-only hormonal birth control: Pill and injection.

Parker C.Injectable contraceptives: Underused and undervalued?Prof Care Mother Child. 1997;7(4):95-7.

Trivedi MK, Shinkai K, Murase JE.A review of hormone-based therapies to treat adult acne vulgaris in women.Int J Womens Dermatol. 2017;3(1):44-52. doi:10.1016/j.ijwd.2017.02.018

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