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Key Points for Providers and Clients Progestin-only pills

Take one pill every day. No breaks between packs.

Safe for breastfeeding women and their babies. Progestin only pills do not affect milk production.

Add to the contraceptive effect of breastfeeding. Together, they provide effective pregnancy protection.

Bleeding changes are common but not harmful. Typically, pills lengthen how long breastfeeding women have no monthly bleeding. For women having monthly bleeding, frequent or irregular bleeding is common.

Can be given to a woman at any time to start later. If pregnancy cannot be ruled out, a provider can give her pills to take later, when her monthly bleeding begins.

Progestin-only pills


This section focuses on progestin-only pills for breastfeeding women. Women who are not breastfeeding also can use progestin-only pills. Guidance that differs for women who are not breastfeeding is noted.

What are progestin-only pills?
  • Pills that contain very low doses of a progestin like the natural hormone progesterone in a woman’s body.
  • Do not contain estrogen, and so can be used throughout breastfeeding and by women who cannot use methods with estrogen.
  • Progestin-only pills (POPs) are also called “minipills” and progestin-only oral contraceptives.
  • Work primarily by:

– thickening cervical mucus (this blocks sperm from meeting an egg)

– disrupting the menstrual cycle, including preventing the release of eggs from the ovaries (ovulation).

How effective?

Effectiveness depends on the user: for women who have monthly bleeding, risk of pregnancy is greatest if pills are taken late or missed completely.

Breastfeeding women:

  • As commonly used, about 1 pregnancy per 100 women using POPs over the first year. This means that 99 of every 100 women will not become pregnant.
  • When pills are taken every day, less than 1 pregnancy per 100 women using POPs over the first year (3 per 1,000 women).

Less effective for women not breastfeeding:

  • As commonly used, about 3 to 10 pregnancies per 100 women using POPs over the first year. This means that 90 to 97 of every 100 women will not become pregnant.
  • When pills are taken every day at the same time, less than 1 pregnancy per 100 women using POPs over the first year (9 per 1,000 women).

Return of fertility after POPs are stopped: no delay

Protection against sexually transmitted infections (STIs): none

Why Some Women Say They Like Progestin-Only Pills

Can be used while breastfeeding
  • Can be stopped at any time without a provider’s help
  • Do not interfere with sex
  • Are controlled by the woman

    Side effects, health benefits and health risks

  • Side Effects (see Managing Any Problems)

  • Some users report the following:

    Changes in bleeding patterns including:

    – For breastfeeding women, longer delay in return of monthly bleeding

    after childbirth (lengthened postpartum amenorrhea)

    – Frequent bleeding

    – Irregular bleeding

    – Infrequent bleeding

    – Prolonged bleeding

    – No monthly bleeding

    Breastfeeding also affects a woman’s bleeding patterns.

    • Headaches
    • Dizziness
    • Mood changes
    • Breast tenderness
    • Abdominal pain
    • Nausea

    Other possible physical changes:

    For women not breastfeeding, enlarged ovarian follicles

    Known Health Benefits

    Help protect against: risks of pregnancy

    Known Health Risks

    None

    Correcting Misunderstandings

    (see also Questions and Answers)

    Progestin-only pills:

    • Do not cause a breastfeeding woman’s milk to dry up.
    • Must be taken every day, whether or not a woman has sex that day.
    • Do not make women infertile.
    • Do not cause diarrhea in breastfeeding babies.
    • Reduce the risk of ectopic pregnancy.

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