How is the pill taken?

The pill is available in a pack of 21, 22 or 28 tablets. You start taking the pill with the first tablet of a pack on the first day of your menstrual bleeding. One tablet is then taken on each subsequent day until the 21st or 22nd day.

This is followed by a break of seven or six days in which no tablets are taken. Then the taking of the first tablet of a new pack starts again. For the 28-tablet pack, one tablet is taken every day.

If the 28 tablets in a pack are completely used up after 28 days, you start taking the first tablet of a new pack immediately without a break. The last 8 tablets of the 28-tablet pack are placebo, so that in total, only one hormone is taken in the first 22 days. During the period when no hormones are taken, there is usually a withdrawal bleeding similar to menstrual bleeding, as the sex hormones are withdrawn from the body during this time.

In addition to the macro and micro pill, there is also the minipill. The special feature of the minipill is that it contains only progestins. The progestogen-containing tablets must be taken on all 28 days of the cycle.

There are therefore no days without taking them. It is also important when taking the minipill that it must always be taken at exactly the same time, otherwise it will not work safely. The maximum time difference is two hours.

The effect of the minipill is similar to that of the macro or micro pill, but is only triggered by one sex hormone (progestin). LH and FSH secretion is suppressed in the minipill and in the macro- and micro-pill. However, ovulation is only prevented in about 45% of women.

Furthermore, there is a disturbance in the maturation of the egg (follicle maturation), inhibition of the growth of the lining of the uterus and prevention of the implantation of an egg (proliferation and nidation inhibition of the endometrium), thickening of the cervical mucus (cervical mucus) and changes in the mobility of the fallopian tubes (tubae uterinae). The minipill was developed for patients at risk. The estrogen-related side effects therefore do not occur in these patients. The minipill therefore does not increase their existing risk factors, such as the risk of thrombosis, and is a good and safe contraceptive for these high-risk patients.