If you enjoy a good sex life, you almost certainly want to protect yourself against unwanted pregnancy. The minipill can do that for you. But you have to remember to take it every single day of the year. No breaks at all - even when you're on your period.

It's not quite as effective as the ordinary Pill, but it's a good deal freer of side effects. And it's particularly useful for some groups of women who cannot take the Pill - for instance, new mums who are breast-feeding. However, it does have some disadvantages, and we'll tell you about them in a moment.

What is the minipill?
There's a lot of confusion about this name. Many women don't understand it - and, regrettably, even a few doctors have got the wrong end of the stick about it! The minipill is not just a low-dose version of the Pill. Unfortunately, lots of women who are taking low-dose brands of the 'Pill think they are on the minipill, but they aren't.

No, the minipill is quite different from the ordinary or 'combined' Pill. Unlike the ordinary Pill it contains just one hormone - not two. That hormone is progestogen (often mistakenly called a 'progesterone'.)

A progestogen - which is an artificially manufactured hormone - is very like progesterone, which is one of the female hormones the body produces. Unlike the 'ordinary' Pill, the minipill contains no oestrogen.

The Pill is composed of two hormones:

an oestrogen

a progestogen.

That's why it's sometimes called 'the combined Pill'. It is the oestrogen in the ordinary Pill that is responsible for many of its side effects - including some of the rare but very serious ones. So going on the minipill, instead of the Pill, immediately reduces your chances of dangerous side effects.

How does the minipill work?
The minipill stops you from getting pregnant by doing three things:

it thickens the secretions round the neck of your womb - this makes it very difficult for the sperm to get through.

it makes the lining of the womb thinner, and so less 'receptive' to ova (eggs).

sometimes, it stops you ovulating (releasing an egg).

How effective is it?
It's not quite as efficient in protecting you against pregnancy as the ordinary Pill, but it is pretty good. If 100 sexually active women took the minipill regularly for a year, less than two of them would get pregnant. This makes the minipill about as effective as the coil (IUD).

How do I take it?
You must take the minipill at roughly the same time of day, every day - even when you are menstruating. If you don't take it every day, you may easily get pregnant. Also, if you're more than three hours late in taking it, you could fall pregnant.

So clearly, you need to set yourself a fixed time of day when you'll always take your minipill. Some women decide that it'll be suppertime. Others decide that they'll take it when they go to bed.

Obviously, the minipill is not a great idea for you if:

you're not very good at taking tablets regularly

you're in a job - like being part of an airline cabin crew - where hours are irregular and disrupted.

How do I get it?
Begin by going to a doctor or a Family Planning Clinic and asking themabout the minipill. (In practice, FP Clinic staff tend to know more about minipills than anyone else does.)

Discuss whether the minipill would be suitable for you. Ask about the latest situation regarding side effects (see below).

If you decide to go ahead with the minipill, you'll be given a prescription for several packs. Read the leaflet inside. Then start taking the minipill on the first day of your next period.

If you're not having periods at the moment because you've recently had a baby, then start taking it immediately. (Don't do this if there's any suspicion that you might be pregnant again!)

Although nearly all women can use the minipill if they want to, in practice it is commonly used by people who are unable to take the ordinary Pill. These include:

breast-feeding mums - mainly because the Pill tends to stop milk production.

women who cannot take oestrogens.

women over 40 who have been medically advised not to take the Pill.

women who are at special risk of heart disease or strokes - though these patients should NOT take the minipill without taking specialist advice.

women who are heavy smokers. Smoking and the ordinary Pill make a very dodgy combination - and may cause heart attacks or clots. If you can't give up cigarettes, your doctor may feel that the minipill is less of a risk for you.

What are the side effects of the minipill?
At present, the minipill seems to carry considerably less risk than the ordinary Pill. The chief side effects are:

periods tend to be irregular, which can be a nuisance.

sometimes periods stop - this may be a worry to you, and you may need the reassurance of a pregnancy test.

if you did become pregnant while taking the minipill, there is a chance that the pregnancy might be ectopic - that is outside the womb. So if your period is late and you get pain in your lower tummy, contact a doctor.

you may get spots on your skin.

you could get tender breasts.

there's a small risk of cysts in the ovaries.

nausea and headache sometimes occur.

Who shouldn't take the minipill?
Doctors may refuse to prescribe the minipill for you:

if you have an abnormally high cholesterol or other blood fats.

if you have breast cancer. if you have unexplained vaginal bleeding.

if you've ever had an ectopic pregnancy, you wouldn't want to risk another one!

if you are very heavy - the minipill may not provide a big enough dose for you.

Are there various kinds of minipill?
Yes. So if one brand doesn't suit you (say, if it gives you bad spots on your face), you can easily switch to another. At the time of writing (March 2001), there are six brands available in Britain. They are:

Group one (both identical) Micronor, Noriday.

Group two
Femulen.

Group three (broadly similar)
Microval, Norgeston (both identical), Neogest.

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