Searching for the right birth control can feel like a serious quest, and sometimes it takes trial and error to decide on the right option for you. One type that many people have had success with, though, is progestin-only birth control.
You may have heard the term thrown around at your doctor’s office or even with your friends. But it can be difficult to keep track of all the different birth-control options, and it’s understandable to have questions. Here’s the deal with progestin-only birth control and how to decide if it’s right for you.
What Is Progestin-Only Birth Control?
Let’s back up a sec here: progestin is a form of progesterone, a hormone that’s involved in your menstrual cycle and pregnancy, according to the American College of Obstetricians and Gynecologists (ACOG).
Progestin in the form of birth control works a few ways to prevent pregnancy, ACOG explains. It thickens mucus in the cervix, making it tough for sperm to enter the uterus and fertilize an egg; it stops ovulation; and it thins the lining of the uterus.
What Are the Types of Progestin-Only Birth Control?
Progestin is also used in several birth-control methods. Those include:
- The mini pill: The mini pill is a small, progestin-only pill that’s designed to be taken at the same time each day, per ACOG. With typical use, this pill is 91 percent effective, ACOG says.
- The shot (Depo-Provera): The shot contains the hormone depot medroxyprogesterone acetate, which protects against pregnancy for 13 weeks, ACOG explains. (You’ll need four injections a year.) It’s 94 percent effective when typically used, per ACOG.
- Certain intrauterine devices (IUDs): There are different types of IUDs — one type that contains copper and others that contain progestin. The progestin-only IUDs are a T-shape device that is implanted in your uterus, per ACOG. There, the IUD prevents the fertilization of an egg with sperm. It’s 99 percent effective at preventing pregnancy, ACOG says.
- The implant (Nexplanon): The implant is a flexible, plastic rod about the size of a matchstick that’s inserted just under the skin in the upper arm. There, it releases progestin in the body, ACOG explains. Like the progestin IUD, the implant is 99 percent effective at preventing pregnancy.
What Are the Benefits of Choosing Progestin-Only Birth Control?
Progestin-only birth control tends to be well-tolerated, and it doesn’t typically have many side effects, says Christine Greves, MD, a board-certified ob-gyn at the Winnie Palmer Hospital for Women and Babies.
It’s also just a better choice for some people who won’t do well on birth-control methods that contain the hormone estrogen, says Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology and reproductive sciences at Yale Medical School. Some people may be advised not to use estrogen, like those who are breastfeeding, Dr. Minkin says. Others with certain types of migraines, like migraines with aura, shouldn’t use combined estrogen and progestin pills, she says.
And then there’s personal preference. Some people just “do not feel well with estrogen-containing pills,” Dr. Minkin says — in which case, a progestin-only method is helpful.
Who Is Progestin-Only Birth Control Good For?
There are many options to choose from in this birth-control category, Dr. Greves says, making it often a good choice for a lot of people seeking contraception. But there’s some variation between each one. Here’s who doctors typically recommend check out each method:
- The mini pill: “The mini pill is good for someone who is breastfeeding and can remember to take a pill every day,” Dr. Greves says. It can also be helpful if you know you want to get pregnant in the near future, Dr. Minkin says. “You decide you want to get pregnant,” she says. “Just stop taking the pill.”
- The shot (Depo-Provera): This can be a good option for those who don’t want to take a daily pill but also don’t want to have a device implanted in them, Dr. Greves says. Most people with uteruses or assigned female at birth (AFAB) “will not get periods with this method, but they may experience some spotting,” Dr. Minkin says. “And if you are thinking of a pregnancy in the near future, you don’t want to use Depo-Provera because although you might be able to conceive three months after your last shot, it could take as long as nine months to get out of your system.”
- Certain intrauterine devices (IUDs): A progestin IUD is good for “someone who is not interested in conceiving within the next year, cannot take estrogen, and has a difficult time remembering to take a pill at the same time each day,” Dr. Greves says. It’s also a great “set it and forget it” method of birth control that can last for years, she says.
- The implant (Nexplanon): The implant is good for someone who wants to avoid a daily pill, Dr. Greves says. You may experience some erratic bleeding for a number of months, Dr. Minkin says. “But these are also extremely effective for contraception.”
Progestin-Only Birth-Control Side Effects
Side effects from progestin-only birth control can vary by type, whether it’s the mini pill, shot, IUD, or implant. This is what you could experience from each method of contraception, according to ACOG:
- Mini pill: Short cycles of bleeding or spotting, headaches, nausea, and breast tenderness
- The shot (Depo-Provera): Irregular bleeding, longer periods of bleeding, or spotting
- Certain intrauterine devices (IUDs): Spotting, headaches, nausea, breast tenderness, and mood changes
- The implant (Nexplanon): Unpredictable bleeding, digestive issues, headaches, breast pain, weight gain, and acne
How to Pick the Right Progestin-Only Birth Control
It’s a good idea to have a conversation with your doctor, Dr. Minkin says. “Always speak with your provider and be upfront about your periods, your feelings about getting a period, and how likely you are to remember to take a pill,” she says, noting that you should also discuss whether you want to get pregnant sometime in the near future.
Dr. Greves agrees. “It’s best to talk to your doctor,” she says. “Together, you can figure out what’s right for you.”