Microval is a contraceptive pill containing levonorgestrel 30 micrograms — a progestogen-only pill, often called the mini-pill. It prevents pregnancy, is taken every day without a break, and is suitable for many women who cannot take the combined pill, including while breastfeeding.
What is Microval?
The South African Medicine Price Registry lists Microval as a Schedule 2 tablet containing levonorgestrel 30 micrograms.
It is a progestogen-only pill (POP), not a combined pill. That distinction governs everything about how it is taken.
The combined pill contains an oestrogen and a progestogen, comes in packs of 21 active tablets plus a break or dummy week, and works mainly by preventing ovulation.
The progestogen-only pill contains one hormone. Every tablet is active, there is no break, and packs run continuously — you start the next pack the day after finishing the last.
How it works. Levonorgestrel at this dose acts mainly by thickening cervical mucus, so sperm cannot pass through into the uterus. It also thins the uterine lining and, in some cycles, prevents ovulation — but ovulation suppression is inconsistent with the older levonorgestrel POPs, so the mucus effect is the primary mechanism.
That mechanism explains the strict timing. The mucus effect builds within hours of a dose and begins to wear off after about 24 hours. With levonorgestrel POPs, a tablet more than 3 hours late counts as missed — a much narrower window than the 12 hours allowed with desogestrel POPs or the 24 hours with the combined pill. This is the single most important practical fact about Microval, and the commonest reason it fails.
Who it suits. The POP is a good option where oestrogen must be avoided: breastfeeding, migraine with aura, high blood pressure, a history of blood clots, smokers over 35, obesity, and some other cardiovascular risks. Because there is no oestrogen, it does not carry the clot risk of the combined pill.
Levonorgestrel POPs are also sold as Nordette-type mini-pills and generics. Note that levonorgestrel at a much higher dose (1.5 mg) is the morning-after pill — the same hormone, an entirely different product and purpose.
What is Microval commonly used for?
- Preventing pregnancy, its sole purpose.
- Contraception while breastfeeding, where it is a standard choice and does not affect milk supply.
- Contraception where oestrogen is unsuitable — migraine with aura, clot history, high blood pressure, smoking over 35 — or where the combined pill caused side effects.
- Contraception approaching menopause, where it can be continued longer than the combined pill.
Effectiveness depends almost entirely on timing. With perfect use, progestogen-only pills are over 99 per cent effective. With typical use — real people, real lives — that falls to around 91 per cent, and the gap is almost all missed or late tablets. A daily alarm genuinely changes the outcome.
It does not protect against HIV or other STIs. Only condoms do that.
Expect your bleeding pattern to change. This is the commonest reason women stop the POP, and it is worth knowing in advance:
- Irregular or unpredictable spotting is very common, particularly in the first three to six months.
- Periods may stop altogether, which is not harmful.
- Periods may become lighter, or occasionally more frequent.
None of these mean it is not working. The pattern often settles by six months — worth giving it that long before switching, unless the bleeding is heavy or troubling.
How Microval fits into this medicine category
| Method | Type | Notes |
|---|---|---|
| Progestogen-only pill (Microval) | Daily tablet | No oestrogen; strict 3-hour window |
| Desogestrel POP | Daily tablet | 12-hour window; suppresses ovulation more reliably |
| Combined pill | Daily tablet | Oestrogen + progestogen; clot risk; 7-day break |
| Injection | 2–3 monthly | No daily tablet; delayed return of fertility |
| Implant | 3 years | Most effective reversible method |
| Hormonal IUD | 5–8 years | Very effective; lighter periods |
| Copper IUD | 5–10 years | Hormone-free; heavier periods |
| Emergency contraception | One-off | Not a regular method |
For related guides see Primolut N and the sexual health and urology hub.
Worth knowing: the implant and IUDs are considerably more effective than any pill, because they remove the daily-timing problem entirely. In South Africa both are available free at public clinics. If remembering a tablet within a 3-hour window every day sounds difficult, that is a reason to discuss them rather than to persevere.
What to check before using Microval
Tell your doctor or pharmacist if you:
- Have or have had breast cancer.
- Have unexplained vaginal bleeding, which needs investigating before starting.
- Have severe liver disease or a liver tumour.
- Have had an ectopic pregnancy before.
- Have ovarian cysts.
- Take enzyme-inducing medicines — carbamazepine, phenytoin, phenobarbital, rifampicin, some HIV medicines, or St John’s Wort. These substantially reduce effectiveness, and additional contraception or a different method is needed. This interaction is easy to miss and it causes pregnancies.
- Have diabetes, high blood pressure or high cholesterol.
- Are breastfeeding — the POP is suitable, but confirm the timing of starting.
- Could already be pregnant.
Practical points:
- Take it at the same time every day, with no break between packs.
- Set a daily alarm. With a 3-hour window this is not optional advice.
- If you are more than 3 hours late, take it as soon as you remember, continue as normal, and use condoms for the next 2 days. If you had unprotected sex in that time, seek advice about emergency contraception.
- If you vomit within 2 hours of taking it, or have severe diarrhoea, treat it as a missed pill.
- Starting it: if begun on day 1 to 5 of your period, it works immediately. Started at any other time, use additional contraception for 2 days.
- Collect your next pack before you run out.
Possible cautions and when to ask a pharmacist or doctor
Common effects: irregular bleeding or spotting, headache, breast tenderness, nausea, mood changes, acne and reduced or absent periods. Most settle within three to six months.
Get emergency help for:
- Severe one-sided lower abdominal pain, particularly with a late or unusual period, faintness or shoulder-tip pain. An ectopic pregnancy must be excluded urgently. The POP does not cause ectopic pregnancy, but if a pregnancy occurs on it, the risk that it is ectopic is relatively higher.
- Severe chest pain or breathlessness, or severe calf pain and swelling.
- Sudden severe headache, weakness, numbness, or difficulty speaking.
- Yellowing of the skin or eyes.
Seek prompt advice for:
- A missed period, or a period that is unusually light, if you have missed or been late with a tablet. Take a pregnancy test.
- Heavy or prolonged bleeding.
- Bleeding after sex.
- A new breast lump.
- Persistent low mood since starting it.
- Severe abdominal pain.
- Starting a new medicine, particularly an antibiotic such as rifampicin or an anti-epileptic.
See a doctor if:
- The bleeding pattern is unacceptable after six months. There are many alternatives; persevering with something that makes you miserable is not necessary.
- You keep missing tablets. That is a reason to discuss the implant, injection or an IUD, not a personal failing.
- You want STI testing, which the pill does nothing for.
- You are approaching menopause and want to know when contraception can stop.
Related medicine guides
- Browse Sexual Health & Urology Medicines guides
- Read: Primolut N used for
- Read: Kamagra Oral Jelly used for
Frequently asked questions
What are Microval pills used for? Preventing pregnancy. Microval is a progestogen-only contraceptive pill containing levonorgestrel 30 micrograms.
Is it the same as the combined pill? No. It contains one hormone rather than two, is taken every day with no break, and has a much stricter timing window.
How late can I take it? Up to 3 hours. Later than that counts as a missed pill — use condoms for the next 2 days.
Do I take a break between packs? No. Start the next pack the day after finishing the last, with no gap.
Can I take it while breastfeeding? Yes. The progestogen-only pill is a standard choice while breastfeeding and does not affect milk supply.
Why has my period stopped, or become irregular? Both are common and expected on the POP, and neither means it has stopped working. The pattern often settles by six months.
Does it protect against HIV or STIs? No. Only condoms do.
Is it the same as the morning-after pill? Same hormone, very different product. The morning-after pill contains levonorgestrel 1.5 mg — fifty times the dose — as a single emergency tablet.
What if I miss one? Take it as soon as you remember, carry on as normal, and use condoms for 2 days. If you had unprotected sex in that window, ask about emergency contraception.