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Progestin-only contraceptives primarily function through mechanisms that prevent pregnancy by altering the conditions within the female reproductive system. A significant action of these contraceptives is the thickening of cervical mucus, which creates a barrier to sperm transport. This cervical mucus becomes less permeable to sperm, effectively inhibiting their movement through the cervix into the uterus, thus reducing the likelihood of fertilization.

In addition to this primary mechanism, progestin-only contraceptives also work by thinning the endometrial lining, making it less receptive to a fertilized egg. However, the main emphasis is on the alteration of cervical mucus, making it the predominant method of birth control when it comes to progestin-only options. Other potential mechanisms, such as altering hormonal feedback or affecting ovulation, are not the primary focus of these contraceptives as they primarily act through barrier effects and endometrial changes.