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Progestogen Only Pill
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| The progestogen only pill (POP) is an effective method of contraception if used correctly. It is commonly used when the combined pill (which also contains oestrogen) is not suitable. It can also be safely taken if you are breastfeeding. |
How does the POP work?
The POP contains a progestogen hormone. This is similar to the progesterone hormone made by the ovaries. It works mainly by thickening the mucus made by the cervix which forms a 'mucus plug' in the cervix. This stops sperm from getting through to the uterus (womb) to fertilise an egg. The POP also makes the lining of the uterus thinner. This makes it unlikely that a fertilised egg will be able to attach to the uterus. It also has some effect on the ovary and ovulation may not occur (the release of an egg each month). One type of POP, Cerazette®, stops ovulation in more than 9 out of 10 women.
How effective is the POP?
The POP is 99% effective if taken correctly. This means that 1 woman in 100 using the POP correctly will become pregnant each year. (Compare this to when no contraception is used. More than 80 in 100 sexually active women who do not use contraception become pregnant within one year.) Correct use includes taking it at the same time every day. If it is not taken correctly, more women will become pregnant.
What are the advantages of the POP?
It does not interfere with sex. You can take it when you are breastfeeding. The risks associated with the oestrogen in the combined pill (for example blood clots) do not occur. It can therefore be used by some women who cannot take the combined pill. For example, if you are over 35 and smoke, if you have migraines, if you have high blood pressure.
What happens to your periods when you take the POP?
The effect on periods can vary. Some women taking the POP continue to have regular normal periods. However, some have irregular periods and some have very infrequent, or no, periods. Some women also have occasional 'spotting' between periods.
Changes in bleeding patterns with POP use are common: 2 in 10 women have no bleeding, 4 in 10 women have regular bleeding and 4 in 10 women have irregular bleeding. You should continue to take the POP everyday, including when you have periods. However, if you do develop irregular bleeding while taking the POP then you should inform your doctor. Irregular bleeding can sometimes be due to another reason, for example an infection, which may need to be treated.
Are there any side-effects with taking the POP?
Side-effects are uncommon. If one or more do occur, they often settle down over a couple of months or so. Examples of possible side-effects include: mood swings, reduced sex drive, increase in acne and breast discomfort.
Who cannot take the POP?
Most women can take the POP. Your doctor or family planning nurse will discuss any current and past illnesses. For example, you should not take the POP if you have recently had breast cancer, have hepatitis or take certain medication.
How do I take the POP?
Start taking the pill on the first day of your next period. It is immediately effective from then on. If you start on any other day, you should use additional contraceptive methods (such as condoms) for the first two days until the POP has become effective. If you have just had a baby the POP is immediately effective if you start taking it before day 21 after the birth. There are different brands of POP.
You should take the POP at the same time of day, every day. Any time of day will do, but the most important thing is to get into a routine. Do not stop taking it when you have a period. You should take it every day. When you finish one pack, start another the next day. If you take a pill more than three hours later than usual (12 hours for a POP called Cerazette®), you lose protection (see below).
What if I forget to take a pill?
If you forget a pill, take it as soon as you remember. If you are more than three hours late in taking it (12 hours for a POP called Cerazette®) then your protection immediately fails. Continue taking your pill each day, but you will need to use extra contraception for two days (such as condoms) until the POP becomes effective again.
What if I am ill with vomiting or diarrhoea?
If you vomit within three hours of taking your POP or have severe diarrhoea, the pill will not be absorbed. Carry on taking the POP as usual, but you will need to use other forms of contraception (such as condoms) for the duration of the illness plus a further seven days after the vomiting or diarrhoea have stopped.
Do other medicines interfere with the POP?
Some medicines may interfere with the POP and make it less effective. Tell the doctor or pharmacist that you take the POP if you are prescribed or buy another medicine.
Further information
Your GP, practice nurse, and pharmacist are good sources of information if you have any queries.
The fpa (formerly the family planning association) also provide information and advice.
fpa's Helpline: 0845 310 1334 or visit their website www.fpa.org.uk
References
- Progestogen-only Pills, Faculty of Family Planning and Reproductive Health Care RCOG (November 2008)
- Milsom I, Korver T; Ovulation incidence with oral contraceptives: a literature review. J Fam Plann Reprod Health Care. 2008 Oct;34(4):237-46. [abstract]
- Contraception, Clinical Knowledge Summaries (2007)
The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest. Find out more about updating.
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