Progestogen only pill

Progestogen only pill

Benefits

  • Periods may be irregular – more or less frequent or stop or become lighter or heavier
  • May help with premenstrual symptoms or painful periods
  • Suitable for those who can’t take oestrogen or the combined pill
  • You don’t have to prepare for or interrupt sex
  • You are protected from pregnancy straight away if you start taking it on the first day of your period
  • When you stop using the pill your fertility will return to normal.

The progestogen-only pill (also known as ‘POP’) is a small round tablet that releases a progestogen hormone. It has to be taken daily. Almost half of all women take oral contraceptive pills as their primary method of contraception. POP is most popular amongst women aged between 16 and 24.

Progestogen only pill effectiveness
Progestogen only pill lasts for
Progestogen only pill period cycle
Progestogen only pill side effects

*for typical use (effectiveness for perfect use 99%)
**very variable, heavier or lighter

How it works

How to use it

Progestogen only pill how

You will need to take one pill every day. There are 28 pills per pack, and you do not take a break between packs. There are two different types of POP: ‘3 hour’ pills must be taken within the same 3 hour period every day. ’12 hour’ pills must be taken within the same 12 hour period.

Choose a convenient time in the day to take your first pill, and continue to take it close to that time every day.

Why it works

Progestogen only pill why

The hormone in POP prevents pregnancy by:

  • Thickening the mucus in the neck of the womb, so it is harder for sperm to penetrate the womb and reach an egg
  • In some women, POP prevents the ovaries from releasing an egg each month (ovulation)
  • Thinning the lining of the womb, so there is less chance of a fertilised egg implanting into the womb.
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Things to consider

POP does not protect you from STIs. You should use a condom as well if you think you are at risk of an STI.

You need to remember to take your pill every day. If you find that you often miss a pill, there are long lasting contraception options available.

What if?

You miss a pill:

  • The chance of getting pregnant depends on when the pills are missed and how many pills are missed. Read more in our Questions section
  • If you are not sure what to do, continue to take your pill and use another method of contraception, such as condoms, and seek advice from your sexual health clinic or GP as soon as possible.

The pill can become less effective at preventing pregnancy if:

  • You have vomiting and/or diarrhoea, as the pill may not be absorbed into your bloodstream. Read more in our Questions section
  • You are taking some medicines. Ask your clinician or pharmacist and read the information that comes with your medicine. Always tell your doctor that you are taking the progestogen only pill if you are prescribed any medicines
  • Follow the instructions in your packet. If you have any questions about taking the pill, ask your clinician or pharmacist. It's important to take the pills as instructed to ensure they are effective.

Suitability

Most women can take POP, but your clinician will ask about your family and medical history to determine whether or not it is the best method for you.

POP is useful for women who cannot take oestrogen, or those who smoke and are 35 or over.

POP is not always suitable for women who:

Side effects & risks

Although serious side effects are not common, there are some risks associated with POP.

Common Rare
Short term:

Spotty skin, breast tenderness, nausea / vomiting, stomach upset, weight change and headaches, change to sex drive or mood. These should go after a few months.

Long term:

Periods may be irregular, lighter, heavier or more frequent or may stop altogether.

Some women may develop small fluid-filled cysts on their ovaries. These are not dangerous and do not usually need to be removed.

You should discuss any concerns with your clinician.

Questions?

If you start your pill in the first five days of your cycle then it will be effective immediately. If you start your pill at any other time on your cycle then you should use additional protection for 48 hours.

The progestogen only pill may prevent ovulation and therefore prevent you going through your usual menstrual cycle.

There are two types of POP:

Progestogen only pill time 3hr

3 hour

Progestogen-only pill must be taken within three hours of the same time every day. Common brands include: Femulen, Micronor, Norgeston and Noriday

Progestogen only pill time 12hr

12 hour

Progestogen-only pill must be taken within 12 hours of the same time every day. Common brands include: Cerazette.

The chance of getting pregnant depends on: when the pills are missed, how many pills are missed and whether you have had sex without using another form of contraception in the last 7 days.

Progestogen only pill time1

If you are taking a three-hour progestogen-only pill and are less than three hours late taking it, or if you are taking the 12-hour progestogen-only pill and are less than 12 hours late:

  • Take the late pill as soon as you remember, and
  • Take the remaining pills as normal, even if that means taking two pills on the same day.

The pill will still work, and you’ll be protected against pregnancy – you do not need to use additional contraception. Don’t worry if you have had sex without using another form of contraception. You do not need emergency contraception.

Progestogen only pill time2

If you are taking a three-hour progestogen-only pill and are more than three hours late taking it, or are taking the 12-hour progestogen-only pill and are more than 12 hours late you will not be protected against pregnancy. - and you may need emergency contraception.

You should:

  • Take the last pill you missed straightaway (if you have missed more than one, take only one)
  • Take your next pill at the normal time
  • Depending on when you remember, it may mean taking two pills on the same day (one at the time of remembering, and one at the regular time), or even at the same time
  • If you are taking a three-hour pill (such as Femulen, Micronor, Norgeston or Noriday) you will need to use additional contraception for two days after missing the pill. It takes two days for the pill's contraceptive effect on cervical mucus to be re-established after missing a pill
  • If you are taking a 12-hour pill that stops ovulation (a desogestrel pill, such as Cerazette), you will need additional contraception for two days.

If you vomit within two hours of taking the progestogen only pill, it may not have been fully absorbed into your bloodstream. Take another pill straight away and the next pill at your usual time.

If you don’t take the replacement within three hours (or 12 hours for the 12-hour pill) of your normal time, use additional contraception, such as condoms, for two days (7 days for the 12-hour pill).

If you continue to be sick, keep using another form of contraception while you're ill and for two days after recovering.

Very severe diarrhoea (6 to 8 watery stools in 24 hours) may also mean that the pill doesn't work properly. Keep taking your pill as normal, but use additional contraception, such as condoms, while you have diarrhoea and for two days after recovering (7 days if you are taking a 12-hour pill).

Speak to your GP or contraception nurse or call NHS 111 for more information, or if your sickness or diarrhoea continues.

You may not be able to take POP if you have or have had:

  • Heart disease or a stroke
  • Disease of the liver
  • Systemic lupus erythematosus
  • Breast cancer.

Speak to your GP or sexual health clinic about whether POP is right for you.

If you are healthy and there are no medical reasons for you not to take the POP, you can take it until your menopause or until you are 55 years old.

Some reports suggest that there may be a very small increased risk of breast cancer and ovarian cancer, but the pill does help protect against other types of cancers such as womb, colon and uterine cancers.

There is no evidence to suggest the pill causes infertility. Most women who have regular periods will find that their normal cycle will return within six months. Some women find that their usual cycles begin again very quickly after stopping, but for others it can take longer.

Some reports suggest that there may be a very small increased risk of breast cancer and cervical cancer, but the pill does help protect against other types of cancers such as ovarian, colon and uterine cancers.

Some women may develop small fluid-filled cysts on their ovaries. These are not dangerous and do not usually need to be removed.

When you first start the pill you will usually be given three months' supply to see how it suits you. After that you should go back to the doctor or nurse to get new supplies and to have your blood pressure checked. If there are no problems, you can be given up to a year’s supply of the pill.

You may sometimes be provided with or prescribed a different brand of pills, but the nurse or clinician will explain that the hormones and doses will be the same. The clinics are likely to stock the pill that was cheaper at the time.

The POP has a different hormone than the combination in the combined pill, so if you have had side effects on the combined pill then you may wish to try the progestogen only pill as an alternative.

Yes, you can easily change between pills.

Some women find that their weight changes due to fluid retention or an increase in appetite, but this should settle over time.

Some medicines make the progestogen only pill less effective (including those used to treat epilepsy, HIV and TB, and the herbal medicine St John’s Wort). Ask your GP, clinician or pharmacist and read the information that comes with your medicine.

The antibiotics rifampicin and rifabutin (which can be used to treat illnesses including tuberculosis and meningitis) can reduce the effectiveness of the progestogen only pill. Other antibiotics do not have this effect. If you are prescribed rifampicin or rifabutin, you may need additional contraception (such as condoms) while taking the antibiotic and for 28 days after.

Always tell your doctor that you are taking the progestogen only pill if you are prescribed any medicines.

When you stop using the POP your fertility will return to normal. (Don’t worry if your periods don’t start immediately. For some women it can take a few months).

Yes, you can use the POP after having a baby.

Yes, you can use the POP while breastfeeding.

Where can I get it?

The POP is available free on the NHS. You should visit your sexual health clinic or GP to discuss your suitability.

You can also order the progestogen only pill now from SH:24 for free.