Health benefits, risks and side effects of the progestogen only pill
The main side effect of the progestogen only pill is irregular bleeding. It’s very safe to take – there are almost no medical reasons why you shouldn’t take it, as it has very few health risks.
It doesn’t interact with any of the conditions that mean you can’t take the combined pill, including; history or family history of thrombosis, migraines with aura, or body mass index (BMI) over 35.
This means it’s usually safe to take the progestogen only pill if you’ve had a history of blood clots.
It isn’t suitable for people who have:
breast cancer or who have a history of breast cancer
severe liver disease
irregular vaginal bleeding, unless you’ve investigated the treatable causes
Real contraception experiences
Having no period on a progestogen only pill was great. You'll be fine if you can deal with not having a period. I know that's not good for everyone. A few people I know said they wouldn't feel comfortable not knowing if they were late.
My doctor switched me to the mini pill because of migraines on the combined pill. I took it for 6 months and it made me bleed constantly for over a month, a week later I started bleeding all over again. I put up with it for a while and then switched to the copper coil because I couldn’t stand it anymore.
I've been on the mini pill for about 2 years. It’s made my periods completely irregular, I don’t know when I am going to bleed. It can last 10 days at a time but it is usually quite light and less cramps. I've had zero weight changes, my skin has been OK and no mood changes. I haven't had any pregnancy scares - I’ve set an alarm on my phone and when that goes off I reach for my pill pack. Overall, it's been fine.
Health benefits of the progestogen only pill
Can help with ovulation pain
As the progestogen only pill containing desogestrel stops ovulation in 97% of people who use it, it can help with ovulation pain. No ovulation means no pain.
Can help with menstrual problems, but can also make them worse
Half of all people on the progestogen only pill have either no bleeding or infrequent bleeding. This means it can help with heavy periods, painful periods, anaemia associated with heavy periods and endometriosis.
It’s important to know that it might also cause frequent or prolonged bleeding in some people, which could make these conditions worse.
If you’re choosing the progestogen only pill to help with menstrual problems, it's hard to know if you’ll be in the group whose periods get better or the group whose periods get worse.
But it’s easy to stop and start the progestogen only pill at any time, so it could be worth trying to see if it improves any problems you’re having with periods. You can always stop if it doesn’t.
It’s recommended to try it for a minimum of 3 months to see whether any early side effects settle down.
Health risks of the progestogen only pill
There are no serious health risks linked to using the progestogen only pill.
If you have breast cancer
There’s no known evidence that the progestogen only pill increases the risk of breast cancer. However, it’s not recommended for people who have current breast cancer. Many breast cancers grow more when more hormones are present, so methods of contraception that use hormones – such as the progestogen only pill – aren’t recommended for people who currently have breast cancer, just in case.
If you’ve had breast cancer in the past, then whether you can take hormonal contraceptives will depend on the type of contraceptive you’re considering and the type of breast cancer you’ve had.
Side effects of the progestogen only pill
There are common, proven side effects associated with using the progestogen only pill. There are also other side effects that some people experience, but without clear evidence that they’re caused by the pill. These side effects will not cause problems with your health, but they can be difficult to live with.
Irregular bleeding
This side effect has a proven link to taking the progestogen only pill.
If you take the pill containing desogestrel:
5 in 10 people can expect to have either no bleeding or infrequent bleeding
4 in 10 people can expect to have 3–5 bleeding or spotting episodes in 3 months
1 in 10 people can expect 6 bleeding or spotting episodes in 3 months
20% of people taking the progestogen only pill will get bleeds or spotting that last more than 14 days at a time
Although the progestogen only pill is still an effective contraceptive, this effect might not be something you want to live with.
If you do find that the irregular bleeding is a problem for you, try the pill for 3 months to see if the bleeding pattern settles down.
If it does not settle, there are things you can try to help. Take a look at our information about irregular bleeding and what you can do.
Unproven side effects
People have reported acne, mood changes, headaches and changes to sex drive while on the progestogen only pill. As there’s no medical evidence to directly link the pill to these changes, we can’t be sure that the effects are directly caused by it. But they are things you might experience on this contraception.
Changes in mood – a review of all the evidence
If you suffer from mood changes because of premenstrual syndrome (PMS) and the progestogen only pill stops you from ovulating, you should find that this improves.
A review of many different published studies found no evidence linking depression to taking progestogen methods of contraception, like the progestogen only pill, contraceptive injection and implant.
The review looked at both randomised controlled trials and observational studies.
Randomised controlled trials are one of the most reliable ways of testing. A group of people are randomly given either a progestogen only method of contraception or an alternative method. Then they’re asked if they’ve experienced any depression.
If more of the people on the pill experienced depression, it might suggest a link. But none of the studies that used these randomised controlled trials linked progestogen only pill use and depression.
Observational studies are another, less reliable, way of testing whether the progestogen only pill is linked to depression. These studies observe what happens after people have chosen a type of contraception. The problem here is that people with depression may just happen to choose this particular type of contraception.
In the review, some of the observational studies showed the progestogen only pill increased depression, and some showed it decreased depression.
Headaches
There’s some evidence that suggests that the progestogen only pill may reduce how often you get migraines. There’s no evidence that it increases the frequency of headaches or makes them worse.
Low sex drive
There’s no evidence to suggest that the progestogen only pill causes reduced sex drive.
But people have told us how the pill has affected their sex drive in different ways. You can read more about this in the contraception experiences.
Weight changes
There’s no evidence to suggest that using the progestogen only pill causes you to gain or lose weight. Some people do experience this, though.
Acne
Acne is caused by increases in the normal oils your skin produces to stop it drying out.
Testosterone and progestogen can increase how much oil your skin makes. The progestogen only pill may improve acne if it stops ovulation, as the ovary produces testosterone during ovulation.
However, progestogen itself can also increase the oiliness of the skin. So, unfortunately, how the progestogen only pill affects acne is a bit unpredictable.
Real contraception experiences
I've been on the progestogen only pill for well over a year and have loved it – it's stopped my periods completely and I've had no negative side effects.
I was on the mini pill for years. I didn't have a period in that whole time, but when we wanted to start trying for a baby, I came off the pill and my period came back within a very short time. I only had one period as I got pregnant straight away! Obviously, everyone’s body is different but I just wanted to give you a positive story!
I went back on a pill but this time chose the progestogen only one. It was great! No side effects at all and meant I could keep studying dance without having to worry about bleeding. However, recently I have started spotting which didn't happen the first time, and my mood swings/anxiety have shot through the roof. I understand the evidence doesn't support this theory, but in my case it was true.
Very rare side effects
Ectopic pregnancy
An ectopic pregnancy is a pregnancy that implants and starts to grow in the fallopian tubes or somewhere else outside the womb. Learn more about ectopic pregnancy here.
Pregnancy is very unlikely to occur at all on the progestogen only pill as it’s a very effective method of contraception. But if you do have a pregnancy while you’re on it, it’s slightly more likely to be ectopic. About 1 in 10 pregnancies that occur on the progestogen only pill that contains levonorgestrel is likely to be ectopic. There’s very little research on ectopic pregnancy and the desogestrel-containing progestogen only pill.
As the overall risk of pregnancy is so small, you can still take the progestogen only pill even if you’ve had an ectopic pregnancy in the past.
What to do if you experience side effects
Everyone experiences different types of hormonal contraception differently. If you're getting side effects that you do not like, keep a record of how you feel on it, then try a different method to see whether it’s any better.
Sometimes it can be hard to know if any symptoms you have are because of your contraception or something else.
We recommend that you:
keep a record of any side effects to see how they change over time
discuss it with your clinician, particularly if it carries on after using the contraception for 3 months
stop if you have unpleasant side effects over a longer period of time, and try an alternative method of contraception
Sometimes it takes a lot of trial and error before finding the right method of contraception for you. And what’s right for you may change over time. So just because one method suited you in the past, doesn’t mean it will suit you now.
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