Progesterone-Only Oral Contraceptive Pill
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—Elaine, 9th May 2022
What is the progesterone-only oral contraceptive pill and what is it used for?
POPs prevent pregnancy by thickening the mucus at the cervix (neck of the womb), preventing sperm from entering the womb to fertilise an egg. They can thin the lining of the womb, which may make it more difficult for a fertilised egg to implant.
Newer POPs can also act on the ovaries to reduce the frequency of ovulation (release of an egg). This provides more effective contraceptive cover than older POPs, which do not reduce ovulation as reliably.
Please note: Oral contraceptive pills do not protect against sexually transmitted infections (STIs). You should always use a barrier method, such as a condom, to reduce your risk of STIs.
Important Medical Information
Who is this service suitable for?
This service can provide progesterone-only oral contraceptive medication for female (birth sex) patients aged between 17 and 55 years, subject to clinical suitability.
To use this oral contraceptive pill service safely, we require up-to-date height & weight measurements and a recent blood pressure reading. If you have had a recent blood pressure check by your GP/ nurse, you can use this. If not, a reading from your local gym, pharmacy or home monitor can be used.
We are not able to provide prescriptions for contraceptive injections, implants or coils via this service.
Please be aware, this service is not suitable if you have malabsorption problems from any cause, including after weight loss surgery (e.g. gastric band or sleeve). You should speak with your local GP or family planning clinic for contraceptive advice.
How do you take the progesterone-only oral contraceptive pill?
If this is your first time taking a progesterone-only oral contraceptive pill or you are restarting:
- Start it on days 1-5 of your next period and you will have full contraceptive cover immediately.
- If you have not been sexually active since your last period, you can start it at any time of your cycle. If taken correctly, you will have full contraceptive cover after 48 hours. You should use additional contraception during this time.
- If you are changing from another contraceptive pill/form of contraception, please contact us via your patient record for specific instructions.
Each progesterone-only pill packet contains 28 tablets and is labelled with the days of the week and arrows to follow. Start the packet with the correctly labelled pill from the top row.
It is essential that you take your pill at the same time every day.
When you have finished the packet, start a new packet the next day; do not wait for a period or stop when you bleed. This is a daily pill, there is no break.
What are the potential side effects of progesterone-only oral contraceptive pills?
Progesterone-only contraceptive pills are very well-tolerated The most common side effect reported is a change in bleeding pattern:
- 20% will have no bleeding
- 40% will have regular bleeding
- 40% will have irregular bleeding
Occasionally, this bleeding pattern may change. Although frustrating as it is unpredictable, the actual bleeding pattern is of no medical consequence. However, if you do develop bleeding out of the blue, it is important to speak with a doctor about this.
Other progesterone-only pill side effects include breast tenderness, bloating, headaches, mood swings, and acne. These are not common and usually settle within the first few months.
Ovarian cysts can occasionally develop when using the POP. These can cause pain, but are not dangerous and usually resolve when the pill is stopped.
There is a small increased risk of breast cancer in women who use all forms of hormonal contraception, compared with those who do not. If you are concerned about this, you should discuss this with a doctor via online video consultation.
There is no evidence that the POP causes weight gain.
For full details of potential mini pill side effects, please ensure that you read the patient information leaflet that comes with your medication before you start to use it.
Does taking the mini pill increase my risk of getting a blood clot?
Can I delay my period when taking the progesterone-only oral contraceptive pill?
Unfortunately, you cannot delay your period by using POPs. This type of pill does not provide good cycle control and the bleeding pattern is often unpredictable. However, some patients will have very light bleeding or no bleeding at all when using the progesterone-only contraceptive pill.
If you are due your period and you would like to delay it, you may request Period Delay Treatment via our online prescription service. This treatment contains a synthetic version of the hormone progesterone and works by keeping the progesterone levels high in the body and so, delaying the start of your period. You may use this medication to delay your period by up to 17 days. Please note: this is not guaranteed and some women do spot or bleed when using this medication.
What happens if I forget to take a progesterone-only oral contraceptive pill?
The main concern about missing your pill is what effect this will have on your contraceptive protection. This depends on how late your missed pill is and how many you missed.
If you forget to take your progesterone-only contraceptive pill, take it as soon as you remember and the next one at the usual time (do not take more than one missed pill). This may mean taking 2 pills in one day.
What to do also depends on the type of POP you are taking.
If it is an older POP:
- If the missed pill is less than 3 hours late, then you still have contraceptive cover provided you have taken the previous pills in your packet correctly.
- If the missed pill is more than 3 hours late, then you do not have contraceptive cover and you are not protected against pregnancy. Continue to take your pills as usual and use additional contraception for 2 full days, until contraceptive cover begins again.
If it is a newer POP:
- If the missed pill is less than 12 hours late, then you still have contraceptive cover provided you have taken the previous pills in your packet correctly.
- If the missed pill is more than 12 hours late, then you do not have contraceptive cover and you are not protected against pregnancy. Continue to take your pills as usual and use additional contraception for 2 full days, until contraceptive cover begins again.
Advice for all POPs:
If you have unprotected sex after the missed pill or in the 48 hours when you do not have contraceptive cover, you will need to take emergency contraception. To discuss the best emergency contraception options, you can speak with a GP via online video consultation.
If you have vomiting or diarrhoea within 2 hours of taking your pill, then it may not be absorbed properly. Carry on taking the pill but use other forms of contraception for the duration of the illness and for 48 hours after.
If you have any questions or concerns about this, please speak to a Healthcare Professional.
Progesterone-only contraceptive pills are most effective if taken correctly. If you are having trouble remembering to take your pill here are some tips to help:
- Set a reminder on your phone.
- Try to take it in the morning so you have more time to remember if you forget.
- Combine pill-taking with another morning task e.g. leave your pill packet beside your toothbrush.
- Download a reminder App.
If you still have problems remembering to take your pill then you should speak with a doctor about alternative contraceptive options.
If you are using progesterone-only oral pills for reasons other than contraception, then missing a very occasional pill is of no significant consequence.
Can I take other medications with the progesterone-only contraceptive pill?
Some medications (prescribed and over the counter), herbal remedies and supplements can interact with the progesterone-only contraceptive pill. This can cause contraceptive failure and increase the possibility of potential side effects.
Please seek advice from a healthcare professional (e.g. doctor, pharmacist or nurse):
- Before starting any new medications, herbal remedies or supplements if you are taking the progesterone-only oral contraceptive pill.
- If you are taking regular medication and are planning to start using progesterone-only contraceptive pills (or any contraceptive).
Examples of medications that can interact with progesterone-only pills include emergency contraceptive pills, St John’s wort, antiviral medications used to treat HIV/ AIDs, certain epilepsy medications, some antifungal medications, and some antibiotic medications.
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