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Progestogen only pill (POP)



Click here to watch a video about the progestogen only pill and here to watch a video on how to take the progestogen only pill.

  • 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.

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.

Effectiveness
91%
Lasts for
Varies
Period cycle**
Irregular
Side effects
Rare

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


How it works

How to use it

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 2 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

Why it works

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.


Watch a video of a clinician explaining how to take POP.

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.
  • 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.
  • 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:

  • think they may be pregnant;
  • are taking certain medicines;
  • have or have had certain health conditions.

Side effects & risks

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

Common

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.

Rare

Long term:

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?


Does the progestogen only pill cause weight gain?
open

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


Why does POP affect my periods?
open

The progestogen only pill may prevent ovulation and therefore prevent you going through your usual menstrual cycle. It is normal for POP to stop periods or make them lighter or irregular. At the beginning this may be worrying, and some people will end up taking a few pregnancy tests before they feel confident that the pill is working.


How quickly does POP start protecting me against pregnancy?
open

If you start your pill in the first day 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.


What is the difference between the various brands of POP?
open

There are 2 types of POP: 3 hour progestogen-only pill must be taken within 3 hours of the same time every day. Common brands include: Femulen, Micronor, Norgeston and Noriday 12 hour progestogen-only pill must be taken within 12 hours of the same time every day. Common brands include: Cerazette.


Can I take POP if I’m approaching menopause?
open

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.


Is the POP less likely to give me mood swings and other side effects than the combined pill?
open

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.


I am on the 3 hour window pill, can I change to the 12 hour window one?
open

Yes, you can easily change between pills.


What if I miss a pill?
open

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 such as condoms.

First check your pill packet. If you are on a pill containing desogestrel then you are taking a 12 hour pill. This means that each pill must be taken within 12 hours of the same time every day. If you are less than 12 hours late, then take the missed pill as soon as you remember and take your next one on time. You do not need to take extra precautions as the pill will still work, and you’ll be protected against pregnancy. If you are more than 12 hours late, then take your missed pill as soon as you remember it, take the next one on time and keep taking the pill. You may want to consider emergency contraception. You will not be protected until you have taken 2 more pills at the correct time and will need to use condoms when you have sex for those 2 days. You will be able to rely on your pill for contraception again at about the time that you are due to take your third pill.

If you are on a pill containing norethisterone or levonorgestrel, then you are taking a 3 hour pill. This means that the pill must be taken within 3 hours of the same time every day. If you are less than 3 hours late, then take the missed pill as soon as you remember and take your next one on time. You do not need to take extra precautions as the pill will still work, and you’ll be protected against pregnancy. If you are more than 3 hours late, then take your missed pill as soon as you remember it, take the next one on time and keep taking the pill. You may want to consider emergency contraception. You will not be protected until you have taken 2 more pills at the correct time and will need to use condoms when you have sex for those 2 days. You will be able to rely on your pill for contraception again at about the time that you are due to take your third pill.


Can taking POP increase the risk of developing cancer?
open

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.


Can I use POP whilst breastfeeding?
open

Yes, you can use the POP while breastfeeding.


I don’t like the thought of taking medication for a long time. Will there be any long-term effects on my health if I take the POP for several years?
open

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 6 months. Some women find that their usual cycles begin again very quickly after stopping, but for others it can take longer.


Why do the pill packets look different?
open

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.


Will the POP affect my future fertility?
open

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.)


I’ve heard that some women get cysts from POP, are these serious?
open

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


Why does the doctor only give me a couple of months supply of the pill?
open

When you first start the pill you will usually be given 3 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.


Can medicines affect how the pill works?
open

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.


Can I use POP after having a baby?
open

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


I’ve had a serious health condition; can I take POP?
open

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


What if I vomit or have diarrhoea whilst taking the progestogen only pill?
open

If you vomit within 2 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 3 hours (or 12 hours for the 12 hour pill) of your normal time, use additional contraception, such as condoms, for 2 days. If you continue to be sick, keep using another form of contraception while you're ill and for 2 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 2 days after recovering. Speak to your GP or contraception nurse or call NHS 111 for more information, or if your sickness or diarrhoea continues.


To make an appointment or for further advice, please call:

0300 303 1948

Phoneline open 08:15-16:45 Monday-Friday

(closed 12:30-13:30 for lunch)