Progestogen-only contraceptive pill (POP)

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The progestogen-only pill (POP) is an oral contraceptive containing a low dose of the hormone progestogen. It is taken every day to prevent pregnancy.

What is the POP?

The POP (sometimes referred to as the ‘mini-pill’) contains progestogen only. Progestogen is similar to the hormone progesterone, which is naturally produced by the female body.

How does the POP work?

The POP works by:

thickening the mucus of the cervix so that sperm cannot enter the uterus (womb)
changing the lining of the uterus, making it unsuitable for pregnancy
affecting ovulation (egg release from the ovary) in some women

How effective is the POP?

The progestogen-only pill is 92-99% effective. This means that on average, if 100 women take the POP, between 1 and 8 women may become pregnant in a year. It is most effective when taken according to instructions.

What are the advantages of the POP as a method of contraception?

contains a very low dose of hormone
reversible and rapid return to usual fertility
side effects are rare
can be taken by women who are unable to take the combined contraceptive pill because of health problems or side effects with oestrogen

What are the disadvantages of the POP as a method of contraception?

it must be taken at the same time every day to be effective
in younger women, it may be less effective than other hormonal methods
unpredictable bleeding pattern (see side effects)
does not protect against sexually transmitted infections

What are the possible health benefits of the POP?

may safely be used by breastfeeding women
is a safe alternative for women with contraindications to oestrogen

What are the possible side effects or complications of taking the POP?

Side effects are uncommon but may include:

changes in bleeding patterns including:
- periods stopping completely
- irregular periods or spot bleeding
ovarian cysts – usually there are no symptoms and do not require treatment
headaches
breast tenderness
ectopic pregnancy
(pregnancy in the Fallopian tubes)

This is a rare complication and is less likely to occur in POP users than if no contraception was used.

Is the POP suitable for all women?

Most women can safely use the POP.

The POP may be PARTICULARLY SUITABLE for women who:

cannot take oestrogen
are breastfeeding
are over 35 and smoke
prefer an oral method of progestogen contraception

The POP MAY NOT BE SUITABLE for women who:

have severe liver disease
have severe arterial disease
have malabsorption syndrome

The POP is NOT SUITABLE for women with:

breast cancer
irregular vaginal bleeding which has not been investigated

What do I need to know about starting the POP?

Starting the POP for the first time requires an assessment by a doctor and a prescription. This allows the doctor to assess your medical history and explain when to start the POP. It is important to follow these instructions to know when you will be protected from pregnancy. The assessment visit also enables you to ask any questions that you may have about the POP and be certain that it is the most suitable method for you.

What do I need to know about the ongoing use of the POP?

All pills in a POP packet are active pills. There is no ‘pill free’ break or non-hormonal pills. The pill should be taken at the same time every day or within 3 hours of that time. To renew your POP prescription you will need to see a doctor for review at least once a year.

The POP may not be effective if:

a pill is missed
a pill is taken more than 3 hours late
vomiting occurs within 2-3 hours of taking a pill
medications are taken, as certain medications may interfere with the effectiveness of the POP. Some non-prescribed medications, such as St Johns wort (or hypericum) can make the POP less effective. Always check with the pharmacist.

If you are concerned about any of the above situations, check with your doctor or health professional.

What should I do if I miss a pill?

With the POP it is very important that pills are taken at THE SAME TIME EVERY DAY for it to be most effective.

If you are MORE than 3 hours past your regular pill taking time, take it as soon as you remember and then resume taking your pills as usual, but use other contraception (eg condoms) or avoid intercourse for the next 48 hours.

Do I need Emergency contraception?

If sexual activity has occurred around the days before or after pills have been missed or taken late , or after illness, emergency contraception should be considered. Emergency contraception can be used to help prevent pregnancy. It is taken by the female partner and can be obtained from pharmacies without prescription, general practitioners (GPs), sexual health or Family Planning Queensland (FPQ) clinics.

What should I do if I am sick?

If you vomit within 2 hours of taking the pill it may not be effective. Take another pill as soon as you can. Severe diarrhoea can sometimes interfere with the effectiveness of the POP. Follow the ‘missed pill’ advice as outlined above.

If you are not sure what to do if you are sick or have missed a pill, contact your doctor, local FPQ clinic or read the instructions/information sheet provided in the pill packet.

Where is the POP available?

The POP is available on prescription from your local FPQ clinic or doctor.

www.fpq.com.au
Phone 07 3250 0240

Disclaimer

Family Planning Queensland (FPQ) has taken every care to ensure that the information contained in this publication is accurate and up-to-date at the time of being published. As information and knowledge is constantly changing, readers are strongly advised to confirm that the information complies with present research, legislation and policy guidelines. FPQ accepts no responsibility for difficulties that may arise as a result of an individual acting on the advice and recommendations it contains.

Funded with assistance by Queensland Health