Progesterone-only pill

The progesterone-only pill is also known as the POP or mini pill. The medication contains progestogen, a synthetic version of the natural female hormone progesterone. The progestogen-only pill is different from combined oral contraceptives because the pills don’t contain the hormone oestrogen. The mini pill can be an excellent oral contraceptive alternative if you cannot tolerate the combined pill.

There are two types of the progestogen-only pill:

• 3-hour mini pill: This is the traditional progesterone-only pill. You need to take every tablet within a three-hour time window each day.
• 12-hour mini pill: Newer progestogen-only pills such as Cerazette and Cerelle. These contain the hormone desogestrel, and you need to take every tablet within a 12-hour time-window each day.

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The mini pill prevents pregnancy in three different ways. The progestogen hormone thickens the mucus in the cervix, preventing sperm from reaching your egg, it can prevent ovulation, and it also reduces the chances of a fertilised egg implanting in your womb.

The mini pill is 99% effective if you remember to take it at the same time every day. However, if you forget, take it late, or suffer from sickness or diarrhoea, it may not protect against pregnancy. With typical use, most women will find it is around 91% effective.

Your family planning doctor will advise you on how and when to take the pill and when you will need to use extra protection to stay safe and prevent pregnancy.²

To effectively protect against pregnancy, it’s essential to follow the instructions provided by your family planning doctor and in the leaflet contained in your pill packet.

Each packet contains 28 pills. You should take one tablet every day, making sure to stick within the correct time window for your pill type. It may help to keep your pills near your toothbrush so that you don’t forget. When you have finished the pack, continue to the next pack without a break.

You can start the mini pill at any time during your menstrual cycle. If you take the first mini pill on one of the first five days following the start of your period, the POP will prevent pregnancy immediately. If you start the mini pill later in your cycle, you should use additional protection for two days. You should also use extra contraception for two days if you have a short menstrual cycle.³

A review of the research shows that there is little evidence of weight gain when using the progesterone-only pill. On average, women gained less than 2kg over 6 -12 months. This gain was around the same in women using other methods of contraception. Your doctor can advise on ways of maintaining a healthy weight. ⁶

One of Virtually Healthcare’s family planning specialists reports on the common concerns they see in their consultations.

The mini pill is 99% effective if taken reliably at the same time every day. This can be a 3-hour or 12-hour window, depending on your pill type. However, in real life, it’s easy to forget. During typical use, the progesterone-only pill is around 91% effective. The combined oral contraceptive pill prevents more than 99% of pregnancies if taken correctly.

If you are a little late taking your progestogen-only pill, it’s safe to take it if you are less than three hours late for the 3-hour pill or 12-hours late for the 12-hour progestogen-only pill. Don’t worry if that means taking two tablets in one day.
Continue to take the remaining pills as normal; you will still be protected against pregnancy and don’t need additional contraception.

If you are outside the three or 12-hour window ( depending on your mini pill type), you will not be protected against pregnancy and need additional contraception.

Take the pill as soon as possible, but only take one tablet if you have forgotten several doses. Take the next pill at your normal time. Use additional contraception for two days to protect against pregnancy. If you have had unprotected sex, you may need emergency contraception.