health articles

Progesterone-only pill

Virtually Healthcare is a cutting-edge GP practice providing high-quality contraceptive care. The contraceptive clinic is free, convenient and easily accessible online, by phone, or in person.

What is the 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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How does the mini pill work?

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

How do you take the progesterone-only pill?

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

Does the mini pill cause weight gain?

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

Contraceptive care at Virtually Healthcare

The specialist family planning GPs at Virtually Healthcare provide comprehensive contraceptive care. They will discuss your health, personal preferences, and pregnancy plans before suggesting the best contraceptive options for your lifestyle. These could include the progesterone-only pill and other hormonal methods, including the combined oral contraceptive, contraceptive implants, injections or patches. They may also suggest the coil, barrier methods such as condoms and caps, or an intrauterine system like the Mirena device.

The Virtually Healthcare difference

Virtually Healthcare is an innovative GP practice, providing expert healthcare in the comfort of your home. Virtually Healthcare is designed to fit in with busy modern lives. You can access consultations conveniently and easily with virtual appointments available seven days a week.

The team includes more than 40 clinicians working together to investigate and treat disease and help you optimise your health and wellbeing. As well as highly-skilled GPs, the team includes experienced family planning and sexual health specialists, physiotherapists and practice nurses to offer a comprehensive primary care service.

During the pandemic, many patients have found it challenging to access healthcare. Virtually Healthcare provides rapid access video or telephone appointments, with same-day consultations available if you contact us before 3 pm. Our clinicians can provide professional assessment and advice, arrange investigations, prescribe treatment or arrange for a face-to-face review.

At Virtually Healthcare, we focus on you. Our clinicians take a holistic approach to care. Whether you want an easy, convenient way to get contraception or a discreet testing service for STIs, our dedicated team can provide expert advice and treatment.

What are the pros and cons of the progesterone-only pill?

Every contraceptive method has advantages and disadvantages. Your doctor will take you through the risks and benefits so that you can make an informed choice. For the mini pill, these include:

The advantages

  • The progesterone-only pill provides continuous contraception, allowing sex to be spontaneous and uninterrupted.
  • You don’t need to use an internal or external condom during sex.
  • The POP can make your periods lighter, less painful and more regular.
  • Your fertility should swiftly return to normal when you stop the progesterone-only pill.
  • It is safe to use the POP when breastfeeding.
  • You may be able to use the mini pill even if the combined oral contraceptive is unsuitable for you, for example, if you’re over 35 or a smoker.

The disadvantages

  • The POP doesn’t protect against STIs; you will need to use a barrier method for STI protection.
    You may develop spots or acne.
  • Many women get side effects, including mood swings, headaches, nausea, and breast tenderness. These are usually temporary and tend to settle after the first few months.
  • The progesterone-only pill can affect your periods. You may have irregular bleeding initially, this usually settles, and many women have light bleeding or no periods at all when using the POP.
  • Some drugs can affect the effectiveness of the mini pill, so talk to your GP or pharmacist if you regularly take medications or herbal remedies. TB treatments, anti-epilepsy drugs and St John’s Wort can reduce the effectiveness of the progesterone-only pill.
Hot topics in contraceptive care

Is the mini pill less effective than the pill?

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.

What should I do if I forget a pill?

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.

Types of consultations we offer

We offer written, telephone and video consultations with a range of male and female clinicians from GPs, nurse practitioners, and primary care specialists such as physiotherapy.