Progestogen only pill: counselling

Women who are considering taking the progestogen-only pill (POP) should be counselled in a number of areas:

Potential adverse effects

• irregular vaginal bleeding is the most common problem

Starting the POP

• if commenced up to and including day 5 of the cycle it provides immediate protection, otherwise additional contraceptive methods (e.g. condoms) should be used for the first 2 days
• if switching from a combined oral contraceptive (COC) gives immediate protection if continued directly from the end of a pill packet (i.e. Day 21)

Taking the POP

• should be taken at the same time every day, without a pill-free break (unlike the COC)

Missed pills

• if < 3 hours^ late: continue as normal
• if > 3 hours^: take the missed pill as soon as possible, continue with the rest of the pack, extra precautions (e.g. condoms) should be used until pill taking has been re-established for 48 hours

Other potential problems

• diarrhoea and vomiting: continue taking POP but assume pills have been missed - see above
• antibiotics: have no effect on the POP^*
• liver enzyme inducers may reduce the effectiveness

Other information

• discussion on STIs

^ for Cerazette (desogestrel) a 12 hour period is allowed