POP – Progestogen Only Pill – Mini-Pill – Progestogen Pill

The following is an extract from

“Sexplained Two – For Changing Times” by Helen J Knox

Cover of “Sexplained Two – For Changing Times”, by Helen J Knox

Used here with permission
All text Copyright © Helen Knox

What is the POP?

The POP, or mini-pill as it’s also known, is an oral contraceptive pill which contains just one hormone – progestogen.

There are two types of POP:

– traditional and desogestrel (DSG)

How does the POP work?

The POP forms a barrier of thick, infertile mucus at your cervix (neck of your womb), so that sperm can’t swim through to meet an egg.

It also effects the lining of your womb – helping to prevent pregnancy.

When or how do I use the POP?

The pills must be taken EVERY DAY of the year at exactly the same time – without a break.

Will the POP control my periods?

No, it won’t control them at all.

No-one can tell how it will affect your periods.

Will the POP make my periods heavier or lighter?

Generally, you’ll have lighter periods, which may stop whilst you use it.

But some women get irregular light bleeding (spotting) in the first few months while other women continue to bleed as they did before taking it.

If I forget a POP, what should I do?

1) If you’re using a ‘traditional’ POP, and remember within three hours of your usual time just take it and continue as usual.

2) If you’re using a ‘desogestrel’ POP, and remember within 12 hours, continue as usual.

If you’ve forgotten for more than three / 12 hours** respectively, continue taking the POP as usual when you remember, but to be safe you must use extra protection or have no sex (abstain) for 48 hours / although the manufacturer advises 7 days*, for the desogestrel (DSG) POP.

If you had sex before realising you’d forgotten your pill, seek emergency contraception (EC).

If in doubt, ask your pharmacist.

Are all POP used the same way?

No. There is one, which contains the progestogen ‘desogestrel’, and has a 12-hour window if forgotten, instead of just 3 hours.

If you use this one, please read the manufacturer’s information leaflet that comes with the medication and follow their guidance about the 12 hour / 7-day rule.

Here, where the important information relates to desogestrel (DSG) POPs, it is indicated by the symbol *, since the manufacturer recommends 7-days.

This information largely relates to ‘traditional’ POPs.

Key:

**  Manufacturer states 7 days

**  Manufacturer states 12 hours

How reliable is the POP?

When taken properly it’s nearly as reliable as the COC Pill, especially in women over 35.

Do diarrhoea or vomiting affect it?

Yes, they do – your protection will be reduced if you have bad diarrhoea or vomiting, especially within 3 hours of taking your POP.

EXTRA PROTECTION is important during illness and with some medication.

To be absolutely sure, and for the infertile mucus plug to be maintained at the cervix, continue taking your pill; but you should use extra protection for 48 hours (*7 days DSG) after recovery.

Do antibiotics or other prescription drugs affect the POP?

Yes. Drugs for TB and some other medicines can affect it; as can St John’s Wort (herbal antidepressant); but antibiotics don’t affect it.

But, if you’re worried about drug interactions it’s safer to use extra protection before checking with your doctor, pharmacist, or clinic.

Will my weight make a difference?

Be guided by your prescriber.

Manufacturer’s licenced guidance states that one pill per day should be taken, every day.

• It used to be said that women who weigh over 70 kgs should take two traditional POPs a day to maintain protection, so you may hear this advice.
• Likewise, if you are over 100 kg and taking a desogestrel (DSG) POP, you may be advised to take two of these, per day.

For how many years can I use the POP?

This excellent method can usually be used up to the age of 55.

Who is suitable to use the POP?

It’s suitable for most women but also if you:

1. are a smoker over 35 years of age;

2. are breast feeding;

3. have high blood pressure;

4. get migraines;

5. are diabetic;

6. have sickle cell disease (type of blood disease); and/or

7. if you don’t want to take or don’t like the combined pill for some reason.

Who is NOT suitable to use it?

Most young women are safe to use it but it’s not suitable for everyone.

You should discuss with your Doctor if you or someone in your family has had or have:

1. breast cancer;

Should I stop using the POP and give my body a break? (Very Common Question)

No, you shouldn’t. It’s a very safe form of contraception.

If you are someone who stops having periods whilst using it, your doctor may ask to test your blood after three years and may give you additional hormone treatment for a short while.

Can I use the POP safely, if I smoke?

Yes, you can.

If you’re taking the COC Pill and smoke, when you reach 35 years of age you’ll be automatically transferred to the POP, or another progestogenic method if you still want to use hormonal contraception.

Do I have to have sex to use it?

No, you don’t.

What should I be aware of if my girlfriend’s using the POP?

You have an interest and a responsibility to understand the POP and how it works to prevent your girlfriend becoming pregnant.

Her outward appearance won’t change when she’s taking the POP, so you’ll have to trust her to take it properly.

If your girlfriend were to become pregnant, with or without a termination you’d have to deal with the difficult emotions. Without a termination, you’d be responsible for paying child maintenance for up to 25 years (i.e. until they leave full-time education).

There will also be times when you will need to use condoms for protection against pregnancy and routine protection against infection.

The only way to protect yourself in case she hasn’t taken it properly is to use a condom routinely for safer sex.

Since most women would find it hard to trust a man saying he was taking the POP, you should read about how it works, as you also rely on it for protection against pregnancy.

Do recreational drugs affect the POPs reliability?

No. Not as far as is known.

Drugs can, however, be bad for your long-term physical and mental health and can increase your risk of contracting sexually acquired infections.

If you dehydrate you may be more likely to develop thrombosis (blood clots).

Will it make me put on weight?

There is no evidence that the POP makes you put on weight.

Simply watch what you eat!

Will it protect me from pregnancy AND infection?

No, it won’t. You will still need to use condoms for protection against sexually acquired infection.

The barrier of mucus, which forms at your cervix, may slow down the progress of an infection into your womb and tubes, but it won’t prevent you from catching it.

Are the effects of the POP reversible?

Yes, they are. It’s out of your system after 27 hours.

But remember: you can get pregnant after that if you have unprotected sex. So, if you don’t want this, use condoms from the day after your last pill.

When does the POP start to work when I begin to take it?

You’re contraceptively protected from the moment you take your 1st pill on the 1st day of your period.

If you start it later than the second day of your period, you need to use extra protection or don’t have sex for two days (**7 days DSG pills).

You’re safe from pregnancy if you continue to take it properly, thereafter.

Also:

• never take unnecessary risks;
• check with your clinic, GP or
• pharmacist if in doubt about anything;
• use extra protection unless you’re
• reliably informed that it’s not necessary;
• always take the pill you’ve forgotten, even if this means taking two pills on one day and use extra protection (a condom) or don’t have sex (abstain) for 2 days
• (**7 days DSG pills);
• there are many different types of pill. If you think one doesn’t suit you, you can always try others until you find the one which is best for you.

This video by a Consultant in Sexual and Reproductive Health, in South London, may also be of interest.

Extracts from The Sexplained Column – The Agony Aunt Blog

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