Progesterone pill

• The progestogen-only pill is usually more than 99% effective if taken properly. This implies that less than 1 woman out of 100 who use the POP correctly will become pregnant within a year.
  
  
• With the way it is popularly used by women (not the recommended way), the POP is only about 92% effective.
  
  
• You will be required to take a pill daily, without any short or long breaks between the packs.
  
  
• The progestogen-only pill is a suitable choice for women who are unable to use estrogen-containing contraception’s.
  
  
• It is suitable for women who are 35 years and older, and also women who smoke.
  
  
• Just as the combined pill, the progestogen-only pill should be taken at a specific time daily for maximum effect. If the POP is taken more than 3 hours (for the “conventional” progestogen-only pill) or 12 hours (for the desogestrel pills) after the designated time, it loses its effect.
  
  
• It may not be effective for women who have severe diarrhea or are sick (vomiting).
  
  
• Certain drugs interfere with its actions and also alter its effectiveness. If you need more details, consult your GP.
  
  
• It may cause your periods to become irregular, more frequent, and lighter or stop completely.
  
  
• It causes certain side effects such as breast tenderness and spotty skin, although these usually clear off or subsides within a few months.
  
  
• It doesn’t proffer any protection against sexually transmitted infections; therefore, you may require extra contraception such as condoms.

There are two forms of POP and they are:

• 3-hour progestogen-only pill: this is the standard or traditional progestogen-only pill usually used, and it has to be taken within 3 hours at the same time, daily.
  
  
• 12-hour progestogen-only pill: this is the desgosterol progestogen-only pill and it has to be taken within 12 hours of a specific time, daily.

It is important that you follow the manufacturer’s instruction that is given on the pack of your pills because missing your pills or taking it with certain medication can alter its effectiveness.

Within a pack of POP (progestogen-only pills) there 28 pills and they need to be taken daily and within 3-12 hours of a specific time, depending on the type.

Note that, the pills have to be taken continuously as there are no breaks between the packs. Always start a new one, once the old pack is exhausted.

• Select your preferred time of the day to take your first pill from the pack.
  
  
• Make sure you take your pills, at the same selected time daily until you have exhausted the pack.
  
  
• Start another pack the next day- remember that there’s no break.

The POP can be started anytime during your monthly cycle.

If it is started within the first 5 days of your monthly cycle, it will proffer you immediate and complete protection against pregnancy, thereby saving you the stress of extra contraception.

However, if the duration of your monthly cycle is short, you will be required to use extra contraception such as condoms for at least 2 days.

If the pills are started any time after the fifth day of your monthly cycle, it would not proffer complete protection from pregnancy immediately, thus the need for an extra contraceptive method such as condoms for at least 2 days.

You can start the POP (progestogen-only pill) on the 21^st day after delivery. On doing this, you will get complete protection from pregnancy immediately.

If these pills are taken after the 21^st day after delivery, you will be required to use extra contraception such as condoms for at least 2 days.

After having a miscarriage or abortion, you can start taking the progestogen-only pill about 5 days after. This would offer you complete and immediate protection from pregnancy.

However, if the pills are started anytime after 5 days after a miscarriage or abortion, you will need to make use of extra contraception for 2 days.

The action to take after missing your pill depends on a variety of factors, some of which are:

• The type of pill
  
  
• How many pills you missed
  
  
• If you engaged in sex without making use of another contraceptive
  
  
• How long it’s been since you missed your progestogen-only pill (POP)

If you are less than 3 or 12 hours late when taking the 3 or 12-hour progestogen-only pill respectively, then you should

• Quickly take your pills once you remember.
  
  
• Continue taking your pills normally (at the selected time), even if it would involve taking 2 pills that day.

If taken within this period, the pill will still take effect and you will not be required to make use of extra contraception.

There is no cause for alarm if you have had sex during this period with using extra contraception, you don’t need it.

If on any day, you are more than 3 or 12 hours late when taking the 3 or 12 hour POP, you will have no protection against pregnancy.

In this situation, this is are the actions you need to take.

• Whenever you remember, take 1 pill immediately regardless of how many pills you may have previously missed.
  
  
• Ensure you take the next time at the selected time - sometimes, you may take 2 pills a day (whenever you take it late), but this causes no harm.
  
  
• Continue taking the pills at the selected time daily
  
  
• Make use of extra contraception such as condoms for at least 2 days after restarting your pills or avoid sex.
  
  
• If you had unprotected sex during the period where you missed your pills, you may need to make us of the emergency contraception-you get can either get this or professional advice at your contraception clinic or from your GP
  
  
• Do not forget to mention to them that you have been on progestogen-only pills because this influences the type of emergency contraception that will be given to you.

The progestogen-only pill takes about two days to take effect- thicken cervical mucus secretions to protect you from pregnancy.

It was recommended by the faculty of Sexual Health and Reproductive Healthcare that you make use of additional contraception for a period of 2 days whenever you restart your pills after stopping.

There’s usually a patient information leaflet that comes with the pack of your pills and instruct you to make use of condoms for at least 7 days after restarting your pills- if you forget or stop. This instruction is given because it takes the pills 7 days to stop your ovulation.

If you get sick or vomit 2 hours or less after taking your pill, make sure you take another pill immediately and also take your next pill at the selected time. Taking another pill immediately after vomiting is important because the previous pill may not have been fully absorbed into your blood and so a replacement would be needed for maximum effect.

However, if you are unable to take another pill immediately or within 3 or 12 hours after the usual time, you may need to make use of extra contraception such as condoms for at least 2 days or 7 days (when taking the 12-hour progestogen pills).

If you keep being sick for a long while, make sure to keep using a different contraception method such as condoms while sick and also for a period of 2 days after you have recovered.

If you are experiencing very severe diarrhea with a frequency of 6-8 stools daily, the pills may not be as effective. In this case, you should continue using the pills normally, but alongside extra contraception such as condoms until 2 or 7 days (if you have been on the 12-hours progestogen pills) after you have recovered.

Almost every woman can make use of the progestogen-only pill, but it may be unsuitable for you if:

• You are pregnant or think you are
  
  
• You want your period to remain the same
  
  
• You are on certain medications that can alter the effectiveness of the pill
  
  
• You experience unexplained bleeding in between your monthly periods or after sexual intercourse.
  
  
• You have any liver condition
  
  
• You have or have had any arterial or heart condition or a stroke.
  
  
• Have or have had breast cancer.
  
  
• You have liver cirrhosis or tumors

Women who are healthy and have no health-related conditions that can hinder them from taking the progestogen-only pills can take it until menopause or even till they are 55 years old.

POP is completely safe for breastfeeding mothers. While breastfeeding, a little amount of progestogen may be passed to your baby, but this is completely suitable (safe) for your baby. It also has no effect on the quality and quantity of milk you produce.

Although rare, there’s a minor chance of getting pregnant whilst using the progestogen-only pill.

If you experience this, there’s no evidence or search that shows that your baby may be harmed by the pill. If you suspect that you might be pregnant, quickly contact your GP or visit any local contraception clinic in your area.

You may also need to seek medical advice, if you experience unusual or sudden pain in your abdomen or if your period becomes lighter or shorter than it usually is.

Although rare, these may be warning signs of an ectopic pregnancy.

• It doesn’t interfere with sex
  
  
• It is absolutely safe for breastfeeding mothers
  
  
• It is a great option for women who cannot use estrogen-containing contraceptive such as contraceptive patches, combined pills and the vaginal ring.
  
  
• It is suitable for women within all age ranges, including women who smoke and are 35 years or older.

• It may affect the frequency and nature of your period, making it either more frequent, lighter or even cause it to stop completely. You may also notice some spotting in between your monthly period.
  
  
• It proffers no protection against STIs
  
  
• You would need to remember to take it at a specific time daily.
  
  
• Certain medicines can alter its effectiveness such as antibiotics (some uncommon ones).

Most women are highly tolerant of the progestogen-only pill and rarely experience any side effects. However, some of them include:

• Acnes
  
  
• Nausea and/or vomiting
  
  
• Increased or reduced libido
  
  
• Mood swings
  
  
• Breast enlargement and tenderness
  
  
• Development of cysts (small-fluid fills sacs/bags/pouches) on your ovaries, although they gradually disappear over time without the need for treatment.

If at all they occur, these side effects usually occur within the first few months of starting the POP, but they usually disappear gradually over time and should have stopped after a few months.

If you need advise or have questions or worries concerning your pill, feel free to speak with your GP or practice nurse. You may be asked to stop taking this pill and switch to another if need be.

Most times, when you take more than one medicine at once, they can influence each other’s actions and either increase or reduce their effectiveness.

Certain medicines can interfere with the actions of the progestogen-only pills and reduce its effectiveness.

If you are on other medications and would like to find out its effect on your pills, you can;

• Speak to your GP, practice nurse or pharmacist
  
  
• Read through the information leaflet contained in the pack of your medicine.

If you intend to change your contraceptive method and need some medical advice, feel free to consult your GP, contraceptive nurse or family planning nurse, or any sexual health clinic.

When taking the POP, there should be no break between subsequent packs. Therefore, your doctor or nurse may advise you to begin the new pill right away or start it the next day after the old pack is exhausted.

You may also be advised to make use of a different contraceptive method whilst switching to a new pill because of the time it takes to start functioning properly.