The progestogen-only pill (POP)
The progestogen-only pill contains a single hormone, a progestogen. This is sometimes called POP or the mini pill.
The pill works by thickening cervical mucus which makes it harder for sperm to reach an egg. For the majority of people, it can also stop your ovaries from releasing an egg (ovulation) but the pill needs to be taken daily to provide effective contraception.
Different POPs may contain a different progestogen (Levonorgestrel, Norethisterone, Desogestrel or Drospirenone)
How effective is the progestogen-only pill?
The progestogen-only pill (POP) is 99% effective when used perfectly. However, “typical use” puts the pill at about 91% effective (approximately 1 in 11 people taking the pill become pregnant each year). This “typical use” reflects real life where pills can easily be missed/forgotten.
The pill must be taken every day with no break and it should be taken at about the same time every day.
How do I take the progestogen-only pill?
The progestogen-only pill must be taken every day with no break. It should be taken at about the same time every day. If you take it later than 12 hours for Desogestrel POP, or 3 hours for the older POPs (Levonorgestrel, Norethisterone) there is a danger that it will not work and you may become pregnant.
With Drospirenone POP you take 24 active pills and then 4 placebo hormone-free pills. If you take a pill later than 24 hours after it is due then there is a danger it will not work and a risk of pregnancy.
Who can use the progestogen-only pill?
The progestogen-only pill is not suitable for people with certain medical conditions such as liver disease or breast cancer. However, there are generally very few signs or reasons why this type of pill would not work for you.
The doctor or nurse at your local sexual health clinic will be talk to you about your medical history and general health to help you identify the best type of contraceptive pill for you.
Where can I get the progestogen-only pill?
The progestogen-only pill is available free of charge from any Devon Sexual Health Clinic. To find out more information on our clinics, including young person drop-in clinics, see our clinic information page.
All consultations are completely confidential unless we are worried about your safety. You can also get the progestogen-only pill from most GP surgeries. To find your nearest GP, you can use our ‘find a service’ option.
Are there any side effects to the progestogen-only pill?
The progestogen-only pill (POP) may cause temporary side-effects such as acne, sore breasts, sickness, migraines, mood swings. It can also cause ovarian cysts.
The main effect we see with POP is a change in bleeding pattern. It can make vaginal bleeding lighter, or more irregular, and it may stop you bleeding altogether. You won’t know how it will affect you until you try it.
There has been some research that user of the pill may have a small increased risk of breast cancer compared to non-users. This risk remains very small and reduces with time after stopping the pill.
If side effects continue for more than 3 months, contact your local sexual health clinic and we can advise you about different contraceptive pills or alternative forms of contraception.
Progestogen-only pill pros & cons
- 99% effective (if taken perfectly)
- Can make periods lighter
- Safe to use when breastfeeding
- Works if you can’t take oestrogen
- Doesn’t protect against STIs
- Temporary side effects such as headaches, nausea, sore breasts and mood swings
- Can cause ovarian cysts
- Can cause acne
Frequently asked questions about
Progestogen-only pill
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What should I do if I have missed a pill?
If you have missed a pill (more than 3 hours late for Levonorgestrel and Norethisterone progestogen-only pills, more than 12 hours late for Desogestrel, or more than 24 hours late for Drospirenone) take it as soon as you remember and take the next one when it is due. Use condoms for another 48 hours. If you have had unprotected sex since you missed the pill you may need emergency contraception.
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What happens if I vomit after taking the Desogestrel or Drospirenone POP?
If you are taking Desogestrel or Drospirenone POP and are sick within 3-4 hours of taking the pill, it may not be absorbed. Take a new pill as soon as you feel you can keep it down. If you can take a replacement pill within 12 hours of when you normally take your pill then you are still protected. If not, then you will have missed a pill – see the missed pill advice above.
If you are taking the Norethisterone or Levonorgestrel POP and are sick within 2 hours of taking the pill, another pill should be taken as soon as possible. If the new pill is not taken within 3 hours of the normal time for taking the progestogen-only pill, or in cases of persistent vomiting or very severe diarrhoea, this will count as a missed pill – see the missed pill advice above
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What happens if I have severe diarrhoea?
If you have bad diarrhoea this can also affect the absorption of the progestogen-only pill – treat each day with severe diarrhoea as a missed pill day. See missed pills FAQ for more information.
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Will the progestogen-only pill make me gain weight?
Research has shown that there is no significant difference in weight increase between people who use the progestogen-only pill and those who do not. Research has also shown that there is no significant difference between weight increase and the length of time someone takes the pill for.
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Will the progestogen-only pill protect me against STIs?
No. To avoid STIs you should also use a condom. You and your partner should also consider coming for a check-up at the start or end of a relationship, it’s quick, easy, free of charge and nowhere near as embarrassing as some people think!
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How soon after taking the progestogen-only pill can I have sex?
It all depends on where you are in your menstrual cycle when you start. If you start the Desogestrel, Levonorgestrel and Norethisterone progestogen-only pills on the first day of your period, you can have sex straightaway, otherwise you should use condoms for 2 days. If you start the Drospirenone progestogen-only pill, you should use condoms for 7 days.
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What age can I start taking the progestogen-only pill?
As soon as you are sexually active. A visit or consultation with a Devon Sexual Health Clinic is completely confidential, we won’t tell anyone about it unless we have concerns about your safety or well-being.
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Will taking the progestogen-only pill affect my fertility?
There is no evidence that taking the progestogen-only pill for any length of time will have an impact on your fertility.
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Does the progestogen-only pill make your boobs get bigger?
It very much depends on your body and how you react to the hormones. Some women may notice a slight increase in the size of their breasts, for some women they may get slightly smaller but for most there will be no change
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Can the progestogen-only pill make you depressed?
There is no scientific evidence to prove that the progestogen-only pill can cause depression although a recent Danish study suggested that the pill could cause depression, there were flaws in the research and the results are not conclusive. However, the pill does contain hormones, which are known to have an impact on our moods. If the pill you are taking is not working for you, you can try a different type of pill, a different brand or different form of contraception. We will be happy to help you find the best form of contraception for you.