A woman can get pregnant if a man’s sperm reaches one of her eggs (ova). Contraception tries to stop this happening by keeping the egg and sperm apart or by stopping egg production. One method of contraception is the progestogen-only pill (POP).
It contains the hormone progestogen but doesn't contain oestrogen. You need to take the progestogen-only pill at or around the same time every day.
The progestogen-only pill thickens the mucus in the cervix, which stops sperm reaching an egg. In can also stop ovulation, depending on the type of progestogen-only pill you take.
We have included further information about the progestogen-only pill below to help you make an informed choice about your contraception. After reading it, if you think the progestogen-only is the right contraception choice for you pop along to one of our clinics and have a chat with one of our specialised nurses or doctors - no appointment is needed.
About the progestogen-only pill
- you take a pill every day, with no break between packs of pills
- the progestogen-only pill can be used by women who can't use contraception that contains oestrogen – for example, because they have high blood pressure, previous blood clots or are overweight
- you can take the progestogen-only pill if you're over 35 and you smoke
- you must take the progestogen-only pill at the same time each day – if you take it more than three hours late (or 12 hours late if you take a desogestrel pill, such as Cerelle) it may not be effective
- if you’re sick (vomit) or have severe diarrhoea, the progestogen-only pill may not work
- some medicines may affect the progestogen-only pill's effectiveness - ask your GP for details
- your periods may stop or become lighter, irregular or more frequent
- Side effects may include spotty skin and breast tenderness - these should clear up within a few months
- the progestogen-only pill doesn’t protect against sexually transmitted infections (STIs). By using condoms as well as the progestogen-only pill, you'll help to protect yourself against STIs
Using the progestogen-only pill
The progestogen-only pill works by thickening the mucus in the neck of the womb, so it is harder for sperm to penetrate into the womb and reach an egg.
It’s important to follow the instructions that come with your pill packet, because missing pills or taking the pill alongside other medicines can reduce its effectiveness.
There are 28 pills in a pack of progestogen-only pills. You need to take one pill every day, within either three or 12 hours of the same time each day, depending on which type you are taking. There’s no break between packs of pills - when you finish one pack, you start the next one the next day.
Starting the first pack of pills
- choose a convenient time in the day to take your first pill
- continue to take a pill at the same time each day until the pack is finished
- start your next pack of pills the following day. There is no break between packs of pills
You can start the progestogen-only pill at any time in your menstrual cycle. If you start it on day one of your menstrual cycle (the first day of your period) it will work straight away and you will be protected against pregnancy. You won’t need additional contraception.
If you start the progestogen-only pill on any other day of your cycle, you will not be protected from pregnancy straight away and will need additional contraception until you have taken the pill for 2 days.
What to do if you miss a pill
If you forget to take a progestogen-only pill, what you should do depends on:
- the type of pill you are taking
- how long ago you missed the pill and how many pills you have forgotten to take
- whether you have had sex without using another form of contraception during the previous 7 days
If you are less than three or less than 12 hours late taking the pill
If you are taking a 3 hour progestogen-only pill and are less than 3 hours late taking it or if you are taking the 12-hour progestogen-only pill and are less than 12 hours late:
- take the late pill as soon as you remember, and
- take the remaining pills as normal, even if that means taking 2 pills on the same day
The pill will still work, and you’ll be protected against pregnancy - you do not need to use additional contraception. Don’t worry if you have had sex without using another form of contraception. You do not need emergency contraception.
If you are more than three or more than 12 hours late taking the pill
If you are taking a 2 hour progestogen-only pill and are more than three hours late taking it, or are taking the 12-hour progestogen-only pill and are more than 12 hours late you will not be protected against pregnancy.
You will need to use additional contraception, such as condoms for 2 days after missing a pill. You should:
- take the last pill you missed straight away (if you have missed more than one, take only one)
- take your next pill at the normal time
Depending on when you remember, it may mean taking 2 pills on the same day (one at the time of remembering, and one at the regular time), or even at the same time.
Speak to your GP or contraception nurse or call NHS 111 or the Sexual Health Line on 0300123 7123 if you are unsure whether you are protected against pregnancy or if your sickness or diarrhoea continues.
Who can use the progestogen-only pill?
Most women can use the progestogen-only pill. You may not be able to use it if you have had:
- heart disease
- liver disease
- breast cancer
- cysts on your ovaries
- unexplained vaginal bleeding
If you are healthy and there are no medical reasons why you should not take the progestogen-only pill, you can take it until your menopause or until you are 55.
Advantages and disadvantages
Some advantages of the progestogen-only pill include:
- it does not interrupt sex
- you can use it when breastfeeding
- it is useful if you cannot take the hormone oestrogen, which is in the combined pill, contraceptive patch and vaginal ring
- you can use it at any age – even if you smoke and are over 35
- it can reduce the symptoms of premenstrual syndrome (PMS) and painful periods
Some disadvantages of the progestogen-only pill include:
- you may not have regular periods while taking it - your periods may be lighter, more frequent or may stop altogether, and you may get spotting between periods
- it does not protect you against STIs
- you need to remember to take it at or around the same time every day
- some medications, including certain types of antibiotic, can make it less effective
The progestogen-only pill is generally well tolerated and side effects are rare. Some side effects can include:
- breast tenderness and breast enlargement
- an increased or decreased sex drive
- mood changes
- headache and migraine
- nausea or vomiting
- cysts (small fluid-filled sacs) on your ovaries (these are usually harmless and disappear without treatment)
- stomach upset
- weight gain
These side effects are most likely to occur during the first few months of taking the progestogen-only pill, but they generally improve over time and should stop within a few months.
Download the Family Planning Association guide to the progestogen-only pill.