Progestogen Only Pill (POP)

The Progestogen Only Pill (POP) is an oral contraceptive option containing the hormone progestogen. The POP must be taken every day, without a break, to be most effective. There are three types of POP available in Australia, containing either levonorgestrel (LNG-POP), norethisterone (NET POP), or drospirenone (DRSP-POP).

The POP prevents pregnancy by:

• thickening the mucus in the cervix, making it harder for sperm to enter the uterus.
• thinning the lining of the uterus, so a fertilised egg cannot be implanted.
• DRSP-POP will stop the ovaries from releasing a monthly egg.
• LNG-POP and NET-POPs sometimes stop a monthly egg from being released (this varies between cycles, and from person to person).

With typical use, the POP is 93% effective at preventing pregnancy. Effectiveness depends on the age of a person and how consistently the POP is taken.

The POP is very safe and suitable for most people, including those over 40, and those who are breastfeeding. A health professional will take a detailed medical history to ensure the POP is suitable for you.

The POP may not be suitable for those who:

• May have difficulty taking the pill at the same time every day.
• Have ever had breast cancer
• Take certain prescribed medication, such as some epilepsy drugs.

The LNG and NET POPs must be taken at the same time every day. The medication sleeves contain 28 active (hormone) pills with no inactive (placebo) pills.

The POP can be started at any time during a menstrual cycle.

• If started during the first five days of a period, the POP is effective immediately.
• If started at any other time, the LNG and NET POPs become effective once three consecutive daily pills have been taken.

If the POPs with LNG or NET are taken more than three hours late, the medication is less effective, and the risk of pregnancy is increased. If you are able to take your LNG/NET-POP less than 3 hours late, take your pill as soon as possible and then continue to take them daily at your regular time.

Do not rely on the LNG or NET POP if you have missed your pill (more than 3 hours late). Start taking them again as soon as you remember. The LNG and NET POPs will become effective again once you have had the third daily pill. Consider emergency contraception if there is a risk of pregnancy. If you need advice about taking your pills, please call the Sexual Health Helpline on 08 9227 6178.

The DRSP-POP has 24 active pills and 4 inactive (placebo) pills. Try and take this around the same time each day.

The POP can be started at any time during a menstrual cycle.

• If started during the first five days of a period, the POP is effective immediately.
• At other times, the DRSP pill is effective after taking active pills for 7 days.

The DRSP POP is not currently covered by the Pharmaceutical Benefits Scheme (PBS).

If the DRSP-POP is taken more than 24 hours late, the medication is less effective, and the risk of pregnancy is increased. If you can take your DRSP-POP less than 24 hours late, take your pill as soon as possible and then continue to take them daily at your regular time.

Do not rely on the DRSP-POP if you have missed your pill. Start taking them again as soon as you remember. The DRSP pill is effective again after taking active pills for 7 days. Consider emergency contraception if there is a risk of pregnancy. If you need advice about taking your pills, please call the Sexual Health Helpline on 08 9227 6178.

The chance of a pregnancy occurring while using the POP is greater if:

• The POP is late/missed.
• Other prescribed medications are taken, such as some epilepsy drugs, and some medications used to treat tuberculosis or HIV.
• Herbal medicines such as St John’s Wort are taken.
• Vomiting or severe diarrhoea occurs within two hours of taking the pill.

Different methods of emergency contraception are available, such as emergency contraceptive pills and the copper IUD.

Emergency contraception is most effective when used as soon as possible after unprotected sex, so visit a clinician, pharmacist, or call the Sexual Health Helpline on (08 9227 6178) as soon as possible.

The POP:

• Is an effective form of contraception if taken correctly (take at the same time every day).
• May alter bleeding patterns.
• Can be used by those who cannot take or tolerate oestrogen.
• Is safe to use while breastfeeding.
• Is safer for those who smoke.
• Does not increase the risk of deep vein thrombosis (DVT).
• Allows fertility to return quickly after stopping.

The progestogen only pill does not protect against sexually transmissible infections (STIs).