The progestogen-only pill
f you can't take the combined pill, the progestogen-only version may be more suitable. This factsheet from fpa explains how it differs from the Pill in how you take it, its advantages and possible side effects.
What is it and how does it work?

The progestogen-only pill (POP) contains a hormone called progestogen. It's different to the combined pill, which contains two hormones: oestrogen and progestogen. There are different types of POP.

If taken according to instructions, the POP is 99 per cent effective. This means that using this method, one woman in 100 will get pregnant in a year.

If the POP is usually started on the first day of a period it immediately protects against pregnancy. Some women can start taking the POP up to the fifth day if they don?t have short menstrual cycles. If started on any other day, an extra method of contraception must also be used for two more days.

The POP works by:

* stopping sperm reaching the egg by thickening the mucus from the cervix
* stopping the egg from settling in the womb
* sometimes stopping the ovaries releasing an egg (this is the main action of a POP called Cerazette)


A pill is taken every day until the pack is finished. The new pack is started immediately, without any break, which means pills are taken during your period.
Advantages

* It doesn't interfere with sex.
* There are no serious side effects.
* Can be used if you're a smoker over 35.
* Can be used while breastfeeding.
* Can help with premenstrual tension and period pain.


Disadvantages

* Periods may be irregular, light or more frequent. This should settle down and isn't harmful.
* Temporary side effects can spotty skin, headaches, tender breasts. These should settle down after a few months.
* Some women develop cysts on their ovaries. These aren't dangerous, often have no symptoms and usually disappear without treatment.
* If you become pregnant using the POP, there's a small risk of ectopic pregnancy (where a baby develops outside the womb). This is uncommon but dangerous.
* Some prescription and complementary medicines affect how the POP works.


Can anyone use the progestogen-only pill?

The POP doesn't suit everyone. Some conditions that may stop you from using it are:

* you think you might be pregnant
* you don't want any changes to your periods


You have now, or have had in the past:

* a heart attack or stroke
* active liver or gall bladder disease
* breast cancer
* cysts on the ovaries
* unexplained bleeding from the vagina


What to do if you forget a pill

It's important to take it at the same time every day, but if you forget, here's what to do:

If you're less than three hours late. Take it as soon as you remember, then take the next one on time. You'll still be protected against pregnancy.

If you're more than three hours late. You won't be protected against pregnancy. Continue to take the POP as usual and use an extra method of contraception for the next two days to protect yourself from pregnancy.

If you are using the POP called Cerazette, you have up to 12 hours to remember to take your pill. If you are more than 12 hours late, follow the advice above.

If you've been sick or had diarrhoea. If you vomit within two hours of taking the POP or have severe diarrhoea, you must use an extra method for the next two days.
General comments

Initially you'll be given three months' supply of the POP to see if it suits you. After that, you must go back for regular supplies. Some medicines affect how the POP works, check with your doctor, nurse or pharmacist.