1. What are Progestin-Only Pills (POP)?
Progestin-only pills (POPs) are also called “minipills” and they are progestin-only oral contraceptives. These pills contain very low doses of a progestin like the natural hormone progesterone in a woman’s body. They do not contain estrogen. Hence, they can be used throughout breastfeeding and also used by women who cannot use other methods with estrogen.
2. How do POPs work?
POPs work by two ways as below:
- Thickening cervical mucus (this blocks sperm from meeting an egg)
- Disrupting the menstrual cycle, including preventing the release of egg from the ovaries (the process of ovulation)
3. What are the advantages of using POPs?
Like the other oral pills, the POPs do have some advantages over the other methods like:
- Method adoption & pill taking can be controlled by the woman
- Do not interfere with sex
- Can be stopped at any time without a provider’s help
In addition, they also provide added advantage as below:
- POPs can be used by the woman during breastfeeding
4. What are the side effects of POPs?
The commonly reported side effects include:
- Changes in bleeding patterns including:
- Frequent bleeding
- Irregular bleeding
- Infrequent bleeding
- Delayed return of periods in breastfeeding women ( lengthened postpartum amenorrhea)
- Prolonged periods
- No monthly bleeding
- Mood changes
- Breast tenderness
- Abdominal pain
These side effects are minor and may not last for long.
5. Who can take the POP?
Nearly all women can use POPs safely and effectively including women who:
- Are breastfeeding (starting as soon as 6 weeks after childbirth)
- Have or have not had children
- Are not married
- Are of any age, including adolescents and women over 40 years old
- Have just had an abortion, miscarriage, or ectopic pregnancy
- Smokers or ex-smokers
- Have anaemia now or had in the past
- Have varicose veins
- Are infected with HIV whether or not on antiretroviral therapy
6. How to take POPs?
Start taking the pill on the first day of your next period. It is immediately effective from then on. If you start on any other day, you should use additional contraceptive methods (such as condoms) for the first two days until the POP has become effective. You should take the POP at the same time of day, every day. Any time of day will do, but the most important thing is to get into a routine.
You should take it every day. Do not stop taking it when you have a period. When you finish one pack, start another the next day. If you take a pill more than three hours later than usual (12 hours for a POP called Cerazette®), you lose the protection of the POP, in which case you may need additional protection.
7. When to start taking POPs?
If you are having menstrual cycles or switching from a non-hormonal method
- If you are starting within 5 days after the start of your monthly bleeding, no need for a backup method.
- If it is more than 5 days after the start of your monthly bleeding, you can start POP any time however the Doctor must make sure that you are not pregnant. You will need a back-up method for the first 2 days of the pill.
If you are switching from other hormonal methods
- Immediately if you have been using the method regularly and correctly
If you want to take it after miscarriage or abortion
- Immediately if started within 7 days of abortion/ miscarriage. No need for a back up method.
- If it is more than 7 days, the Doctor must make sure that you are not pregnant. You will need a back up method for the first 2 days of the pill.
If you want to start immediately after child birth
- If breast feeding – start POP after 6 weeks of delivery
- If you are not breast feeding and more than 4 weeks after giving birth, you can start POP any time after making sure that you are not pregnant already. You will need back up for two days.
8. What if I forget to take a pill?
If you forget a pill, take it as soon as you remember. If you are more than three hours late in taking it (12 hours for a POP called Cerazette®) then your protection immediately fails. Continue taking your pill each day, but you will need to use extra contraception for two days (such as condoms) until the POP becomes effective again.
9. If you are keen POPs, don’t forget these:
- Take one pill every day
- To be taken at the same time every day
- Safe for breastfeeding women and their babies
- POPs add to the contraceptive effect of breastfeeding.
- Bleeding changes are common but not harmful.