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Sexual Health (young people)

Progesterone only pill (POP or 'mini pill')

Hormone contraceptives are grouped by the type and number of hormones in them. There are two main groups:

Here we talk about the progesterone only pill.
 
“If taken correctly, it can be more than 99% effective. This means that fewer than one woman in 100 who use the progesterone-only pill as contraception will get pregnant in one year" (NHS Choices 2015). However average use of the pill has a 9% failure rate (Centre for Disease Control 2015).
 
Women said that they liked taking pills because they are easy to use, reliable and are under their control. Progesterone only pills are taken every day continuously. They act mainly by making the mucus covering the cervix thicker which stops sperm reaching an egg. Most need to be taken within 3 hours of the same time every day to work reliably. Newer progesterone-only pills containing desogestrel (such as Cerazette, Desorex, Cerelle and Feanolla) can also prevent an egg from being released by the ovaries (stopping ovulation) most of the time. This pill also needs to be taken every single day without a break, but within 12 hours of the usual time.

 

Talks about the importance about getting the timing right for taking a mini pill.

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Talks about the importance about getting the timing right for taking a mini pill.

Age at interview: 21
Sex: Female
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So last week I think it was I forgot to take my mini pill and I took it a few hours over. So that was it, I was like right - No we can’t  we can’t do nothing we can’t do nothing for at least a week (giggle). 
 
Did you explain to him?
 
Yeh and his, his attitude is if I did we could just get rid of it, and I was like well it’s not that easy I said. It’s easy for you to say it but then I’m the one that’s  got to go up the hospital l’m the one that’s got to have everything done to me and then it goes on my records it don’t go on your records and I said and it’s not a nice thing to go through I said. And he goes well we’ll keep it then and I was like are you mad (giggle) I can’t have two kids under the age of two.

This affects the advice given about what to do if a pill is taken late or missed. This advice is detailed in the FPA leaflet ‘the progesterone only pill’.

One of the advantages of progesterone only pills is that they are safe to take for most women, even if there is a medical reason why the combined pill wouldn’t be a safe option for you. This means most women can use them, even if they smoke, have raised blood pressure, are overweight, have diabetes, or suffer from the kind of migraines that rule out the combined pill. They do still interact with some other medications, so it is important to check this if taking tablets for another condition such as epilepsy or HIV (see more on contraception and epilepsy). 

Bleeding patterns are not entirely predictable with progesterone only methods of contraception. Bleeding can be light and regular, stop altogether, be more unpredictable or more frequent. If there is lots of bleeding, especially with any other symptoms like pain or discharge, it is important to have a check-up and review with a doctor or nurse. This is to make sure there isn’t another cause for the bleeding, such as an STI. The bleeding pattern does not tell you if your pill is working as contraception or not but you will be covered if you are taking it correctly.

 

Changed from the mini pill as she was bleeding continuously.

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Changed from the mini pill as she was bleeding continuously.

Age at interview: 21
Sex: Female
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What kind of pill you took the first time?
 
It was, I think it was, well I took, I think I kind of took a few different kinds, I tried taking the mini pill because I had had kind of, in my whole life I've had about five migraines and so my doctor was like you know "You should probably take the mini pill."  But it didn't really work for me, my periods are quite kind of forceful and they don't really [laughs] I have to take a really strong pill or I just basically bleed continuously, they don't really, I so stopped taking that.

The progesterone only pill can also affect acne (spots) and for some women causes premenstrual type symptoms such as breast tenderness.
 
The women we spoke to said that taking the pill shows a responsible attitude to contraception and means that sex can be more spontaneous.
 
Some of the women we talked to stopped taking the pill due to worries over the side effects. Some women didn't remember to take it every day - in which case they often switched to the contraceptive injectioncontraceptive implant or another LARC.

 

Experienced side effects on the mini pill and changed to the contraceptive injection.

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Experienced side effects on the mini pill and changed to the contraceptive injection.

Age at interview: 22
Sex: Female
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Which pill are you on?
 
It was the mini pill I started taking but everyone was saying that I was getting really grumpy and stuff like that and I wasn't too sure, I didn't notice any changes in myself and if it had been I thought that I was just being the same as what I was usually.  So I stopped taking that and went on the depo jabs because it's meant it be a lower dose of the pill but you don't have to keep taking it. 
 
Okay and it was your decision to change from the pill to the depo or someone else, a health professional suggested it to you?
 
I was using, no it was my decision, I was using the pill, the mini pill and yeah I just, my decision, I just read up on it. You know you get leaflets and I just thought I went in and asked my GP about it and that was it.

There are pros and cons of taking the pill, and some of the women we spoke to had been put off by friends and family, or had read negative stories in the media. Others didn't like the idea of taking hormones, although many feel that it's better to take the pill than risk an unwanted pregnancy.
 
One said that she understands why clinics have 'a bit of an agenda' but feels that women are sometimes under pressure to go on the pill.

 

Felt under pressure by the family planning service to use the contraceptive pill. (Actor)

Felt under pressure by the family planning service to use the contraceptive pill. (Actor)

Age at interview: 25
Sex: Female
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I think quite good. I don't know, the last time I went I sort of felt a bit under pressure from them to go back on the pill and I can understand it because I'd gone to get the morning-after pill because, you know, I hadn't been consistent in using condoms. And I can see why, from their point of view that I should be on a more reliable form of contraception. 

But I've got my reasons for not wanting to go back on the pill and it's not that, you know, it's not that I'm thinking of using the IUD because I don't want to have an effective method of contraception. I felt a bit under pressure from them to go back on the pill.

Did they sort of talk to you explicitly about... did they ask you?

Yes, they sort of said why don't you have the contraceptive injection because, that's another one that I forgot about! Because of not being reliable in taking pills. I had sort of already explained that that isn't the reason that I don't want to go back on the pill. And then they were sort of saying, well you know you could go on the mini-pill. But I think they were just sort of making me aware of more options.

It wasn't a negative experience, I just felt that they'd got a bit of an agenda! But that's their job so it's fair enough.

Frequently women find that their male partners don't know much about the pill. Some wish the men would learn more while others explain it to their partners themselves.

 

Talks about the need to 'educate' boyfriends about the pill. (Actor)

Talks about the need to 'educate' boyfriends about the pill. (Actor)

Age at interview: 20
Sex: Female
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Yeah I actually think that we need to educate men more, I mean there is a lot of pressure on girls'

You say educate the men, about what specifically?

Well I think that men should probably know what their girlfriends need to know. Especially about like the contraceptive Pill. Like their girlfriend knows that if they miss a pill and take it 12 hours, more than 12 hours late then they should not have sex for a week and guys need to know that too. It would take some of the pressure off the girls having to remember it every day if the guy could share that.  

And I guess they should know when to take the after-sex pill, that you can take it up to 72 hours afterwards. And maybe the different safety risks for using the condom and the Pill and sexually transmitted diseases and the symptoms that go with those. If they just knew a bit more then it would take the pressure off the girl.

So do you think you could start educating your boyfriend?

Yeah, well I think I already have. Like sometimes he reminds me to take a Pill when I've forgotten and so that's quite nice and it just makes me feel like he's taking part in the contraceptive side of our sex life as well, so that's good.

Practically, he's more involved?

Yeah he knows more about it and that's really helpful and so yeah, I do try to educate him.

Last reviewed January 2016
Last updated January 2016

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