5.2 Progesterone Oral Contraceptive Pill Review

How effective any contraceptive is depends on how old you are, how often you have sex and whether you follow the instructions. If 100 sexually active women don’t use any contraception, 80 to 90 will become pregnant in
a year. If the POP is always used perfectly, according to instructions, it’s over 99% effective. This means that less than one POP user in 100 will get pregnant in one year. If the POP is not always used according to instructions, about nine

Most women can use the POP. A doctor or nurse will ask you about your own and your family’s medical history. Do mention any illness or operations you’ve had. Some of the conditions which may mean you shouldn’t use the POP are:

• you think you might already be pregnant
• you take certain medicines.
• You have now or had in the past: heart disease or a stroke disease of the liver  breast cancer.

If you’re healthy and there are no medical reasons for you not to take the POP, you can take it until your menopause or until you’re 55 years old.

Some of the advantages of the POP are

• It’s useful if you can’t take estrogens, like those found in the combined pill,  contraceptive patch or contraceptive vaginal ring.
• You can use it at any age, but it’s especially useful if you smoke and are 35 or over.
• It may help with premenstrual symptoms and painful periods. You can use it if you’re breastfeeding.

There are no serious side effects with the POP however:

• It’s common for your periods to change while you’re taking the POP. Bleeding may be irregular, light, more frequent, last longer or stop altogether. This may settle down and isn’t harmful. If you have any concerns, see your doctor or nurse. Changing to a different POP may help.
• The POP doesn’t protect you against sexually transmitted infections, so you may need to use condoms as well.
• You have to remember to take the pill at the same time every day.
• You may get some side effects when you first start taking the POP, such as spotty skin, breast tenderness and headaches. These may stop within a few months.

If you’re more than three hours* late

• Take a pill as soon as you remember. If you’ve missed more than one, only take one.
• Take your next pill at the usual time. This may mean taking two pills in one day. This isn’t harmful.
• You’re not protected from pregnancy. Continue to take your pills as usual but use an additional method of contraception, such as condoms, for the next two days.
• If you’ve had unprotected sex during this time you may need emergency contraception. Seek advice immediately

.
If you’re less than three hours* late

• Take a pill as soon as you remember.
• Take your next pill at the usual time. You’re protected from
  pregnancy.

*12 hours if you’re taking a desogestrel POP

If you vomit within two hours of taking the POP, it won’t have been absorbed by your body. Take another pill as soon as you feel well enough. As long as you’re not sick again your contraception won’t be affected. Take your next pill at the normal
time. If you continue to be sick, seek advice.

If you have very severe diarrhoea that continues for more than 24 hours, this may make the POP less effective. Keep taking your pill at the normal time, but treat each day that you have severe diarrhoea as if you’d missed a pill. Follow the missed pill instructions

If you’ve had sex without contraception, or think your method might’ve failed, there are different types of emergency contraception you can use.

• An IUD is the most effective option. It can be fitted up to five days after sex, or up to five days after the earliest time you could’ve ovulated (released an egg).
• An emergency contraceptive pill with the active ingredient ulipristal acetate can be taken up to five days (120 hours) after sex. It’s available with a prescription or to buy from a pharmacy. ellaOne is the only brand in the UK.
• An emergency contraceptive pill with the hormone levonorgestrel can be taken up to three days (72 hours) after sex. It’s more effective the earlier it’s taken after sex. It’s available with a prescription or to buy from a pharmacy. There are different brands. Emergency pills are available for free from some pharmacies. Age restrictions may apply.

If you took all your pills correctly and you didn’t have an upset stomach or take any other medicines which might affect the POP, then it’s unlikely you’re pregnant. Continue to take your pills as normal. There’s no evidence that if you take the POP when you’re pregnant it will harm the baby. If you’re worried, ask your doctor or nurse for advice or do a pregnancy test. Taking the POP doesn’t affect a pregnancy test. If you do become pregnant there’s a risk of ectopic pregnancy (where the pregnancy develops outside your uterus (womb), usually in a fallopian tube). Seek medical advice as soon as possible if you have a sudden or unusual pain in your lower abdomen (this might be a warning sign of an ectopic pregnancy) or if you think you might be
pregnant.

You still need barrier contraception to protect yourself from sexually transmitted infections