What is the progestogen-only pill (POP)?

The progestogen-only pill (POP) is a type of contraception (birth control). It is a pill that you take daily to avoid getting pregnant. One type is known as the ‘mini pill’.

The POP is different from the combined oral contraceptive pill (‘the pill’). The combined pill contains both oestrogen and progestogen. The POP contains only progestogen.

The POP is useful if you can't take the combined pill for health-related reasons.

Talk to your doctor about whether this type of contraception is suitable for you. You need a prescription from your doctor or family planning clinic to take the progestogen-only pill.

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What are the different types of progestogen-only pill?

There are 2 types of progestogen-only pills in Australia. They contain different types of the hormone progestogen.

• One type contains levonorgestrel or norethisterone (this type is also called the mini pill).
• The other type contains drospirenone.

How does the progestogen-only pill work?

POPs that contain levonorgestrel or norethisterone work by:

• thickening the mucus at the entrance to the uterus (womb), which stops sperm from getting through
• preventing ovulation (the release of an egg from the ovaries) in some people

POPs containing drospirenone also thicken this mucus and reliably prevent ovulation.

How do I take the progestogen-only pill?

Mini pill

This type of POP comes in a packet with 28 hormone pills. You need to take the mini pill at the same time every day, without a break.

If you take it more than 3 hours late it might not work.

Drospirenone POP

This type of pill comes in a packet with:

• 24 hormone pills
• 4 non-hormone pills

Take the pill at the same time every day. If you take it more than 24 hours late it might not work.

How effective is the progestogen-only pill at preventing pregnancy?

The progestogen-only pill works well if you take it properly. But with typical use, about 7 in every 100 people who use it will get pregnant.

The mini pill is less effective in people younger than 25 years old than in older people.

There are other forms of contraception that have been shown to be very effective, such as the contraceptive implant or intrauterine contraceptive device (IUD). Talk to your doctor about the different types of contraception.

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What can affect the POP working properly?

The POP may not work properly if you:

• miss a pill
• are late taking a pill
• have vomiting or diarrhoea (which can stop the pill from being absorbed properly)

Some medicines or herbal remedies may also stop the pill from working. Ask your doctor or pharmacist about how any other medicines you need to take might affect it.

If you are not sure what to do if you miss a pill or have been unwell:

• ask your doctor or pharmacist
• call your local family planning clinic

What should I do if I forget to take the POP?

Check the instructions that come with your pill carefully. They will tell you what to do if you are late taking your pill or miss a dose. Missing a pill may mean your pill won’t protect you from getting pregnant.

If you are not sure what to do if you miss a pill:

• ask your doctor or pharmacist
• call your local family planning clinic

What are the advantages and disadvantages of the progestogen-only pill?

Advantages of the POP:

• It can be used by most females, including many who cannot take the combined pill.
• It can be used straight after having a baby and while breastfeeding.
• Your cycle and fertility return quickly when you stop taking it.
• The drospirenone POP may help with period pain and your periods may stop altogether.

Disadvantages of the POP:

• You need to remember to take the POP every day.
• It can cause irregular periods, vaginal bleeding or spotting.
• You may experience side effects when taking the POP (see below).

The POP does not protect against sexually transmitted infections (STIs). For protection against STIs, you can use condoms at the same time as taking the POP.

What are the side effects of the progestogen-only pill?

Possible side effects when taking the POP include:

• headaches
• mood changes
• weight gain
• breast tenderness
• lack of interest in sex
• acne

Talk to your doctor if you are having troublesome side effects.

Resources and support

Family Planning Australia has fact sheets on contraception.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.