Progesterone Only Pills

Progesterone only pills (POP) contain only micro doses of progesterone (300-500 mcg) that comprise 15-30 percent of progesterone that is contained in combined estrogen-progesterone pills.

How do Progesterone Pills work?

1. Under the influence of POP the amount of cervical mucus decreases and increases its thickness. This reduces sperm viability and penetration.
2. Use of POP causes changes in endometrium. These changes prevent implantation
3. POP inhibits follicular development and ovulations in 50 percent of women. Some progesterone only contraceptives, like Depo-Provera completely inhibit ovulation.

Contraceptive effectiveness of POP is 0.3-9.6 per 100 women per year.

POP are taken continuously without breaks between packets. The pills must be taken every day to a much stricter time (within 3 hours). Keep in mind that effectiveness of this method of contraception greatly depends on user compliance.

Indications:

• Women over 35 (including smokers)
• The period of breastfeeding.(4-6 weeks after childbirth). POP are safe to use as a method of contraception during breastfeeding due to absence of estrogen. Be aware that POP might increase the flow of milk
• Diabetes
• Contraindication to estrogens

Contraindications

• Pregnancy
• High risk in case of unwanted pregnancy
• Malignant tumors
• Irregular menstrual cycle
• History of extrauterine pregnancy
• Abundant periods
• History of idiopathic jaundice during pregnancy
• Compromised liver function
• Thromboembolic diseases
• Damage of brain vessels

Side effects

• Menstrual cycle disorders (10.6 percent)
• Sickness, vomiting
• Depression
• Weight increase

Disadvantages:

• POP are less reliable as a method of contraception than combined hormonal pills
• A POP user must be very careful about taking the pills. The period of time between two pills should not be longer than 24 hours
• A POP user should be aware that these pills increase the risk of ovarian cyst and extrauterine pregnancy (2 cases per 100 women per year)
• POP often cause intermenstrual blood-tinged discharges
• Pop might shorten menstrual cycle (25 days and shorter)

Advantages of POP

• Low amount of progesterone and absence of estrogen in the medication. This is a great advantage for those who have some contraindications to estrogen and for breastfeeding mothers
• Lower risk of heart diseases and deep vein thrombosis, compared with combined birth-control pills
• POP do not affect carbohydrate metabolism and coagulating of blood
• POP has a therapeutic effect on painful periods, predmenstrual tension, ovulatory pains and inflammatory diseases of inner sex organs
• Fertility restores within 3 months after a woman stops using this method of contraception.

Recommendations for POP users

1. Use some other method of contraception during the first 7 days of using POP. For instance you can use a barrier method of contraception like a condom.
2. If you forgot to take a pill and the period between two pills is longer than 27 hours, use an additional method of contraception within 48 hours or abstain from sex
3. If one day you forgot to take a pill, than take it as soon as possible and take the next pill at usual time. If you forgot to take two pills, than you should take double dose during two days and simultaneously you should use an additional method of contraception
4. If the cycle is longer than 45 days you should apply to a doctor in order to exclude pregnancy
5. If you have intermenstural blood-tinged discharges, than continue taking POP. If the amount of discharges gets more abundant apply to a doctor for consultation.
6. Use an additional method of contraception if you have diarrhea.
7. Stop using POP 3 months before planned pregnancy (use some other method of contraception during this period)
8. If you have any complaints that occurred during use of POP apply to your doctor.