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Progestin Only Pills (POPs)

What are POPs?

Progestin only pills (POPs) are birth control pills with­out estrogen. Regular birth control pills contain estro­gen and progestin and are called combination pills. POPs are options for women who cannot take estrogen such as women with severe migraines, high blood pres­sure or a history of blood clots. They are also options for women who are breast feeding and sometimes older women. They are considered safer because they are less likely to cause increased blood pressure, headaches, depression and cardiovascular complications.

How do they work?

POPs prevent pregnancy mostly by thickening the cervical mu­cus and thinning the uterine lining, along with some ovulation suppression. They may be slightly less effective than combination pills but still very effective when taken correctly. Typical user failure rate is >8%.

How do I take POPs?

  • Start the first day of your period.
  • Start today if there has been no unprotected intercourse since your last period. Use an additional form of contraception such as condoms for at least 48 hours.
  • If switching from combination pills, start the day after the last active pill and skip the placebo week.

Start a new pack of pills the day after finishing the previ­ous pack. POPs come in a pack of 28 pills with no pla­cebo week. It is very important to take the POP at the same time each day. If you are more than 3 hours late taking a POP, you will need to use another form of birth control, such as condoms, for at least 48 hours as long as the next 2 pills are on time.

If you do miss a pill, take it as soon as you remember, even if this means taking 2 pills in one day. Be sure to take your next pill on time after a missed pill and use an additional form of birth control, such as condoms, for 48 hours. If you miss 2 pills in a row, take 2 daily for the next 2 days and use condoms for 48 hours after the missed pills. You can take emergency contraception if you had intercourse when you were late taking pills.

NOTE! You MUST take every pill in the package; there are no inactive pills.

What can I expect my periods to be like?

Women who take POPs may have irregular bleeding, spotting between periods, regular periods or no periods. If you have more than 45 days without a period, you may want to do a pregnancy test. Your periods will return to normal very quickly and you will be able to get pregnant if you stop taking POPs.

What are the benefits of taking POPs?

  • No estrogen side effects or complications.
  • Decreased risk of endometrial cancer.
  • Safe for breastfeeding mothers.
  • Quick return to fertility when discontinued.

What are the side effects of POPs?

  • Irregular periods, spotting or no periods. Having no periods is not harmful as long as pregnancy is ruled out.
  • Slight increased risk for tubal (ectopic) pregnancy. See your practitioner immediately if you experience severe abdominal pain.
  • Must be taken on time.

You should not take POPs if you:

  • Have vaginal bleeding between periods that has not been evaluated.
  • Have any chance of being pregnant.
  • Are taking certain drugs for; epilepsy (seizures), tubercu­losis or narcolepsy, or supplements like St. John’s Wort.
  • Have any liver problems or disease.
  • Have breast cancer.

POPs will not protect against sexually transmitted infections. Use condoms correctly and consistent­ly to reduce your risk.