Progestogen only pill

Benefits

  • periods may be irregular – more or less frequent or stop or become lighter or heavier

  • may help with premenstrual symptoms or painful periods

  • suitable for those who can’t take oestrogen or the combined pill

  • you don’t have to prepare for or interrupt sex

  • you are protected from pregnancy straight away if you start taking it on the first day of your period

  • when you stop using the pill your fertility will return to normal.

The progestogen-only pill (also known as ‘POP’) is a small round tablet that releases a progestogen hormone. It has to be taken daily. Almost half of all women take oral contraceptive pills as their primary method of contraception. POP is most popular amongst women aged between 16 and 24.

*for typical use (effectiveness for perfect use 99%)

**very variable, heavier or lighter

Which brand of pill should I choose?

There are several different brands of progestogen only pill. The main differences are that some pills need to be taken within the same 3 hour period every day, and others within a 12 hour period.

Which brand works best for you will depend on your medical history, your health and your lifestyle. If you’re unsure about which brand to order, email our clinicians for advice at info@fettle.health. The health questions in our order form will help us ensure that we prescribe an appropriate pill.

If you find that one brand doesn’t suit you, you can choose a different brand at your next order.

We offer the most commonly prescribed brands of progestogen only pill:

Cerazette

One pill every day.

£25.00 for 3 months, including next working day delivery

Cerelle

One pill every day.

£20.00 for 3 months, including next working day delivery

Norgeston

One pill every day.

£20.00 for 3 months, including next working day delivery

Noriday

One pill every day.

£20.00 for 3 months, including next working day delivery

How it works

How to use it

Progestogen only pill how

You will need to take one pill every day. There are 28 pills per pack, and you do not take a break between packs. There are two different types of POP: ‘3 hour’ pills must be taken within the same 3 hour period every day. ’12 hour’ pills must be taken within the same 12 hour period.

Choose a convenient time in the day to take your first pill, and continue to take it close to that time every day.

Why it works

Progestogen only pill why

The hormone in POP prevents pregnancy by:

  • thickening the mucus in the neck of the womb, so it is harder for sperm to penetrate the womb and reach an egg
  • in some women, POP prevents the ovaries from releasing an egg each month (ovulation)
  • thinning the lining of the womb, so there is less chance of a fertilised egg implanting into the womb.

Things to consider

POP does not protect you from STIs. You should use a condom as well if you think you are at risk of an STI.

You need to remember to take your pill every day. If you find that you often forget to take your pill, there are long lasting contraception options available, such as the hormonal coil or the implant . Visit your nearest sexual health clinic or your GP for more information.

What if?

You miss a pill:

  • the chance of getting pregnant depends on when the pills are missed and how many pills are missed. Read more in our Questions section.
  • if you are not sure what to do, continue to take your pill and use another method of contraception, such as condoms, and seek advice from our clinicians by emailing info@fettle.health.

The pill can become less effective at preventing pregnancy if:

  • you have vomiting and/or diarrhoea, as the pill may not be absorbed into your bloodstream. Read more in our Questions section.
  • you are taking some medicines. Always read the information that comes with your medicine, and tell your doctor that you are taking the progestogen only pill if you are prescribed any medicines. The health questions in our order form will ask you if you are taking certain medicines that can make POP less effective.

Suitability

Most women can take POP, but we will ask about your family and medical history in our order form to determine whether or not it is the best method for you.

POP is useful for women who cannot take oestrogen, or those who smoke and are 35 or over. POP is not always suitable for women who:

Side effects & risks

Although serious side effects are not common, there are some risks associated with POP.

CommonRare
Short term

Spotty skin, breast tenderness, nausea / vomiting, stomach upset, weight change and headaches, change to sex drive or mood. These should go after a few months.

Long term

Periods may be irregular, lighter, heavier or more frequent or may stop altogether.

Some women may develop small fluid-filled cysts on their ovaries. These are not dangerous and do not usually need to be removed.

Questions?

If you start your pill in the first day of your cycle then it will be effective immediately. If you start your pill at any other time on your cycle then you should use additional protection for 48 hours.

The progestogen only pill may prevent ovulation and therefore prevent you going through your usual menstrual cycle.It is normal for POP to stop periods or make them lighter or irregular. At the beginning this may be worrying, and some people will end up taking a few pregnancy tests before they feel confident that the pill is working - get in touch if you’d like to discuss this with one of our clinicians.

There are two types of POP:

3 hour

Progestogen-only pill must be taken within three hours of the same time every day. Common brands include: Norgeston and Noriday.

12 hour

Progestogen-only pill must be taken within 12 hours of the same time every day. Common brands include: Cerazette.

The cost of the pill depends on which brand you choose.

  • Cerazette - £25
  • Cerelle - £20
  • Norgeston - £20
  • Noriday - £20

Our prices are for a 3 month supply and includes a prescription from a qualified clinician, access to clinical advice by text (before and after you’ve ordered), 1st class postage and discreet packaging of your pills, text updates to help you track your order, and text reminders to help you reorder before your supply runs out.

The chance of getting pregnant depends on when the pills are missed, how many pills are missed and whether you have had sex without using another form of contraception.

First check your pill packet to see if you are taking a 12 hour or 3 hour POP.

If the hormone is called desogestrel then you are taking a 12-hour pill.

This means that the pill must be taken within 12 hours of the same time every day.

  • If you are late with the pill but less than 12 hours late then take the missed pill as soon as you remember it and take your next one on time. You do not need to take extra precautions.
  • If you are more than 12 hours late then take your missed pill as soon as you remember it, take the next one on time and keep taking the pill. However you will not be protected until you have taken two more pills at the correct time and will need to use condoms during this time. You will be able to rely on it for contraception again at about the time that you are due to take your third pill on time.

If you are on a pill containing norethisterone 350 micrograms (Micronor, Noriday) or levonorgestrel 30 micrograms (Norgesten) then you are taking a three-hour pill.

  • This means that the pill must be taken within three hours of the same time every day.
  • If you are more than three hours late then take your missed pill as soon as you remember, take the next one on time and keep taking the pill. However you will not be protected until you have taken two more pills at the correct time and will need to use condoms during this time. You will be able to rely on it for contraception again at about the time that you are due to take your third pill on time.

If you are not sure what to do, continue to take your pill and use another method of contraception, such as condoms, and seek advice from our clinicians by replying to a text from us or emailing info@fettle.health.

If you vomit within two hours of taking the progestogen only pill, it may not have been fully absorbed into your bloodstream. Take another pill straight away and the next pill at your usual time.

If you don’t take the replacement within three hours (or 12 hours for the 12-hour pill) of your normal time, use additional contraception, such as condoms, for two days.

If you continue to be sick, keep using another form of contraception while you're ill and for two days after recovering.

Very severe diarrhoea (6 to 8 watery stools in 24 hours) may also mean that the pill doesn't work properly. Keep taking your pill as normal, but use additional contraception, such as condoms, while you have diarrhoea and for two days after recovering.

Seek advice from our clinicians by replying to a text from us or info@fettle.health or contact your GP or NHS 111 if your sickness or diarrhoea continues.

You may not be able to take POP if you have or have had:

  • heart disease or a stroke
  • disease of the liver
  • systemic lupus erythematosus
  • breast cancer.

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

Some reports suggest that there may be a very small increased risk of breast cancer and ovarian cancer, but the pill does help protect against other types of cancers such as womb, colon and uterine cancers.

There is no evidence to suggest the pill causes infertility. Most women who have regular periods will find that their normal cycle will return within six months. Some women find that their usual cycles begin again very quickly after stopping, but for others it can take longer.

Some reports suggest that there may be a very small increased risk of breast cancer and cervical cancer, but the pill does help protect against other types of cancers such as ovarian, colon and uterine cancers.

Some women may develop small fluid-filled cysts on their ovaries. These are not dangerous and do not usually need to be removed.

When you first start the pill you will usually be given three months’ supply to see how it suits you. After that you should have your blood pressure checked and then reorder. If there are no problems, you can order up to 12 months’ supply of the progestogen only pill.

We will send a reminder by text two weeks before your supply is due to run out. You can reorder using the same online order form and your new supply will be dispatched to arrive the next working day. You should always make sure that you have a new supply ready to avoid missing any pills.

The POP has a different hormone than the combination in the combined pill, so if you have had side effects on the combined pill then you may wish to try the progestogen only pill as an alternative.

Yes, you can easily change between pills.

Some women find that their weight changes due to fluid retention or an increase in appetite, but this should settle over time.

Some medicines make the progestogen only pill less effective (including those used to treat epilepsy, HIV and TB, and the herbal medicine St John’s Wort). Ask our clinicians if you’re unsure by emailing info@fettle.health and read the information that comes with your medicine.

The antibiotics rifampicin and rifabutin (which can be used to treat illnesses including tuberculosis and meningitis) can reduce the effectiveness of the progestogen only pill. Other antibiotics do not have this effect. If you are prescribed rifampicin or rifabutin, you may need additional contraception (such as condoms) while taking the antibiotic and for 28 days after.

Always tell your doctor that you are taking the progestogen only pill if you are prescribed any medicines.

When you stop using the POP your fertility will return to normal. (Don’t worry if your periods don’t start immediately. For some women it can take a few months).

Yes, you can use the POP after having a baby.

Yes, you can use the POP while breastfeeding.