The oral progesterone only contraceptive pill is suitable for sexually active menstruating women of any age who are at risk of unwanted pregnancy. This includes women in whom oestrogens are contraindicated including those patients with venous thrombosis or a past history or predisposition to venous thrombosis. However POP preparations have a higher failure rate than that of combined preparations (BNF, 49, p407)

There are now two types of POP:

• Traditional POPs which act upon the cervical mucus and lining of the uterus and they may stop ovulation in up to 40% of women. These products have a traditional 3 hour window (taken within 27 hours of the previous one)
• Cerazette POP prevents ovulation and has a 12 hour product licence. Therefore it should be the pill of choice in women under the age of 30 who specifically request the POP; women who cannot take the COC for medical reasons; women over 11 stone (70kg) where effectively with traditional POPs may be reduced.

What to tell the patient about Progestogen-only pills

• How the pill works
• Risks and benefits of the pill
• How to take the pill
• When to start
• Missed pill advice
• Side effects, serious, non-serious
• Reasons to stop the pill immediately
• Safer sex advice
• Follow-up
• Give written information
• Where to get and how to get further advice and information

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