How to take your POP

Taking POP or mini pill

Progestogen-only pills (POP or mini pill) contain only one hormone and are taken every single day with no breaks. Most modern POP contain 75mcg of desogestrel, but there are several different brand names. Older POP contained different progestogen hormones but these are now very rarely used. The only older brands still available are Norgeston (levonorgestrel) and Noriday (norethisterone).

Starting desogestrel 75mcg POP

Traditionally it is recommended to start POP on the first day of a period, and contraceptive cover starts immediately.

More recently, research supported by the Faculty of Sexual and Reproductive Healthcare (FSRH) has shown that it is possible to start the POP up to day 5 after your period begins for the contraceptive cover to start immediately.

It is also possible to start POP at any other time in the cycle if you can reasonably assume that you are not pregnant. If you start later than day 5 in the cycle, the FSRH advises using condoms as well for the first 48 hours.

If you are not sure if you may be pregnant (e.g. you have had sex without using contraception, within the last 21 days), you can still start the POP, but you should take a pregnancy test 21 days after you last had unprotected sex. Taking POP whilst in early pregnancy has not been shown to cause any harm.

These non-traditional starting regimes are not described in the manufacturer's Patient Information Leaflets and are 'off-label' meaning that doctors take all responsibility for the prescribing.

Continuing desogestrel POP

POP should be taken at the same time every day. Choose a time of day you are likely to remember - for many women this is first thing in the morning when they wake up - you could keep your pills on your bedside table or near your toothbrush, so you see them straight away. Other women prefer to take them at bedtime. Some women like to use a mobile phone app or alarm to remind them to take their POP.

When one strip of pills is completed, continue straight on, to the next strip of POP without taking any breaks. Do not stop the pills, even if bleeding, until you no longer require contraception.

Don't forget/miss POP

It's very important not to forget pills or to be late taking them. Try and take them at the same time each day. It's a good idea to get into a routine - then you are less likely to forget.

What to do if you forget/miss a desogestrel POP

Less than 12 hours late: take the missed tablet as soon as you remember and take the next one at the usual time. It will still protect you from pregnancy.

More than 12 hours late: You may not be completely protected against pregnancy. Take a tablet as soon as you remember and take the next one at the usual time. This may mean taking 2 in 1 day. This is not harmful. (If you have forgotten more than one tablet you don't need to take the earlier missed ones.) Continue to take your tablets as usual but you must also use an extra method, such as a condom, for the next 2 days (48 hours).

See also See NHS contraception guide - What should I do if I miss a pill (progestogen-only pill)? for further details.

You may also need to consider emergency contraception if you have had sex recently.

When does the POP become effective?

If started before day 5 of a period, POP is effective immediately. At any other time, it takes 48 hours and 2 POP pills, before the contraceptive works.

Don't forget sexually transmitted infection (STI) protection

Desogestrel POP does not protect you from STIs, so it is recommended to use condoms carefully and consistently with a new partner, at least until you have both had an STI screen. Having regular screening is extremely important, especially for your future fertility. Many women with STIs have no symptoms at all, so it's important to get tested. You can either visit a local STI clinic or order a home chlamydia or STI test kit. Chlamydia testing is also available from sexual health clinics, GPs, young peoples clinics, and some pharmacies, or through Brook.

Common side effects when first starting POP

Many women are very happy taking POP and do not experience side effects. Most side effects if noticed will settle within the first few months of use.

The most troublesome issue can be erratic, irregular bleeding within the first few months. This will usually settle after about three months with many women then having either no periods at all or very infrequent light periods.

Other possible side effects, occurring in less than 1 in 10 women include: mood changes, decreased sexual drive (libido), headache, nausea, acne, and breast pain. These will usually settle within the first few months.

Norgeston and Noriday

Norgeston and Noriday are taken in exactly the same way as a desogestrel POP. The only difference is that you only have 3 hours after missing a pill before the contraceptive cover is lost.

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