7.3.2.1 Oral progestogen-only contraceptives

ChoiceDrugDosage
1st choiceCerelle® (desogestrel 75 microgram) tabletsDose:
1 tablet daily at the same time each day, starting on day 1 of cycle then continuously; if administration delayed by 12 hours or more it should be regarded as “missed pill” (see advice below)

Prescribing Notes

  • Progestogen–only pills (POPs) are associated with irregular bleeding in up to 40% of users. Bleeding patterns do not tend to improve with time and are not likely to be any different with a different progestogen.
  • POPs may be more suitable than combined hormonal contraceptives for women with diabetes, those who are breastfeeding, women with a history of thromboembolism, older women (over 35, especially smokers), women with hypertension or when oestrogen is contraindicated.
  • It is no longer recommended that women who weigh over 70kg are prescribed two progestogen-only pills a day.
  • The efficacy of the POP will be affected by enzyme-inducing drugs and an alternative contraceptive method should be sought.

Missed Pill rules for POPs

  • If you forget a pill, take it as soon as you remember and carry on with the next pill at the right time. If the pill was more than 3 hours (12 hours for desogestrel) overdue you are not protected. Continue normal pill-taking but you must also use another method, such as the condom, for the next 2 days.
  • The Faculty of Sexual and Reproductive Healthcare (FSRH) recommends emergency contraception if unprotected sexual intercourse occurred after the missed pill and within 48 hours of restarting the POP.
  • Refer to FSRH guidance * for further details.

*Some recommendations may be outside terms of product licence.