188.8.131.52 Oral progestogen-only contraceptives
|1st choice||Cerelle® (desogestrel 75 microgram) tablets||Dose:|
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)
- 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.