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Sexual and Reproductive Health

Progestin Only Pill (POP)

​​​​What is the progestin only pill (POP)?
  • POP is a type of birth control pill you take every day to prevent pregnancy.
  • POP contains one hormone (progestin). Other birth control pills contain two hormones (estrogen and progestin).
  • POP comes as a 28-day pack (there are hormones in all 28 pills). There are no hormone-free pills.

POP prevents pregnancy by:

  • decreasing the cervical mucus and making it thicker which slows the movement of the sperm, making it harder to get to the egg
  • making the lining of the uterus thin
  • slowing down the egg in the fallopian tube
  • sometimes stopping an egg from being released (about half the time)

How well does POP work?

  • There’s an 85% chance of getting pregnant after one year of having unprotected sex.
  • With typical use (this means not following the exact directions, for example, you might miss pills or take them late) POP is 91% effective.
  • With perfect use (this means you follow the exact directions all the time) POP is 99.7% effective.
  • You are more likely to get pregnant if you take your pill over 3 hours late.
  • POP doesn’t protect you from sexually transmitted infections (STIs) and HIV.
  • Use a condom every time you have sex (vaginal, oral, anal) to lower your risk of STIs and HIV.

How do I start taking the POP?

To start POP, you will need to see your health care provider. You need a prescription for POP.

There are different ways to start the first package. If you start POP:

  • on day 1 to 5 of your period, it works right away to prevent pregnancy
  • on any other day, you need to use an extra form of birth control (e.g., condoms, abstinence) for 48 hours

Take one pill at the same time every day.

Who can take POP?

You can take POP if you:

  • are over 35 and smoke
  • have a history of migraines with aura or other nervous system problems affecting speech, vision, movement, or sensations
  • need birth control without estrogen
  • have side effects from other types of birth control
  • have recently had a baby or are breastfeeding

Before taking POP talk to your health care provider if you have breast cancer, a history of breast cancer or other medical concerns.

What are the side effects of POP?

The most common side effect is a change in your period. It might be early, late, or you might have spotting. Some women don’t have periods at all while taking POP.

There is a chance (especially in the first 3 months) that you might have:

  • acne
  • mild headaches
  • tender breasts
  • tiredness
  • dizziness
  • moodiness or depression
  • decreased sex drive
  • upset stomach (nausea)
  • cysts on the ovaries
  • extra hair on your face or body

If you have side effects, don’t stop taking POP. Talk to your health care provider. Most side effects get better after 3 months.

If you are concerned you could be pregnant and have been taking POP, talk to your healthcare provider. There is a higher risk of pregnancy outside of the uterus (ectopic pregnancy).

Did You Know

  • You have the right to make the decision to have sex or not.
  • Plan ahead and decide to protect yourself to lower your risk of pregnancy, STIs, and HIV.
  • It is important to talk with your partner about how you can protect each other.
  • You can get pregnant as soon as you stop taking POP.
  • It is safe to take POP for many years. There is no need to “take a break” from POP.
  • Some medicines can affect POP. Talk to your doctor or pharmacist before you take any medicine (prescriptions or over-the-counter).
  • Don’t take POP if you are pregnant or think you might be.

What if I forget to take a pill?

If you forget to take a pill, take it as soon as you remember (even if it means you take 2 pills in one day).

Use another method of birth control (e.g., condoms, abstinence) for 48 hours if you:

  • take your pill more than 3 hours late
  • forget to take 1 or more pills
  • start a pill pack late
  • are throwing up (vomiting) or have diarrhea

Think about getting emergency contraception to help prevent pregnancy if:

  • your back-up method of birth control fails (e.g., condom breaks)
  • you had unprotected sex in the 5 days before you took your pill late

Ulipristal Acetate should not be used for emergency contraception when taking POP; it will not be effective.

For More Information

  • Health Link – Health Advice 24/7: 811
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