Progestogen only pill
| Progestogen-only pill | |
|---|---|
| Background | |
| Type | Hormonal |
| First use | 1973 |
| Failure rates (first year) | |
| Perfect use | 0.3% |
| Typical use | 9% |
| Usage | |
| Duration effect | 1 day |
| Reversibility | Yes |
| User reminders | Taken within same 3-hour window each day |
| Advantages and disadvantages | |
| STI protection | No |
| Weight | No proven effect |
| Period disadvantages | Light spotting may be irregular |
| Period advantages | Often lighter and less painful |
| Medical notes | |
| Unaffected by being on most (but not all) antibiotics. May be used, unlike COCPs, in patients with hypertension and history of migraines. Affected by some anti-epileptics. | |
Progestogen-only pills or progestin-only pills (POP) are contraceptive pills that contain only synthetic progestogens (progestins) and do not contain estrogen. They are colloquially known as mini pills.
Although such pills are sometimes called "progesterone-only pills", they do not actually contain progesterone, but one of several chemically related compounds; and there are a number of progestogen-only contraceptive formulations.
The theoretical efficacy is similar to that of the combined oral contraceptive pill (COCP). However, this pill is taken continuously without any breaks between packets, and traditional progestogen-only pills must be taken to a much stricter time every day (within 3 hours vs. a COCP's 12 hours). However, in some countries, the POP Cerazette has an approved window of 12 hours. The effectiveness is, therefore, dependent upon compliance.
Lacking the estrogen of combined pills, they are not associated with increased risks of DVT or heart disease. With the decreased clotting risk, they are not contraindicated in the setting of sickle-cell disease. The progestin-only pill is recommended over regular birth control pills for women who are breastfeeding because the mini-pill does not affect milk production (estrogen reduces the amount of breast milk). Like combined pills, the minipill decreases the likelihood of pelvic inflammatory disease.
It is unclear whether POPs provide protection against ovarian cancer to the extent that COCP do.
There are fewer serious complications than on COCP.
Epidemiological evidence on POPs and breast cancer risk is based on much smaller populations of users and so is less conclusive than that for COCPs.
In the largest (1996) reanalysis of previous studies of hormonal contraceptives and breast cancer risk, less than 1% were POP users. Current or recent POP users had a slightly increased relative risk (RR 1.17) of breast cancer diagnosis that just missed being statistically significant. The relative risk was similar to that found for current or recent COCP users (RR 1.16), and, as with COCPs, the increased relative risk decreased over time after stopping, vanished after 10 years, and was consistent with being due to earlier diagnosis or promoting the growth of a preexisting cancer.
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