Counselling

Historically patients need to be counselled to determine their suitability for a Progesterone Only Pill (POP) because the original brands have to be taken within 3 hours of the same time, every day. With its slightly increased failure rate than the combined pill, it was felt that ladies with a stable lifestyle would be more suited to this regime, especially if this was combined with the reduction in fertility found with ladies aged over 30 and/or breast feeding. However, the introduction of the newer POP Cerazette, with its up to12 hour delay in pill taking has made the POP a useful option as a method of contraception, particularly if the Combined pill is contraindicated. The use of progesterone only products have a reduced risk of venous embolism compared with combined contraceptive pills. Counselling re sexual health and the prevention of STIs should also be included in the consultation. All available methods of contraception should be discussed, to give the patient a wide choice of options.

Types of progesterone only pills

There are 6 brands of old POPs eg Femulen, which must be taken every day and within 3 hours of the same time of day. The newer POP, Cerazette, can have a delay of up to 12 hours before adding in precautions.

Other progesterone only products include

 

Risks, advantages and disadvantages

Advantages

Disadvantages

History – is patient suitable for a POP?

Action

Pill Taking – Education

Choice of POP

The older POPs are cheaper than Cerazette and with reduced fertility found with lactating mothers and ladies over 45, could still be first choice. However with Cerazette’s lower failure rate and greater effectiveness, especially if overweight, then serious consideration should be given to prescribing Cerazette as the POP of choice.

Contraindications

Review

References