Patients should be counseled that oral contraceptives
do not protect against transmission of HIV (AIDS) and other sexually transmitted
diseases (STDs ) such as Chlamydia, genital herpes, genital warts, gonorrhea,
hepatitis B, and syphilis.
This leaflet is about birth control pills that contain
one hormone, a progestin. Please read this leaflet before you begin to take
your pills. It is meant to be used along with talking with your doctor or
Progestin-only pills are often called “POPs” or
“the minipill.” POPs have less progestin than the combined birth
control pill (or “the pill”) which contains both an estrogen and a
HOW EFFECTIVE ARE POPS?
About 1 in 200 (0.5%) POPs users will get pregnant in the
first year if they all take POPs perfectly (that is, on time, every day). About
1 in 20 (5%) “typical” POPs users (including women who are late
taking pills or miss pills) gets pregnant in the first year of use. The
following table will help you compare the efficacy of different methods.
IUD: 1 to 2%
Depo-Provera® (injectable progesterone): 0.3%
Norplant® System (levonorgestrel implants): 0.1%
Diaphragm with spermicides: 18%
Spermicides alone: 21%
Male condom alone: 12%
Female condom alone: 21%
Women who have never given birth: 18%
Women who have given birth: 36%
Periodic abstinence: 20%
No methods: 85%
HOW DO POPS WORK?
- They make the cervical mucus at the entrance to the womb
(the uterus) too thick for the sperm to get through to the egg.
- They prevent ovulation (release of the egg from the
ovary) in about half the time.
- They also affect other hormones, the fallopian tubes and
the lining of the uterus.
YOU SHOULD NOT TAKE POPS
- If there is any chance you may be pregnant.
- If you have breast cancer.
- If you have bleeding between your periods which has not
- If you are taking certain drugs for epilepsy (seizures)
or for TB. (See USING POPS WITH OTHER MEDICINES below.)
- If you are hypersensitive or allergic to any component of
- If you have liver tumors, either benign or cancerous.
- If you have acute liver disease.
RISKS OF TAKING POPS
If you have sudden or severe pain in your lower abdomen
or stomach area, you may have an ectopic pregnancy or an ovarian cyst. If this
happens, you should contact your doctor or clinic immediately.
An ectopic pregnancy is a pregnancy outside the womb.
Because POPs protect against pregnancy, the chance of having pregnancy outside
the womb is very low. If you do get pregnant while taking POPs, you have a
slightly higher chance that the pregnancy will be ectopic than do users of some
other birth control methods.
These cysts are small sacs of fluid in the ovary. They
are more common among POP users than among users of most other birth control
methods. They usually disappear without treatment and rarely cause problems.
Cancer Of The Reproductive Organs And Breasts
Some studies in women who use combined oral
contraceptives that contain both estrogen and a progestin have reported an increase
in the risk of developing breast cancer, particularly at a younger age and
apparently related to duration of use. There is insufficient data to determine
whether the use of POPs similarly increases this risk.
Some studies have found an increase in the incidence of
cancer of the cervix in women who use oral contraceptives. However, this
finding may be related to factors other than the use of oral contraceptives and
there is insufficient data to determine whether the use of POPs increases the
risk of developing cancer of the cervix.
In rare cases, combined oral contraceptives can cause
benign but dangerous liver tumors. These benign liver tumors can rupture and
cause fatal internal bleeding. In addition, a possible but not definite association
has been found with combined oral contraceptives and liver cancers in studies
in which a few women who developed these very rare cancers were found to have
used combined oral contraceptives for long periods of time. There is
insufficient data to determine whether POPs increase the risk of liver tumors.
SEXUALLY TRANSMITTED DISEASES (STDS)
WARNING: POPs do not protect against getting or
giving someone HIV (AIDS) or any other STD, such as Chlamydia, gonorrhea,
genital warts or herpes.
The most common side effect of POPs is a change in
menstrual bleeding. Your periods may be either early or late, and you may have
some spotting between periods. Taking pills late or missing pills can also
result in some spotting or bleeding.
Other Side Effects
Less common side effects include headaches, tender
breasts, nausea and dizziness. Weight gain, acne and extra hair on your face
and body have been reported, but are rare.
If you are concerned about any of these side effects,
check with your doctor or clinic.
USING POPS WITH OTHER MEDICINES
Before taking a POP, inform your health care provider of
any other medication, including over-thecounter medicine, that you may be
If you are taking medicines for seizures (epilepsy) or tuberculosis
(TB), tell your doctor or clinic.
These medicines can make POPs less effective:
Medicines for seizures:
- Phenytoin (Dilantin®)
- Carbamazepine (Tegretol®)
Medicine for TB:
Before you begin taking any new medicines be sure your
doctor or clinic knows you are taking birth control pills that contain a
HOW TO TAKE POPS
IMPORTANT POINTS TO REMEMBER
- POPs must be taken at the same time every day, so choose
a time and then take the pill at the same time every day. Every time you take a
pill late, and especially if you miss a pill, you are more likely to get
- Start the next pack the day after the last pack is
finished. There is no break between packs. Always have your next pack of pills
- You may have some menstrual spotting between periods. Do
not stop taking your pills if this happens.
- If you vomit soon after taking a pill, use a backup
method (such as condom and/or spermicide) for 48 hours.
- If you want to stop taking POPs, you can do so at any
time, but, if you remain sexually active and don't wish to become pregnant, be
certain to use another birth control method.
- If you are not sure about how to take POPs, ask your
doctor or clinic.
- It's best to take your first POP on the first day of your
1. Pick the day label strip that starts with the first
day of your period
2. Place this day label strip on the tablet blister pack
over the area that has the days of the week (starting with Sunday) pre-printed
on the tablet blister pack.
Note: If the first day of your period is a Sunday,
you can skip steps # 1 and #2
- If you decide to take your first POP on another day, use
a backup method (such as condom and/or spermicide) every time you have sex
during the next 48 hours.
- If you have had a miscarriage or an abortion, you can
start POPs the next day.
IF YOU ARE LATE OR MISS TAKING YOUR POPS
- If you are more than 3 hours late or you miss one or more
- TAKE a missed pill as soon as you remember that you
- THEN go back to taking POPs at your regular time,
- BUT be sure to use a backup method (such as condom
and/or spermicide) every time you have sex for the next 48 hours.
- If you are not sure what to do about the pills you have
missed, keep taking POPs and use a backup method until you can talk to your
doctor or clinic.
IF YOU ARE BREASTFEEDING
- If you are fully breastfeeding (not giving your baby any
food or formula), you may start your pills 6 weeks after delivery.
- If you are partially breastfeeding (giving your baby some
food or formula), you should start taking pills by 3 weeks after delivery.
IF YOU ARE SWITCHING PILLS
- If you are switching from the combined pills to POPs,
take the first POP the day after you finish the last active combined pill. Do
not take any of the 7 inactive pills from the combined pill pack. You should
know that many women have irregular periods after switching to POPs, but this
is normal and to be expected.
- If you are switching from POPs to the combined pills,
take the first active combined pill on the first day of your period, even if
your POPs pack is not finished.
- If you switch to another brand of POPs, start the new
- If you are breastfeeding, you can switch to another
method of birth control at any time, except do not switch to the combined pills
until you stop breastfeeding or at least until 6 months after delivery.
PREGNANCY WHILE ON THE PILL
If you become pregnant, or think you might be, stop
taking POPs and contact your physician. Even though research has shown that
POPs do not cause harm to the unborn baby, it is always best not to take any
drugs or medicines that you don't need when you are pregnant.
You should get a pregnancy test:
- If your period is late and you took one or more pills
late or missed taking them and had sex without a backup method.
- Anytime you miss 2 periods in a row.
WILL POPS AFFECT YOUR ABILITY TO GET PREGNANT LATER?
If you want to become pregnant, simply stop taking POPs.
POPs will not delay your ability to get pregnant.
If you are breastfeeding, POPs will not affect the
quality or amount of your breast milk or the health of your nursing baby.
However, isolated cases of decreased milk production have been reported. If you
suspect that you are not producing enough milk for your baby, contact your
doctor or clinic.
No serious problems have been reported when many pills
were taken by accident, even by a small child, so there is usually no reason to
treat an overdose.
OTHER QUESTIONS OR CONCERNS
WARNING: Cigarette smoking greatly increases the possibility
of suffering heart attacks and strokes. Women who use oral contraceptives are strongly
advised not to smoke.
Diabetic women taking POPs do not generally require
changes in the amount of insulin they are taking. However, your physician may
monitor you more closely under these conditions.
If you have any questions or concerns, check with your
doctor or clinic. You can also ask for the more detailed “professional
package labeling” written for doctors and other health care providers.
HOW TO STORE YOUR POPS
Store your POPs at room temperature 68° to 77°F (20° to
Keep out of reach of children