Progesterone only pills (aka POPs) are similar to the traditional birth control pill in that it’s a pill you take every day to prevent pregnancy.  BUT… progesterone only pills don’t contain estrogen like traditional pills.  There are lots of reasons you may want (or need) to avoid estrogen.  Read on to find out if this could apply to you!

First…some terminology. 

There are lots of acronyms in the world of birth control and pills are no exception.  OCPs or oral contraceptive pills are a generic term that can mean any pill that prevents pregnancy – this includes progesterone only pills and combined estrogen/progesterone pills.  COC stands for combined oral contraception – which is specific for combined estrogen/progesterone pills vs POP which stands for Progesterone Only Pills.

So why would someone want to choose a progesterone only pill??

As I mentioned, there are several reasons why you may want to avoid estrogen.  The most common I encounter in my office every day is women who have recently had a baby.  Especially if breastfeeding, you don’t want birth control that contains estrogen because it will likely decrease your milk supply. 

If you are someone who gets migraines especially with aura (those annoying vision changes that can happen in your peripheral vision) you probably should avoid estrogen as well.  Research has showed us this increases your risk of blood clots and stroke (well beyond that of the general population). 

There are other medical conditions that make estrogen containing birth control more risky as well – these include blood clotting conditions, Lupus, and uncontrolled high blood pressure to name a few.

Especially if you have any medical conditions, it’s always best to check with your doctor about the safest birth control options for you.

How do they work?

Progesterone causes your cervical mucus to become thickened which prevents sperm from getting to your prize eggs.  It also prevents you from ovulating at least some of the time. 

How effective are POPs?

They are quite effective.  With typical use they prevent pregnancy 91% of the time.  The most important thing to note is you do have to be quite good about taking your pill at the SAME TIME EVERY DAY.  If you take your pill up to 3 hours late, it can decrease the effectiveness and it’s recommended you use a backup method (like condoms) for the next 3 days.    

Are there side effects?

POPs are generally considered very safe with few side effects.  As I mentioned, it’s a great option for women with certain medical conditions. 

Though here are the most common side effects:

• Irregular bleeding.  While COCs tend to help regulate your period – making it more predictable and lighter.  POPs tend to have more spotting and menstrual irregularities associated with them. 
• Breast tenderness.  This is typically temporary, only for the first month or two after starting the pill.
• Acne.  It’s not that POPs are causing your acne but if you’ve switched from another form of birth control (especially a COC) it’s this transition that can cause acne to flare up.  Generally this only lasts a month or two – but if it lasts longer than this it would certainly be a reason to see your friendly dermatologist (like our amazing Dr. Truong!)

One more thing…

If you are interested in a progesterone only pill but don’t like the idea of irregular bleeding and having to take it at the same time each day, there may be another option for you.  A new birth control called Slynd is now available with a type of progesterone called drospirenone.  Early studies have shown less menstrual irregularities with this pill AND it can be delayed up to 24 hours and still be effective.

Not quite ready to make the switch to POPs?  Check out these other progesterone only birth control options that may be right for you – IUDs, Depo, and Nexplanon.