Progestogen-only oral contraceptive pill

The POP is one of the more reliable forms of contraception.

• It's usually 92% effective, which means that it prevents pregnancy in 92 out of 100 women who use the POP each year.
• If used perfectly (no pills are missed), the POP is more than 99% effective in preventing pregnancy.
• To ensure that the POP works best, you need to remember to take it every day, at about the same time every day, whether you have sex on that day or not.

The POP may not work properly if you miss a pill, are vomiting (being sick) or have ongoing diarrhoea (runny poo). This can stop the pill from being absorbed properly. Read more about what to do if you miss a dose and what to do if you have vomiting or diarrhoea.

Some medicines or herbal remedies may also stop the pill from working. Ask your prescriber or pharmacist about how any other medicines you need to take might affect it. 

You must take the POP every day with no breaks. There are no inactive (sugar) pills.

• The usual dose of the POP is 1 tablet once a day. 
  • Most brands of the POP must be taken within 3 hours of the same time each day.
  • Cerazette® must be taken within 12 hours of the same time every day.
• You can take the POP with or without food.
• You can start taking the POP at any time in your menstrual cycle if you are certain you're not pregnant.
  • If you start on the first day of your period it starts working immediately. 
  • If you start at any other time during your menstrual cycle, it will take 48 hours to start working. This means, to be safe, you need to use additional contraception (eg, condoms) or not have sex for 48 hours (2 days) after starting.
• If you want to start the POP but think you may be pregnant, take a pregnancy test 21 days after the last time you had unprotected sex before you start taking the POP.

The advice for a missed pill depends on which brand you're taking.

Microlut and Noriday

A dose is considered 'missed' when more than 3 hours have passed since the regular dosing time.

• If you forget to take the pill on time, take it as soon as you remember and take the next pill at the normal time (even if this means you take 2 pills within the same day). 
• If you are more than 3 hours late in taking it then your protection immediately fails. Take your pill as soon as you remember, and continue taking your pill each day. However, you will also need to use extra contraception (eg, condoms), or avoid sex for the next 48 hours, until you have taken three consecutive pills. The POP will be effective again.    
• If you have unprotected sex within 48 hours of restarting the progestogen-only pill, contact your doctor, nurse, pharmacist or call Healthline 0800 611 116 for advice. You may need to use emergency contraception.

Cerazette

If you're taking Cerazette, a 'missed' dose is when more than 12 hours have passed since the regular dosing time.

• If you forget to take your pill on time, take it as soon as you remember and take the next pill at the normal time (even if this means you take 2 pills within the same day). 
• If you are more than 12 hours late in taking it then your protection immediately fails. Take your pill as soon as you remember and continue taking your pill each day. However, you will also need to use extra contraception (such as condoms), or avoid sex for the next 48 hours, until you have taken three consecutive pills. Cerazette will be effective again.
• If you have unprotected sex within 48 hours of restarting Cerazette, contact your doctor, nurse, pharmacist or call Healthline 0800 611 116 for advice. You may need to use emergency contraception. 
  
  

Vomiting (being sick) and ongoing diarrhoea (runny poo) from illness or laxatives can interfere with the effectiveness of the POP. The advice on what to do depends on the brand you're taking.

Microlut and Noriday

• If you vomit within 2 hours of taking your pill, take another pill as soon as possible.
• If you don't take a replacement pill within 3 hours of the usual time, or if you have ongoing diarrhoea lasting more than 24 hours, use condoms or avoid having sex, until you have been taking the pill correctly for 48 hours (you have taken three consecutive pills).  
• If you've had unprotected sex while you were unwell or within 48 hours of restarting the POP contact your doctor, nurse, pharmacist or call Healthline 0800 611 116 for advice. You may need to use emergency contraception.

Cerazette

• If you vomit within 2 hours of taking your pill, take another pill as soon as possible.
• If you don't take a replacement pill within 12 hours of the usual time, or if you have ongoing diarrhoea lasting more than 24 hours, use condoms or avoid having sex, until you have been taking the pill correctly for 48 hours (you have taken three consecutive pills).
• If you've had unprotected sex while you were unwell or within 48 hours of restarting Cerazette, contact your doctor, nurse, pharmacist or call Healthline 0800 611 116 for advice. You may need to use emergency contraception. 
  
  

It's safe to take the POP when you're breastfeeding

POPs don't affect breastmilk production. If you've just had a baby, you can start taking it straight away. If you start it more than 3 weeks after having a baby, you need to use additional contraception (eg, condoms) or not have sex for 48 hours (2 days) after starting.

The POP may be an option when you can't use the combined pill for medical reasons, eg, having a history of:

• blood clots or at risk of having blood clots
• migraines
• heavy smoking
• very high blood pressure or heart disease
• diabetes with complications
• not being able to tolerate oestrogen.

The POP must be used with caution if you:

• have ischaemic heart disease or stroke or a past history of these conditions
• have trouble remembering to take your pill each day.

The POP is NOT recommended if you have:

• unexplained vaginal bleeding
• severe liver problems, eg, cirrhosis or liver tumours
• breast cancer, or have recently had breast cancer.

Cerazette, Microlut or Noriday can be purchased from some pharmacies without a prescription if you meet the criteria. Your pharmacist will ask questions about your health and other medicines you're taking. There will be a charge for the medication and appointment.

When can the pill be purchased without a prescription?

You can get the pill from your pharmacy if you have had a prescription within the last 3 years and you are 1 of the following:

• from Aotearoa New Zealand and have run out of your contraception pill
• from overseas and have run out of your contraception pill
• collecting the emergency contraceptive pill and have used the contraceptive pill before
• wanting to restart the contraceptive pill and have used it before
• wanting the contraceptive pill after having a baby and have used it before.

If you are breastfeeding you can be given a progesterone-only pill. For other situations, the pharmacy will refer you back to your healthcare provider.

If you are unsure whether you are eligible for over the counter contraceptive, talk to the pharmacist.

Who can't purchase the pill without a prescription from their pharmacy?

There are some cases where the pill can't be purchased without a prescription from your pharmacy. This includes:

• If you're under the age of 16 years.
• You haven't had a prescription for this pill within the last 3 years.
• If you have risk factors that need medical supervision.

Like all medicines, the POP can cause side effects, although these are very rare and not everyone gets them.  As with all progestogen-only pills, the most common side effect is irregular bleeding. This is a nuisance but it's not dangerous. Often side effects improve as your body gets used to the new medicine.

Read more about medicines and side effects and reporting a reaction you think might be a side effect.