Progestogen-only oral contraceptive pill

Also called the 'mini-pill’ or the progestogen-only contraceptive pill (POCP).

Key points about the progestogen-only contraceptive pill

  • The progestogen-only contraceptive pill (POP) is a form of contraception to prevent pregnancy. 
  • The POP is sometimes known as 'the mini pill'.
  • It contains only progestogen.
  • Examples include Microlut®, Noriday® and Cerazette®.
  • Find out how to take it safely and possible side effects.
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The progestogen-only contraceptive pill (POP) is a form of contraception to prevent pregnancy. It contains only progestogen, a hormone similar to 1 produced by your ovaries. It doesn't contain oestrogen. For oestrogen-containing contraception, see the combined pill.


Examples of the progestogen-only pill are Microlut, Noriday and Cerazette

  • Although each of these has different progestogens, they are equally effective in preventing pregnancy.
  • Microlut and Noriday are funded but Cerazette is not.
  • Your doctor will discuss the best pill for you. If you experience side effects, or if you keep forgetting to take your pill, you may need to try another brand or another type of contraception before you find one that is suitable for you.


How does the progestogen-only pill work?

  • POPs work mainly by thickening the mucus in your cervix so sperm can’t travel through it. 
  • Cerazette® also works by stopping you from producing a monthly egg and changes the lining of your womb so it's less likely to accept a fertilised egg.

Supply issues (September 2024)

  • Noriday: There's a supply issue with Noriday. You may only get 3 months supply at a time to make sure it's available for everyone. Check on the label if you have a repeat dispensing available.
  • You may get an alternative product called Norethindrone Tablets.
  • Read more about the Noriday supply issue(external link).

Pros

Cons

✔ It doesn’t interfere with sex.

✔ It can be used by women who are breastfeeding.

✔ There are very few side effects.

 

✘ It must be taken each day at the same time of the day whether you have sex on that day or not.

✘ It doesn't protect against sexually transmitted infections (STIs), so it’s important to use condoms when you have sex.

✘ It may cause irregular bleeding for a few months after starting. As long as you haven't missed any pills, it will still be working as a contraceptive. If the bleeding continues, talk to your healthcare provider.

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.

You must take the POP every day with no breaks. There are no inactive 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 so, 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 occurrence of unprotected sex before starting 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 2 days until the POP becomes 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 2 days, until Cerazette becomes 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. 
If you are unsure about what to do if you have missed one or more pills, contact your doctor, nurse, pharmacist or call Healthline 0800 611 116 for advice.

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 normal time, or if you have ongoing vomiting or diarrhoea lasting more than 24 hours, use additional contraception (eg, condoms) or avoid having sex while you are unwell.
  • Continue using additional contraception until you've taken your regular doses for at least 2 consecutive days and continue your daily doses as normal. 
  • 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 normal time, or if you have ongoing vomiting or diarrhoea lasting more than 24 hours, use additional contraception (eg, condoms) or avoid having sex while you are unwell.
  • Continue using additional contraception until you have taken your regular doses for at least 2 consecutive days and continue your daily doses as normal. 
  • 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. 
If you're not sure about what to do if you have diarrhoea and vomiting, contact your doctor, nurse, pharmacist or call Healthline 0800 611 116 for advice.

The POP is NOT recommended if you have:

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


The POP must be used with caution if you: 

  • have ischaemic heart disease or stroke or a past history of these conditions
  • are taking some medicines, over-the-counter medicines or herbal remedies – check all other medicines and herbal remedies you are taking with your doctor or pharmacist
  • have diarrhoea and vomiting
  • have trouble remembering to take your pill each day.


The POP is especially recommended: if you are breastfeeding or cannot use the combined pill for medical reasons, eg, having a history of:

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

Like all medicines, the POP can cause side effects, although these are very rare and not everyone gets them.

Side effects What should I do?
  • Breast discomfort
  • Headaches
  • Mood changes
  • Skin changes such as acne
  • Feeling sick (nausea) 
  • These are very uncommon and often go away with time.
  • If severe and ongoing, or if you are vomiting or have severe diarrhoea, tell your doctor or nurse.
Read more about medicines and side effects and reporting a reaction you think might be a side effect.

Overview of contraception methods | Rongoā ārai hapūtanga
Combined oral contraceptive pill
The pill
Emergency contraception

The following links provide further information about the POP:

Progestogen-only oral contraceptive pill (external link)Sexual Wellbeing Aotearoa
Progesterone-only contraceptive pill(external link) Health New Zealand | Te Whatu Ora
 
More detailed information on specific brands of the POP:
Cerazette(external link)
Microlut(external link)
Noriday(external link)

References

  1. Progestogen-only oral contraceptives(external link) New Zealand Formulary

Brochures

Medicines and side effects
Healthify He Puna Waiora, NZ, 2024

5 questions to ask about your medications

5 questions to ask about your medications

Health Quality and Safety Commission, NZ, 2019 English, te reo Māori

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

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