Progesterone Only Pill

Question 1

What is the mechanism of action of the POP?

Answer 1

Thickens cervical mucus

Question 2

What is the regime for the POP?

Answer 2

Must be taken every day without a break at the same time (+/- 3 hours).

Question 3

What is the difference between starting the POP between day 1-5 of cycle and starting it after this?

Answer 3

1. 1-5 days - cover is immediate

2. Later - use condom for 2 days

Question 4

What is the advice given for a missed POP?

Answer 4

Take next one immediately and use condom for 2 days.

Question 5

What is the difference between Cerazette and other POPs?

Answer 5

1. Contains desogestrel
2. More effective
3. Can be taken within 12-hour period

Question 6

What are the advantages of the POP?

Answer 6

1. Suitable for older women
2. Where COCP is contraindicated
3. Good for lactating mothers
4. No increased VTE risk
5. Not affected by broad spectrum antibiotics

Question 7

What are the disadvantages of POP?

Answer 7

1. Higher failure rate than COCP
2. Vaginal spotting (breakthrough bleeding)
3. Breast tenderness
4. Depression, acne
5. Reduced libido, bloating
6. Efficacy reduced with hepatic enzyme-inducing drugs

Question 8

What are the contraindications to all progesterone contraception?

Answer 8

1. Current breast cancer
2. Liver disease
3. Migraine and aura
4. SLE and antiphospholipid antibodies
5. Undiagnosed vaginal bleeding

Question 9

What are the important points for POP counselling (OSCE station)?

Answer 9

1. Advise about bleeding patterns

2. Emphasise importance of meticulous timekeeping