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How does it work? of Progestogen-only pill

There are a few different types of progestogen-only pill. Most work by stopping the man’s sperm from reaching the egg in the woman’s womb when a couple have sex. It does this by making the mucus in the woman’s cervix (neck of the womb) much thicker. This makes it very difficult for sperm to travel through the cervix and into the womb.

Some types of the progestogen-only pill stop the woman’s egg from settling in the womb, by making the lining of the womb too thin for a fertilised egg to settle in. Other types stop the ovaries from releasing an egg.

You start taking the progestogen-only pill on the first day of your period. This gives you protection against pregnancy straight away. You take one pill every day until the pack is finished. You then start taking the next pack the following day, without a break. This means pills are taken during your period. Each pill is marked with a day of the week, so that you can see if you’ve forgotten to take one.

If you don’t start taking the progestogen-only pill on the first day of your period, you normally need to use another type of contraception as well, such as condoms, for the first seven days.

However, new research shows you can also start taking the progestogen-only pill up to and including the fifth day of your period and still be protected from pregnancy straightaway. This may not be suitable for women who have a short menstrual cycle (when your period comes every 23 days or less) – ask you doctor or nurse for advice about whether you need to use another form of contraception as well.

It’s important to take the progestogen-only pill at the same time everyday – chose a time that is convenient for you, such as after breakfast. If you forget to take a pill, you may not be protected against pregnancy; it depends how much time passes before you take the next one:

  • If you’re up to three hours late, you should take the next pill as soon as you remember, and take the next one on time. You will still be protected against pregnancy.
  • If you're more than three hours late, you probably won’t be protected against pregnancy. Continue to take the progestogen-only pill as usual, but use an extra method of contraception (such as condoms) for the next 48 hours to make sure you do not get pregnant.
  • If you've had vomiting or severe diarrhoea within three hours of taking the progestogen-only pill, you should also use an extra method of contraception for the next 48 hours.

When you first start taking the progestogen-only pill, you will usually be given a three-month supply. If you are happy with how the pill is working, you will be prescribed it again, usually for 6 months or a year this time. If you’ve had any problems, you should see the doctor or nurse about changing to a different type of pill.

If you have no medical problems that affect taking the progestogen-only pill (see Who Can Use It), you can continue taking it until the menopause.