Progestogen-only pill (drospirenone)
What is the progestogen-only pill?
Progestogen-only pills (POPs) are a form of oral contraception that is used to prevent pregnancy. POPs contain a hormone called progestogen, which is similar to the hormone progesterone that is produced by the ovaries.
There are two types of POP available in Australia:
- The first type of pill is known by the brand names Microlut or Noriday. It contains progestogen hormones call 'levonorgestrel' or 'norethisterone'. It is sometimes also called the 'mini-pill'
- The second type of pill is known by the brand name Slinda. It contains the progestogen hormone called 'drospirenone'
This factsheet is for the second type of POP called Slinda.
It does not have information about the first type of pills, known as Microlut or Noriday. You can find information about those pills in the factsheet here.
How does it work?
This type of pill comes in a packet with 24 days of active hormone pills and four days of inactive sugar pills. This form of contraception does not contain estrogen.
These pills work by:
- stopping the release of an egg by the ovary (ovulation)
- making the mucus at the cervix thicker so that sperm cannot get through
How effective is it?
POPs are as effective as the combined oral contraceptive pill at preventing pregnancy when taken correctly. This means they are greater than 99% effective with perfect use, but in typical day-to-day use they can be about 93% effective.
Ideally, they should be taken at the same time each day. This pill has a '24 hour missed pill window'. This means if you are more than 24 hours late in taking your pill, you may not be protected from unintended pregnancy. If you think it may be difficult for you to take a pill at the same time every day, talk with your clinician about other options.
POPs may not be effective if vomitting occurs within three hours of taking a hormone pill, or if you have severe diarrhoea. Some medicines may also stop these pills from working, including some anti-epileptic medication and herbal remedies.
Always consult your doctor or contact the Family Planning Australia Talkline if you have any questions about drug interactions with you POP.
Who can take it?
Most people can use POPs. You may not be able to use it if you:
- have breast cancer
- have severe liver disease
- have unusual bleeding from your vagina
- use medicines or herbal remedies which make the POP less effective
Advantages
POPs provide effective contraception if they are taken at the same time each day. When you stop taking it, your fertility immediately returns to its normal level.
POPs can be safely used by people who cannot take estrogen, and they do not carry the same risk of blood clots as the combined hormonal contraceptive pill.
Disadvantages
Periods will often change when using progestogen-only contraception.
With Slinda, the inactive sugar pills are added to improve the bleeding pattern. Bleeding is scheduled to occur during the four days you are taking the inactive pills each month. However, you may experience spotting or irregular bleeding on other days. Some people experience no vaginal bleeding at all.
It is not possible to reliably 'skip your period' with these POPs. However, the longer you are using it, the more chance you have of experiencing no bleeding at all.
Some side effects of POPs may include headaches, breast tenderness and nausea. If you experience these, they will usually decrease or stop after the first few months of taking these pills.
Talk to your doctor if you develop any unwanted side effects. It may be helpful to change the type of POP or the type of contraceptive you are using. If you are at risk of sexually transmissible infections (STIs) you can use condoms at the same time as taking the POP.
How do I take it?
These pills should be taken at the same time each day. Choose a time when you are most likely to remember to take the pill daily. You can fall pregnant if you take your pill more than 24 hours late. It can be helpful to set a reminder on your phone or put your pill pack next to your toothbrush.
POPs are immediately effective if started during the first five days of your menstrual cycle, which starts with first day of bleeding. If you start at any other time during your menstrual cycle, these pills are effective after 7 days of taking active pills. Other contraceptive measures such as condoms should be used during these days.
If you are changing from another method of contraception, or after having a baby, miscarriage or abortion, discuss the best time for starting the POP with your doctor or nurse. Depending on when you start the pill, they may also recommend a pregnancy test to exclude pre-existing pregnancy.
What if I forget to take it?
If you forget to take Slinda (the POP with drospirenone), follow these rules:
If you are less than 24 hours late, this is considered a "late pill". If this happens, you should:
- take the late pill as soon as you remember
- then take the next pill at the usual time - you may end up taking two pills on the same day
- you will still be protected against unintended pregnancy
If you are more than 24 hours late, this considered a "missed pill" and you may be at risk of unintended pregnancy. If this happens, you should:
- take the missed pill as soon as you remember
- take the next pill at the usual time - you may end up taking two pills on the same day
- throw away the other missed pills
- continue taking pills as usual. You will not be protected against unintended pregnancy until you have taken 7 days of hormone (active) pills. If you have less than 7 days until the sugar pills, skip the sugar pills and continue straight onto the next packet of active pills.
- use another form of contraception (such as condoms) or don't have sex until you have taken 7 pills correctly (that is, for the next 7 days)
If you have a missed pill, you may need to use emergency contraception if you:
- miss a pill in the first 7 days of a new pack of pills and have had unprotected sex in the previous 5 days
- start a new pack more than 24 hours late and have had unprotected sex in the previous 5 days
- have unprotected sex in the 7 days after missing a pill
- miss a pill and have missed other hormone pills in the 7 days
The emergency contraceptive pill is available from pharmacies without a prescription - it is important to take it as soon as possible.
There are two types of emergency contraceptive pill. Talk to the pharmacist or doctor about which type is best for you.
Where can I get it?
All types of POPs are available on prescription, which can be obtained from your doctor, Family Planning Australia clinics, community health clinics or youth health clinics.
You can then collect the pills at your local pharmacy.
For more information
Family Planning Australia Talkline - www.fpnsw.org.au/talkline or 1300 658 886
National Relay Service (for deaf people) - 13 36 77
TIS National's interpreting service - 131 450
Visit your nearest Family Planning Australia clinic - www.fpnsw.org.au/clinics
Famil Planning Australia client resource on contraception - What suits me?
Family Planning Australia factsheet - Emergency contraception
