What is the progesterone only pill?

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• 0:04Introduction
• 0:18Who can take it
• 1:11How it works
• 1:24Effectiveness
• 1:51How to take it
• 3:02Side effects

Full transcript

1. 0:04Introduction

   Hi, I'm Dr. Taz Varkey. Today I'm going to talk about the progesterone-only pill. So what is the progesterone-only pill? It's basically a form of the birth control pill, but there's no estrogen.

2. 0:18Who can take it

   There's only progesterone. So most of the time when people refer to the birth control pill, they're talking about the combination estrogen-progesterone pill. But this is just progesterone. And why would you use just progesterone without estrogen? Well, sometimes women can't take estrogen. Maybe they have medical conditions in which that would be dangerous, such as they might have an increased risk of blood clotting because of a family history or maybe even a personal history of blood clotting.

3. 0:44

   They may have high blood pressure. Maybe they're breastfeeding. We can't give breastfeeding women the birth control pill that has estrogen in it. So there's many different medical conditions that would keep us from prescribing estrogen. And for those patients, the progesterone-only pill would be great. The way it works is the same as for other progesterone methods, which is to thicken the cervical mucus and also thin out the lining of the uterus so that even if the egg and the sperm meet, there's nowhere for the embryo to implant.

4. 1:11How it works

   And when I talked about thickening the cervical mucus, the reason that's helpful is because it'll keep the sperm from getting through the cervix and into the uterus to the fallopian tube, and hopefully it'll never meet the egg.

5. 1:24Effectiveness

   So those are the two main ways that the progesterone-only pill works. In terms of its effectiveness, it's 93 to 96% effective. And the reason there's a variance there is it depends on how you take it. The effectiveness might even be higher, but many women don't take it properly. They might miss a pill or they take it late and then it's not going to work as well.

6. 1:51How to take it

   So the instructions on how to take it are very important. And this is something I always go over with each patient. With the progesterone-only pill, you have to take it within three hours of the same time every day. So if you pick a time like nine in the morning, you have to take it between, you can actually make this a larger window that way.

7. 2:10

   If you choose nine in the morning as your planned time, then you can take it anywhere from six to nine or nine to 12. So that actually becomes a six-hour window, and that's a little easier to comply with. But that's going to be very important for maintaining effectiveness. And it's also important to understand that if you forget, you should take that pill right away and then start back to your regular time for the next 48 hours, and then this pill will start working again to protect you against pregnancy.

8. 2:34

   It's very important to note this is not true of the combination birth control pill, because that pill works by preventing ovulation.

9. 2:48

   And I point to the head because ovulation is stimulated by signals from the brain. So with the combination pill, if you miss it by more than 24 hours, you have to take the pill when you remember it, and then you have to use a backup method for the rest of that pack.

10. 3:02Side effects

    Important distinction. In terms of side effects, the most common side effects with the progesterone-only pill would be breakthrough bleeding. Sometimes it just, women have a lot of spotting. And that'll often go away with time, but if it doesn't, you may have to switch to another method. For some women, it can cause, and this is a small percentage, but it can cause a flare-up in acne, might even cause more bloating or creation of what we call small little ovarian cysts.

11. 3:26

    None of these things are life-threatening or dangerous in 99.9% of the cases, but they can be a nuisance. And lastly, a very common question I get with contraception is, will this method affect my fertility? And the answer with the progesterone-only pill is absolutely not.

12. 3:44

    Once you stop it, it's out of your system within 24 hours, and you can get pregnant that same month or within the next month for sure, if all other things are okay with you. So that's it with the progesterone-only pill. I hope this was helpful. Remember, this does not substitute for medical advice from your doctor, so you should always go talk to your doctor and let them take in your unique medical conditions and situation to give you advice. Thank you for watching. And don't forget to subscribe.