Progestin-only pills (POPs) for contraception
- Andrew M Kaunitz, MD
Andrew M Kaunitz, MD
- Professor and Associate Chairman
- Department of Obstetrics and Gynecology
- University of Florida College of Medicine-Jacksonville
Progestin-only contraception is an option for women in whom an estrogen-containing contraceptive is either contraindicated or causes additional health concerns. In addition to progestin-only pills, other types of progestin-only contraceptives include:
●Progestin injections (see "Depot medroxyprogesterone acetate for contraception")
●Progestin implants (eg, Nexplanon, Jadelle) (see "Etonogestrel contraceptive implant")
●Intrauterine contraception (eg, Mirena, Skyla) (see "Intrauterine contraception: Devices, candidates, and selection")
Norethindrone — Only one progestin-only contraceptive pill (POP) formulation is marketed in the United States: norethindrone 0.35 mg tablets (Micronor, Nor-QD, and generics). The progestin dose is substantially lower than the dose in any combination oral contraceptive. It is dispensed in packs of 28 active pills, which are taken continuously (ie, no pill free or nonhormonal pill week) . Unless otherwise noted, the information on POPs in this topic primarily applies to norethindrone POPs.
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- MECHANISM OF ACTION
- Candidates for use of POPs
- - Women in whom estrogen is contraindicated
- Patient evaluation
- Timing doses and missed pills
- Reducing barriers to use
- SIDE EFFECTS
- RISKS AND BENEFITS
- Effect on cardiovascular risk
- Effect on carbohydrate metabolism
- Ectopic pregnancy risk
- Effect on bone mineral density
- Older reproductive age women
- Effect on cancer risk
- Effect on sexually transmitted infections
- Noncontraceptive benefits
- USE AFTER ABORTION OR DELIVERY
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS