HealthCare >> Birth Control >> Progestin :

Women who use Progestin-only Oral Contraceptives should swallow a pill every day to prevent pregnancy. It contains very small amounts of only one kind of hormone, a progestin. Again, they contain only one-half to one tenth as much progestin as combined oral contraceptives. They do not contain estrogen. These are known as progestin-only pills (POPs), POCs and mini pills.

Progestin-only contraceptives are also best recommended for breast-feeding women. They do not reduce milk production.

How do they work?
Progestin works in a manner similar to breast-feeding. It thickens the cervical mucus, making it difficult for sperm to pass through. It reduces ovulation (release of eggs from ovaries) to half of that of menstrual cycle.

Progestin-only oral contraceptives do not disrupt existing pregnancy.

How effective are they?

• For breast feeding women: Progestin is more effective than combined oral contraceptives, which are commonly used, because breast feeding itself provides protection against pregnancy. Pregnancy rates for women not breast-feeding are not available.
  There is only about one pregnancy per 100 women in the first year of use. Mistakes in pill taking lead to pregnancy more often than with combined oral contraceptives. However, pill taking maybe easier, because a woman takes the same pill every day without breaks.
• For all women: Progestin-only oral contraceptives are very effective when used correctly and consistently. There are 0.5 pregnancies per 100 women in the first year of use (1 in every 200). Combined oral contraceptives which are used correctly and consistently are more effective than the above mentioned contraceptives.

It is most effective when taken about the same time every day.

Advantages and Disadvantages:

Advantages:

1. It can be used by nursing mothers starting 6 weeks after childbirth. Neither the quantity nor the quality of milk is harmed. (In contrast, combined oral contraceptives can slightly reduce milk production).
2. It does not increase risk of estrogen-related complications, such as heart attack or stroke. Women take one pill every day without break. It is easier to understand than taking 21-day combined pills.
3. It can be very effective during breast-feeding. Also there is less risk of progestin related side effects, like weight gain, acne etc. than with combined oral contraceptives.

Disadvantages:

1. Women not breast-feeding may experience common side effects. Changes in menstrual cycle are normal, including irregular periods, spotting or bleeding between periods (common), and amenorrhea (missed periods).
2. Less common side effects include headaches and breast tenderness.
3. Should be taken at about the same time each day to work best. For women not breast-feeding, even taking a pill more than a few hours late, increases the risk of pregnancy, and missing two or more pills increases the risk greatly.

When to start?
A woman can be given progestin –only oral contraceptives at any time and told when to start taking them.

A breast-feeding woman can start as early as 6 weeks after childbirth. Fully or nearly fully breast-feeding effectively prevents pregnancy for at least 6 months or until she has menstrual period.

A woman if not breast-feeding after childbirth, can take them immediately or at anytime in the first 4 weeks after childbirth. She need not wait for her menstrual period to return.

A woman who has had a miscarriage or abortion can take progestin-only contraceptives immediately or on the first 7 days after either first or second trimester miscarriage or abortion.

A woman having menstrual cycles may take these contraceptives in the first 5 days of her menstrual bleeding. The first day of the menstrual bleeding is the best. No back up method is needed for extra protection.

Suggested Reading -
Oral Contraceptive Pills - A fact sheet on the instruction of use/benefit/cautions of use of the 'pill'

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