cautions to using the progestogen only contraceptive pill

Last edited 03/2021 and last reviewed 10/2021

Cautions including any relevant action to be taken

• If the individual is less than 16 years of age an assessment based on Fraser guidelines must be made and documented.
• If the individual is less than 13 years of age the healthcare professional should speak to local safeguarding lead and follow the local safeguarding policy.
• Discuss with appropriate medical/independent non-medical prescriber any medical condition or medication of which the healthcare professional is unsure or uncertain.
• Consideration should be given to the current disease status of those with severe malabsorption syndromes, such as acute/active inflammatory bowel disease or Crohn’s disease. Although the use of POP is not contra-indicated it may be less effective and so these individuals should be advised offered Long Acting Reversible Contraception (LARC).
• Women should be advised that it is possible that medications that induce diarrhoea and/or vomiting (e.g. orlistat, laxatives) could reduce the effectiveness of POP.
• Offer Long Acting Reversible Contraception (LARC) to all individuals in particular those with medical conditions for whom pregnancy presents an unacceptable risk and those on a pregnancy prevention plan.

If an individual is known to be taking a medication which is known to be harmful to pregnancy a highly effective form of contraception is recommended.  Highly effective methods include the LARC methods: IUD, IUS and implant.  If a LARC method is unacceptable/unsuitable and a POP is chosen then an additional barrier method of contraception is advised. See FSRH advice

Reference:

1. Patient Group Direction (PGD) (NHS Specialist Pharmacy Service). Supply of a progestogen only contraceptive pill (POP) . (Accessed 17th March 2021).