Progestogen only pill

Jump to: navigation, search
Progestogen Only Pill (POP)
Background
B.C. type Hormonal
First use 1973
Failure rates (first year)
Perfect use 0.5%
Typical use ?%
Usage
Duration effect 1day
Reversibility Yes
User reminders Taken within same 3hour window each day
Clinic review 6 months
Advantages and Disadvantages
STD protection No
Weight No proven effect
Periods Light spotting may be irregular
Periods Often lighter and less painful
Medical notes
Unaffected by being on most (but not all) antibiotics. May be used, unlike COCPs, in patients with hypertension and history of migraines. Affected by some anti-epileptics.

WikiDoc Resources for Progestogen only pill

Articles

Most recent articles on Progestogen only pill

Most cited articles on Progestogen only pill

Review articles on Progestogen only pill

Articles on Progestogen only pill in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Progestogen only pill

Images of Progestogen only pill

Photos of Progestogen only pill

Podcasts & MP3s on Progestogen only pill

Videos on Progestogen only pill

Evidence Based Medicine

Cochrane Collaboration on Progestogen only pill

Bandolier on Progestogen only pill

TRIP on Progestogen only pill

Clinical Trials

Ongoing Trials on Progestogen only pill at Clinical Trials.gov

Trial results on Progestogen only pill

Clinical Trials on Progestogen only pill at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Progestogen only pill

NICE Guidance on Progestogen only pill

NHS PRODIGY Guidance

FDA on Progestogen only pill

CDC on Progestogen only pill

Books

Books on Progestogen only pill

News

Progestogen only pill in the news

Be alerted to news on Progestogen only pill

News trends on Progestogen only pill

Commentary

Blogs on Progestogen only pill

Definitions

Definitions of Progestogen only pill

Patient Resources / Community

Patient resources on Progestogen only pill

Discussion groups on Progestogen only pill

Patient Handouts on Progestogen only pill

Directions to Hospitals Treating Progestogen only pill

Risk calculators and risk factors for Progestogen only pill

Healthcare Provider Resources

Symptoms of Progestogen only pill

Causes & Risk Factors for Progestogen only pill

Diagnostic studies for Progestogen only pill

Treatment of Progestogen only pill

Continuing Medical Education (CME)

CME Programs on Progestogen only pill

International

Progestogen only pill en Espanol

Progestogen only pill en Francais

Business

Progestogen only pill in the Marketplace

Patents on Progestogen only pill

Experimental / Informatics

List of terms related to Progestogen only pill

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Progestogen Only Pills or Progestin Only Pills (POP) are contraceptive pills that only contain synthetic progestogens (progestins) and do not contain oestrogen. They are colloquially known as mini pills.

Although such pills are sometimes called "Progesterone Only Pills," they do not actually contain progesterone, but one of several chemically related compounds and there are a number of progestogen only contraceptive formulations.

How they work

The mechanism of action of progestogen-only contraceptives depends on the progestogen activity and dose.[1]

Very low dose progestogen-only contraceptives, such as traditional progestogen-only pills (and subdermal implants Norplant and Jadelle and intrauterine systems Progestasert and Mirena), inconsistently inhibit ovulation in ~50% of cycles and rely mainly on their progestogenic effect of thickening the cervical mucus and thereby reducing sperm viability and penetration.

Intermediate dose progestogen-only contraceptives, such as the progestogen-only pill Cerazette (or the subdermal implant Implanon), allow some follicular development but much more consistently inhibit ovulation in 97–99% of cycles. The same cervical mucus changes occur as with very low dose progestogens.

High dose progestogen-only contraceptives, such as the injectables Depo-Provera and Noristerat, completely inhibit follicular development and ovulation. The same cervical mucus changes occur as with very low dose and intermediate dose progestogens.

In anovulatory cycles using progestogen-only contraceptives, the endometrium is thin and atrophic. If the endometrium was also thin and atrophic during an ovulatory cycle, this could theoretically interfere with implantation of a blastocyst (embryo).

Efficacy

The theoretical efficacy is similar to that of the combined oral contraceptive pill (COCP). However, they are taken continuously without any breaks between packets and traditional progestogen-only pills must be taken to a much stricter time every day (within 3 hours vs. a COCP's 12 hours, although in some countries the POP Cerazette has an approved window of 12 hours). The real-life efficacy is therefore dependent upon user compliance.

POPs are not dependent upon gut bacterial flora for their absorption and so are not affected by courses of antibiotics. They will, however, be affected by any episodes of diarrhea or vomiting.

Benefits

Lacking the oestrogen of combined pills, they are not associated with increased risks of DVT or heart disease. With the decreased clotting risk, they are not contraindicated in the setting of sickle-cell disease. The low dose of progestogen, and absence of oestrogen, make the minipill safe to use during breastfeeding; in fact, it may increase the flow of milk. Like combined pills, the minipill decreases the likelihood of pelvic inflammatory disease.

It is unclear whether POPs provide protection against endometrial cancer and ovarian cancer to the extent that COCP do.

Side effects

  • With no break in the dosage, flow does not initially occur at a predictable time. Most women tend to establish, over a few months, light spotting at approximately regular intervals.
  • May cause mastalgia or mood swings.
  • Weight gain is less commonly experienced than on COCP.

Breast cancer risk

Epidemiological evidence on POPs and breast cancer risk is based on much smaller populations of users and so is less conclusive than that for COCPs.

In the largest (1996) reanalysis of previous studies of hormonal contraceptives and breast cancer risk, less than 1% were POP users. Current or recent POP users had a slightly increased relative risk (RR 1.17) of breast cancer diagnosis that just missed being statistically significant. The relative risk was similar to that found for current or recent COCP users (RR 1.16), and as with COCPs, the increased relative risk decreased over time after stopping, vanished after 10 years, and was consistent with being due to earlier diagnosis or promoting the growth of a preexisting cancer.[2][3]

The most recent (1999) IARC evaluation of progestogen-only hormonal contraceptives reviewed the 1996 reanalysis as well as 4 case-control studies of POP users included in the reanalysis. They concluded that: "Overall, there was no evidence of an increased risk of breast cancer" with progestogen-only contraceptives, but since there was "inadequate evidence", they were "possibly carcinogenic".[4]

Recent anxieties about the contribution of progestogens to the increased risk of breast cancer associated with HRT in postmenopausal women such as found in the WHI trials[5] have not yet spread to progestogen-only contraceptive use in premenopausal women.[1]

See also

References

  1. 1.0 1.1 Glasier, Anna (2006). "Contraception". In in DeGroot, Leslie J.; Jameson, J. Larry (eds.). Endocrinology (5th edition ed.). Philadelphia: Elsevier Saunders. pp. pp. 2993-3003. ISBN 0-7216-0376-9.
  2. Collaborative Group on Hormonal Factors in Breast Cancer (1996). "Breast cancer and hormonal contraceptives: collaborative reanalysis of individual data on 53,297 women with breast cancer and 100,239 women without breast cancer from 54 epidemiological studies". Lancet. 347 (9017): 1713–27. PMID 8656904.
  3. Collaborative Group on Hormonal Factors in Breast Cancer (1996). "Breast cancer and hormonal contraceptives: further results". Contraception. 54 (3 Suppl): 1S–106S. PMID 8899264.
  4. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans (1999). "Hormonal contraceptives, progestogens only". Hormonal contraception and post-menopausal hormonal therapy; IARC monographs on the evaluation of carcinogenic risks to humans, Volume 72. Lyon: IARC Press. pp. pp. 339-397. ISBN 92-832-1272-X.
  5. Chlebowski R, Hendrix S, Langer R, Stefanick M, Gass M, Lane D, Rodabough R, Gilligan M, Cyr M, Thomson C, Khandekar J, Petrovitch H, McTiernan A (2003). "Influence of estrogen plus progestin on breast cancer and mammography in healthy postmenopausal women: the Women's Health Initiative Randomized Trial". JAMA. 289 (24): 3243–53. PMID 12824205.

de:Minipille no:Minipille fi:Minipilleri

Cost Effectiveness of Progestogen only pill

| group5 = Clinical Trials Involving Progestogen only pill | list5 = Ongoing Trials on Progestogen only pill at Clinical Trials.govTrial results on Progestogen only pillClinical Trials on Progestogen only pill at Google


| group6 = Guidelines / Policies / Government Resources (FDA/CDC) Regarding Progestogen only pill | list6 = US National Guidelines Clearinghouse on Progestogen only pillNICE Guidance on Progestogen only pillNHS PRODIGY GuidanceFDA on Progestogen only pillCDC on Progestogen only pill


| group7 = Textbook Information on Progestogen only pill | list7 = Books and Textbook Information on Progestogen only pill


| group8 = Pharmacology Resources on Progestogen only pill | list8 = AND (Dose)}} Dosing of Progestogen only pillAND (drug interactions)}} Drug interactions with Progestogen only pillAND (side effects)}} Side effects of Progestogen only pillAND (Allergy)}} Allergic reactions to Progestogen only pillAND (overdose)}} Overdose information on Progestogen only pillAND (carcinogenicity)}} Carcinogenicity information on Progestogen only pillAND (pregnancy)}} Progestogen only pill in pregnancyAND (pharmacokinetics)}} Pharmacokinetics of Progestogen only pill


| group9 = Genetics, Pharmacogenomics, and Proteinomics of Progestogen only pill | list9 = AND (pharmacogenomics)}} Genetics of Progestogen only pillAND (pharmacogenomics)}} Pharmacogenomics of Progestogen only pillAND (proteomics)}} Proteomics of Progestogen only pill


| group10 = Newstories on Progestogen only pill | list10 = Progestogen only pill in the newsBe alerted to news on Progestogen only pillNews trends on Progestogen only pill


| group11 = Commentary on Progestogen only pill | list11 = Blogs on Progestogen only pill

| group12 = Patient Resources on Progestogen only pill | list12 = Patient resources on Progestogen only pillDiscussion groups on Progestogen only pillPatient Handouts on Progestogen only pillDirections to Hospitals Treating Progestogen only pillRisk calculators and risk factors for Progestogen only pill


| group13 = Healthcare Provider Resources on Progestogen only pill | list13 = Symptoms of Progestogen only pillCauses & Risk Factors for Progestogen only pillDiagnostic studies for Progestogen only pillTreatment of Progestogen only pill

| group14 = Continuing Medical Education (CME) Programs on Progestogen only pill | list14 = CME Programs on Progestogen only pill

| group15 = International Resources on Progestogen only pill | list15 = Progestogen only pill en EspanolProgestogen only pill en Francais

| group16 = Business Resources on Progestogen only pill | list16 = Progestogen only pill in the MarketplacePatents on Progestogen only pill

| group17 = Informatics Resources on Progestogen only pill | list17 = List of terms related to Progestogen only pill


}}