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What’s new with the progestogen only pill (POP) in the UK?
The updated Faculty of Sexual and Reproductive Healthcare (FSRH) progestogen only pills (POP) guideline has recently been published1 giving the perfect opportunity to establish what’s new and what has not changed. Although long-acting reversible contraception use is rising, oral contraceptives remain popular, accounting for 38% of contraception in 2019/20202 and POP use more than doubling (4.3%–10.8% of contraceptive use) since 2000.3
Pharmacy provision of desogestrel POP
20 years since desogestrel’s UK Marketing Authorisation, it has been made available to purchase as a pharmacy (P) medicine without prescription (under the supervision of a pharmacist). This offers a convenient alternative to prescription and online purchase to those able to afford it. Desogestrel POP is the only POP available as a P medicine in the UK.
Remote prescribing of POP
After initiation of POP, users should be reviewed annually. This can usually be achieved via remote consultation. If review cannot be achieved within a year, this should not be a barrier to continuation of POP.
Drospirenone is a spironolactone (aldosterone antagonist) derivative with mild antiandrogenic activity, already used in combined combined hormonal contraception (CHC). It will become available in the UK as a POP shortly.
Unlike other POPs, the drospirenone POP has a 4-day hormone free interval (HFI).4 It is taken as 24 consecutive daily 4 mg pills followed by four inactive/placebo pills. There is a 24-hour window following scheduled active pill taking without loss of contraceptive effectiveness (ie, a pill can be taken up to 24 hours later than scheduled without being a ‘missed …
Contributors HCL-C drafted the manuscript. CN reviewed and edited the manuscript. Both HCL-C and CN reviewed and edited following peer review for the revised version.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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