Unlike combined oral contraceptives, progestin-only contraceptives contain only synthetic progestin and no estrogen.
What are Progestin-Only Oral Contraceptives (POCs)?
Progestin-only oral contraceptives, also known as “mini-pills,” contain only synthetic progestin and no estrogen. They are ideal for women who cannot use combined contraceptives due to health reasons.
Mode of Action
They act in three different ways:
- They suppress ovulation in some users.
- They thicken cervical mucus to prevent sperm penetration.
- They thin the endometrial lining, hence reducing the likelihood of implantation.
Effectiveness of Progestin-Only Oral Contraceptives
When used consistently and correctly, POCs are highly effective, with a success rate of about 91-99%. Their effectiveness may be reduced with inconsistent use or gastrointestinal disorders such as malabsorption.
Advantages of Progestin-Only Oral Contraceptives
- They are safe for breastfeeding mothers.
- Suitable for women who cannot tolerate estrogen.
- Reduces menstrual cramps and flow.
Limitations of POCs
- Require strict adherence to daily timing.
- Do not protect against STIs.
- They may cause irregular menstrual bleeding.
Side Effects of POCs
- Irregular spotting or bleeding.
- Headaches or nausea.
- Breast tenderness.
Management of POCs
- Start anytime if not pregnant; use backup contraception for 48 hours if started more than 5 days after menstruation begins.
- Address side effects with reassurance or alternative methods if needed.