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Starting the progestogen only pill (POP) following the combined oral contraceptive pill (COC)

Authoring team

  • changing from a combined oral contraceptive
    • start on the day following completion of the combined oral contraceptive course without a break (or in the case of ED tablets omitting the inactive ones)

Timing of initiation

Need for additional precautions after starting

Additional information

Day 1-2 of HFI (hormone free interval)

No

Day 1 is the optimal time to switch

Day 3-7 of HFI OR week 1 following HFI

Yes (48 hours). If UPSI has occurred after Day 3 of HFI advise continuing the CHC method for at least 7 days

If CHC cannot be continued, switch to POP immediately and consider the need for EC and PT

Week 2-3 of CHC use

No, providing the method has been used consistently and correctly (i.e. at least 7 consecutive pills taken or 7 days of patch or ring use prior to switching)

There is evidence to suggest that taking hormonally active pills for 7 consecutive days prevents ovulation in the subsequent 7 days (2)

Reference:

  • BNF 7.3.2.1
  • FRSH (March 2015). Progestogen-only pills.
  • FSRH (February 2019). Progestogen-only pills

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