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

Last edited 03/2019 and last reviewed 03/2020

  • 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)
  • if starting the progestogen only pill after a combined oral contraceptive then the progestogen only pill should be commenced immediately after the last combined pill has been taken and not at the end of the 7 pill free days

    • if starting POP after combined hormonal contraceptive pill (CHC)

  • 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