Progestogen-only contraception

Progestogen-only contraception can often be used by women who, for health reasons, cannot use combined hormonal contraception. Contraceptive methods involving the use of progestogen only include progestogen-only oral contraceptives (mini pills), contraceptive implants and hormonal intrauterine devices (hormonal IUDs, also known as the hormonal coil).

Progestogen-only pills are taken every day, preferably at the same time. This is important both to ensure good contraceptive effect but also to keep menstruation as regular as possible. Progestogen-only contraceptives cannot be used to time menstruation; menstrual bleeding occurs individually in those using mini pills and contraceptive implants. The woman's periods may also stop, which is not dangerous to health and does not signify impaired effect, actually quite the contrary. The contraceptive effect of progestogen-only pills is mainly based on their impact on cervical mucus, which changes so that the sperm cannot pass through the cervix into the womb. The contraceptive efficacy of progestogens is partially also based on effects in preventing egg maturation and release. Progestogen-only pills can also be used to treat endometriosis.

A contraceptive implant is a non-biodegradable rod that releases progestogen. It is placed under the skin in the upper arm. Its contraceptive efficacy lasts for 3 to 5 years depending on the brand in question. Before trying a contraceptive implant, it is a good idea to check with mini pills whether the progestogen in question is suitable. However, this does not help to predict how regular the woman's menstruation will be when using the contraceptive implant.

Hormonal coils, or intrauterine devices (IUDs), release progestogen into the lining of the uterine cavity. In those using a hormonal coil, menstrual bleeding usually becomes much lighter and stops completely in a large proportion of users. Hormonal coils have very good contraceptive efficacy, and they are a good option to treat heavy menstrual bleeding and menstrual pain. Hormonal coils can also be used to treat endometriosis.

A woman who has not given birth can use a coil if her womb is of normal structure and large enough for a coil and if she needs regular contraception, preferably in a long-term relationship. The hormonal coil works for five years.

Progestogen-only contraception can also be used during breastfeeding. 

This article was written by:
SV and SI, 21 Jan. 2013

Key words: Contraception, Progestogen-only contraception, Oral contraception, Contraceptives