Information on Progestogen-only Contraceptive Pills (Desogestrel-only Pill)

(Content revised 02/2026)

1. Progestogen-only Pills (POP)

  • Progestogen-only pills (POP) contain progestogen (a synthetic hormone) without any oestrogen.
  • The formulation currently available at the Maternal & Child Health Centre (MCHC) is the desogestrel-only pill.
    • It works mainly by stopping ovulation.
    • It also interferes with sperm transportation and embryo implantation
  • It is highly effective, with a failure rate of less than 1% among users who take the pill consistently and correctly.
  • Most women can use POP, including those who are breastfeeding or cannot take estrogen.
  • Women who are/ may not suitable for POP include those with a history of breast cancer, meningioma, unexplained vaginal bleeding, other serious medical diseases, or migraine with aura developed after taking POP.
  • Women should be assessed by a healthcare professional for their suitability before starting any hormonal contraceptive method. Moreover, they should be reviewed at regular intervals to ensure continued suitability for ongoing use.
  • Women should return to their service provider for reassessment for suitability to continue hormonal contraceptives if they are newly diagnosed with medical conditions such as heart disease, stroke, diabetes, hyperlipidaemia, thromboembolic disease, meningioma, cancer, or other newly diagnosed diseases.

2. How to Take Progestogen-only Contraceptive Pills (POP)

  • In general, POP can be started within the first 5 days of period. They should be taken every day, at the same time each day (or as close to that time as possible).
  • If vomiting occurs within 3 hours of taking the pill, or have severe diarrhea, take another pill as soon as possible to achieve sufficient contraceptive effect.
  • If vomiting continues or diarrhea remains severe, use condom as backup contraception during the illness and for 7 days after recovery.

3. Possible Side Effects

  • You may experience bleeding irregularities, reduced menstrual flow, or absence of menses, which are related to the hormonal effects of the progestogen.
  • Other common side effects include breast tenderness, nauseas, acne, headaches, and mood changes. These may occur during the initial period of use and usually subside within the first few months.

4. Use of POP and Breast Cancer

  • Breast cancers can develop whether or not you are taking oral contraceptive pills. Studies have showed that women using oral desogestrel-only pills are associated with a small increased risk of developing breast cancer, similar to the risk observed with combined oral contraceptive pills.

5. Use of POP and Thrombosis

  • There is a risk of thromboembolic disease whether or not you are taking the pill.
  • Use of POP is associated with a slightly increased risk of developing blood clots in the arteries. In serious cases, this can lead to ischemic stroke or myocardial infraction.

6. Use of POP and Meningioma

  • Meningiomas are rare tumours that arise from the layers of tissue (meninges) covering the brain and spinal cord. Most meningiomas are benign (non-cancerous). The incidence of meningioma increases with age and is more common in women.
  • Studies have showed that use of hormonal contraceptive pills containing desogestrel for more than five continuous years is associated with a small increased risk of intracranial meningioma, which decreases over time after stop taking the pills.

7. Missed Pill Management for POP

(Information applies to desogestrel contraceptive pills only)

  • Delay taking 1 pill for less than 12 hours
    • Take the delayed pill immediately
    • Continue taking the remaining pills as your usual schedule
  • Delay taking pill(s) for more than 12 hours
    • Take the delayed pill immediately
    • Continue taking the remaining pills as your usual schedule
    • Use condoms as backup contraception in the next 7 days to protect against pregnancy
    • Return to the Maternal and Child Health Centre as soon as possible for counselling and assessing of the need for emergency contraception

8. Taking Other Medicines

Some medicines may interfere with the effectiveness of the POP. It is important to inform your doctor or pharmacist that you are taking POP when being prescribed or purchasing other medicines.

9. Please seek medical assessment as soon as possible if you have any of the following symptoms, and inform you doctor that you are using a POP:

  • Bad fainting attack, collapse or seizures
  • Headaches and sudden onset of visual problems, such as flashing lights, bright zig-zag lines, blurred or distorted vision
  • Slurred speech
  • Weakness or paraesthesia affecting any arms, legs or one side of the body
  • Unexplained breathlessness, with or without coughing up blood
  • Severe central chest pain or sharp pain on either side of chest
  • Severe calf pain (not related to trauma or exercise)
  • Severe abdominal pain
  • Unusual vaginal bleeding (e.g. persistent or heavy bleeding)
  • Yellowing of the skin or whites of the eyes (jaundice)
  • Signs and symptoms of pregnancy
  • Tinnitus, hearing loss, loss of smell and memory loss