Combination pills and progestin-only pills, aka POPs, are the two main types of birth control pills on the market. Combination pills have two types of hormones, estrogen, and progestin, while POPs contain only the latter.
The combination pill is the more commonly prescribed of the two because it’s slightly more effective — about 99% versus 94%. But POPs are often prescribed for people with conditions like blood-clotting issues or arterial diseases. They’re also safer for higher-weight people, and anyone else at risk for a dangerous condition called venous thromboembolism.
If you’ve been diagnosed with a new medical condition or recently had a baby, you may need to go on POPs. Or you may have decided to switch birth control because you’ve been struggling with the side effects of combination pills. Whatever your reasons for switching, here are some tips to help ease the transition to POPs.
6 Ways To Ease The Transition ToPOPs
1. Get a Birth Control Subscription
When you take POPs, missing or being late with even a single dose can dramatically increase your risk of pregnancy. That’s why you’ll want to make sure you always have plenty of pills at the ready.
Pharmacies can run out of your brand, which can be a huge headache when you need a refill. Some states also still allow pharmacists to deny you your pills for religious reasons, which can mean problematic delays.
Consider keeping an extra pack around in case you lose one or if you’re planning any travel. A birth control subscription is easy to get online and can help ensure you never run out of pills. It also allows for more privacy than picking your pills up in person because your prescription is discreetly delivered to your door. Some online options allow you to get up to three months’ worth of pills at a time.
2. Set Reminders or Alarms on Your Phone
If you’ve been taking combination pills, you probably already have a reminder on your phone to take them every day. But you might also be used to hitting snooze on that phone alarm and taking the pills a little later.
With progestin-only pills, it’s super important to always take your pills on time. Some pills have about a 12-hour window, but traditional POPs can be taken no more than three hours late. You might want to set a few alarms in a row in case you forget you ignored the first one.
Another option to consider is a Bluetooth-connected smart case for your progestin-only pills. The Emme Smart Case connects with your phone and reminds you to take your pills on time. It doesn’t just know when you’ve opened the case — it senses when you take a pill out of the pack.
3. Prepare for Cycle Changes
Being on progestin-only pills can mean big changes in your normal period. Don’t be alarmed, but if you’re used to the regularity of combination pills, get ready for a wild new ride.
Progestin-only pills can lighten your typical menstrual flow and even reduce the frequency of cramps or painful periods. But they can also cause breakthrough bleeding or spotting throughout the month, sometimes for days on end.
If you’d rather not free-bleed, remember to keep light pads or tampons on hand, just in case. You could also invest in lined period undies so you’re always prepared for spotting.
4. Stockpile Backup Methods
POPs have a lower efficacy rate than combination pills, even when used correctly. And with POPs, your risk of pregnancy goes up much faster if you miss a dose. For this reason, you might want to use a backup method or have some emergency options at the ready.
One possibility is to keep the morning-after pill on hand (or a prescription option like ella if you weigh more than 165 lbs). You could also keep condoms or other barrier methods on hand for use if you miss a dose.
If you don’t remember to keep backup birth control around, it’s still possible to get last-minute emergency contraception online. And if you think you might’ve missed a dose at any point, consider using a condom just in case.
5. Consider Your Other Medications
One major advantage of POPs is that they don’t have as many side effects or contraindications as combination pills. But there are some cases where you need to be conscious of what else you’re putting in your body.
As with the combination pill, some antibiotics can make POPs less effective, increasing your chances of unplanned pregnancy. Speak to a healthcare provider or get an online consultation if you’re not sure about a drug.
Some supplements, in particular St. John’s Wort, can also increase the risk of unplanned pregnancy on POPs. You’re better off not taking St. John’s Wort at all, but if you must, always use a backup barrier method.
6. Know the Risks
Some studies note that POPs can carry a higher risk of depression than combination pills. If you have a history of mental health issues, mention it in your consultation before getting a prescription for POPs. Pay close attention to any changes in your mood after you start taking the new pills.
POPs can also put you at a much higher risk for ectopic pregnancy than combination pills. Consider using a backup barrier method to mitigate the risk of an ectopic pregnancy.
If you have thoughts of suicide or self-harm, call your local crisis hotline or 988, The Suicide & Crisis Lifeline. If you experience sudden, severe pain in your pelvis, abdomen, and/or shoulder, call 911 or go straight to the emergency room. These may be signs of a more serious issue.
Taking the Leap
There are many reasons you might decide to switch from combination pills to POPs. But it’s important to remember that everyone’s body reacts differently to hormones. When you switch prescriptions, pay close attention to any changes in side effects and get help if something seems off. Remember that it may take a bit of trial and error to find the right birth control for you.