Progesterone Only Pill Review

Progesterone Only Pill Review
You will need a review of your progesterone only contraceptive pill (pop) before being issued with a further supply. This form is to ensure an uninterrupted supply of medication and avoid unnecessary visits to your doctor. This is your opportunity to flag any problems to us by answering a few short questions.

If you would like to continue on this method of contraception and do not feel that you need to see a clinician, please answer the questions below so that your prescription can be renewed if appropriate.


Please use format day/month/year e.g. 12/05/1979

Progesterone Only Pill Review

Has your pattern of bleeding changed since your pill was last reviewed?
Do you experience any bleeding after intercourse?
Are you taking any new medications that your GP may be unaware of?
Would you like to consider changing your method of contraception?
The POP should be taken at the same time every day. Do you ever miss any pills because you forget to take them at the right time?
If you have answered YES to any of these questions, please book an appointment with a clinician for a review.
If you are over 50 and haven’t had a period in a year, you may be able to stop your pill, depending on blood tests. However if you wish, you can safely continue until age 55 when contraception can be reliably stopped. Please book a GP telephone consultation with your doctor if you wish to discuss this further.

If you have any other question or concerns regarding your POP, please make an appointment with one of the practice nurses or your GP.

For further information on the POP and general advice including longer active reversible contraception (LARC) methods, please go to NHS Inform.

Your confirmation

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.