When should progestin-only pills (POPs) be used?

Progestin-only pills (POPs) are often recommended for specific patient populations, particularly in situations where estrogen-containing contraceptives might pose risks. One of the most significant considerations is when a patient experiences migraine headaches. Estrogen can exacerbate migraines in some individuals, so using POPs can mitigate that risk. Additionally, postpartum women who are breastfeeding are encouraged to use progestin-only contraceptives because estrogen can affect milk supply. Therefore, the situational use of POPs in patients with migraines or during the postpartum period aligns with the guidelines for safe and effective contraception while considering individual health situations.

In contrast, using POPs in all female patients may not be appropriate, as it overlooks different medical histories and risk factors. The choice to use them solely in patients with controlled hypertension can be overly restrictive, since many women experiencing controlled hypertension can use other forms of contraception safely. Finally, the idea that POPs are only for non-smokers is misleading, as smokers, particularly those over age 35, should be advised on the risks associated with estrogen but can generally use progestin-only methods safely. Thus, the correct context for prescribing POPs involves specific health considerations, such as migraines and postpartum status, which aligns well with the understanding