• Request Form for Progestogen-Only Pill

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  • Are you using a Desogestrel 75 mcg POP for contraception now?

  • Did you miss out or were more than 12 hours late taking your pills in the last month?

  • Missed contraception rules.

    If you have missed pills, you may be at risk from an unplanned pregnancy. Please follow the missed contraceptive advice in the patient leaflet of your pill or click here  NHS Advise Link or here Sexwise advise link for more advice on missed contraception rules to see if you may be at risk of a pregnancy. 

    What should I do if I think I may be at risk of pregnancy?

    • If you have missed your pill within the last 5 days and have had unprotected sex you may benefit from Emergency Contraception. Please telephone SHiP (tel; 01752 431124) for further advice about emergency contraception
    • If it was more than 5 days ago, continue with your pill and perform a pregnancy test at least 3 weeks after the missed pill
    • If the pregnancy test is positive, please seek medical help from SHiP or your GP and stop taking the POP
    • On re-starting the POP after an episode of missed pills please also use a condom for 48 hours (or until you have taken your third pill after the break)

    To help prevent any future episodes of missed pills you could think about;

    • Switching to a Long-Acting Reversible method of Contraception (LARC) such as the implant, an intrauterine method also known as a ‘coil’ or the injection. Further details about these methods can be found on the SHiP website – link to SHiP website
    • Setting an alarm on your phone to help you remember to take your pill at the same time every day
  • Are you sure you are not currently pregnant?

  • Have you experienced any different or abnormal vaginal bleeding e.g. bleeding after sex in the last 4 weeks?

  • Has there been any change to your medical history since you were last prescribed the Desogestrel 75mcg POP from SHiP?

    This includes medication that is prescribed by a doctor or nurse, purchased over the counter in the pharmacy, herbal remedies and drugs used for study or recreational purposes.

  • Are you allergic to progestogen, soya, nuts or lactose?

  • Have you had a test for sexually transmitted infections in the last 12 months or since you had sex with a new sexual partner?

  • Would you like us to send you a home test for Chlamydia & Gonorrhoea with your prescription for the Desogestrel 75 mcg POP?

    If so, follow this link to the SHiP online test Form: Link

  • Informed Consent 

     I know that missing pills or having diarrhoea and/or vomiting may prevent the POP from working and that I may be at risk from an unplanned pregnancy. I will need to follow the advice for missed pills or contact SHiP for further advice if this happens. 

     I have answered all questions as honestly and accurately as I can and the information, I have given my up-to-date medical history so that the SHiP team can safely assess and advise me.

     I am using this service freely on my own behalf and confirm that any treatment or advice is for my own use only.

     I fully understand the questions and information. If I am unsure about any aspect of the service, I will contact SHiP (tel: 01752 431124) before proceeding.

     I understand about how to take the POP, the side effects, effectiveness and that there are alternative methods of contraception to the POP which I am requesting. 

     I understand that I will inform my GP about medication so that they can provide safe medical care.

  • Please select how you would like to receive your Desogestrel 75mcg POP.

  • Please choose where you would like to pick up your Desogestrel 75mcg POP when it has been approved:

  • Please allow 5 working days from your request, in which time you will receive a text message confirming that you can collect your supply.

    Or if there are any concerns that this medication may not be suitable for you, we will send you a text message advising you that your request has been reviewed and a telephone review is required.

  • Please let us know your postcode

  • Please allow 5 working days from your request, in which time you will receive a text message confirming that your supply has been posted to you.

    Or if there are any concerns that this medication may not be suitable for you, we will send you a text message advising you that your request has been reviewed and a telephone review is required.

    Please also note if the postcode you have entered does not match the details we have for you. We cannot post your supply to an unknown address.

    • Please call SHiP on 01752 431124 if you would like to discuss this with the Pregnancy Advisory Clinic

    • Unfortunately we cannot process your request online. Please contact the health care provider who previously prescribed the POP for you or contact SHiP on 01752 431124 to request a consultation with our contraception team.
  • Unfortunately we cannot process your request online. Please contact the health care provider who previously prescribed the POP for you or contact SHiP on 01752 431124 to request a consultation with our contraception team.

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