Review
Review
It is recommended that women on POP should have a review annually, though this may be brought forward if problems occur. During the review, women should be encouraged to talk about any problematic bleeding/side effects as well as any changes in medication or medical history. If there are concerns about new problematic bleeding, the health professional should consider if this is due to POP, or another cause (consider investigating any unusual new changes to the bleeding pattern). Estrogen replacement and tranexamic acid have been used short term to help with problematic bleeding, but there is little evidence of the risks/benefit long term. If bleeding is particularly troublesome it may be more appropriate to consider an alternative contraception.
Women can stay on POP until age of 55 years and then stop. Some women will experience menopause long before this point and may wish to stop sooner. For those with amenorrhea on POP, under the age of 55y, it is reasonable to check FSH levels (2 occasions, 6 weeks apart) and if > 30IU/l then POP can be stopped after a year. To date, POP is not recommended as effective progestogen component in HRT.