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Progresterone only pill questionnaire (POP)

Progresterone Only Pill Questionnaire (POP)

Section

Do you know the name of the contraceptive pill you want?
Have you been diagnosed with any new health conditions since we last issued you a prescription for the Pill?
Have you experienced any changes to your bleeding pattern that are worrying you (such as unexpected spotting, or after sex)?
Are you up-to-date with your cervical screening (smear test)?
Are you interested in having any sexual health screening?
(This could be important as the oral contraceptive pill does not protect against sexually transmitted infections)
What is your current smoker status?
How many cigarettes do you smoke in a day?
Are you able to provide a blood pressure reading?
(To safely prescribe the contraceptive pill, it is important that we have an up-to-date blood pressure reading)

Blood Pressure

Before you take your blood pressure reading:

  • Sit down comfortably for 5 minutes.
  • Wear loose-fitting clothing.
  • Make sure your arm is around the same level as your heart.
  • Make sure your arm is relaxed.

When taking your blood pressure:

  • Put the cuff on following the instructions that came with your blood pressure monitor.
  • Keep still and silent.

Other tips:

  • Take at least three readings, each two minutes apart.
  • Your first reading may be much higher than the next readings. If this is the case, keep taking readings until they level out and stop falling. Use this as your reading.

Please seek urgent medical attention if you develop any of the following:

  • Blood pressure is 170/115 or above (despite repeating it at least 2 times).
  • Chest pain.
  • Changes in vision.
  • Confusion.
  • Severe headache.

For more tips or to learn more, visit the British Heart Foundation website.

Height and Weight

Do you know your weight?
eg. 60.6
Do you know your height?
eg. 1.75

Additional Questions