Which is not a side effect of POP (Progestin only pill)-

Ans. is 'b' i.e., Venous thromboembolism o POP have no significant metabolic effects (lipid levels, carbohydrate metabolism, and coagulation factors remain unchanged), and thus no increased risk of venous thromboembolism.Progestin only pill (MinipilBo Mechanism of action :# Because of the small amount of progestin in the circulation (25% of that in Combined oral contraceptives), it has significant effect only on those tissues very sensitive to the female sex steroids.# Thus it acts primarily on endometrium and cervical mucus.# It does not have a feedback inhibition effect on FSH secretion, thus patients on POP ovulate normallyo Pill taking# Because of the low dose, the minipill must be taken every day at the same time of day.# The change in the cervical mucus requires 2-4 hours to take effect, and, most importantly, the impermeability diminishes 22 hours after administration, and by 24 hours some sperm penetration occurs. Midday administration is recommended.# If more than 3 hours delay in taking a pill, a back up method should be used for contraceptiono Side effects:a) Increased risk of non - insulin dependent diabetes mellitus in lactating women with recent gestational diabetes.b) Acne:# Mechanism of acne development: Androgenic activity of levonorgestrel decreases the circulating levels of sex-hormone binding globulin (SHBG). Therefore, free steroid levels (levonorgestrel and testosterone) will be increased despite the low dose.# This is contrast to the action of combined oral contraception where the effect of the progestin is countered by the estrogen - induced increase in SHBG.c) Ectopic pregnancy - Not prevented as effectively as intrauterine pregnancy.# Although a previous ectopic pregnancy is not regarded as a contraindication to the minipill.