Femodette

Femodette is a combined hormonal contraceptive pill which can help stop you from getting pregnant. It is available on prescription and from most pharmacies.

Combined hormonal contraceptives (CHCs) like Femodette are one of the most reliable reversible (the effects are temporary) types of contraception. They can successfully prevent pregnancy in 99% of cases, when used correctly.

Femodette contains a ‘third generation’ form of progesterone (a hormone) called gestodene. Third generation progesterones were invented in the 1990s and are designed to have fewer side effects.

Femodette contains two hormones (sex chemicals), oestrogen and progesterone (progestin). These hormones are naturally produced in the bodies of women who have periods.

Femodette changes the amount of these hormones in your body to prevent pregnancy, which is what your body would normally do if you were already pregnant.

Femodette is licensed by Bayer Healthcare, which was founded on 29th December 2006, and is manufactured by Bayer or Delpharm.

Femodette contains the active ingredients ethinyl estradiol (oestrogen) and gestodene (progesterone). It is only currently available in a dose of 20 µg (micrograms) ethinyl estradiol and 75 µg gestodene.

The oestrogen and progesterone in Femodette work together to prevent pregnancy. They do this in 3 ways:

• Gestodene (progesterone) stops a woman’s egg from ripening and being released into her fallopian tubes (the tubes leading to her womb) – stopping her from ovulating.
• Both hormones also thin the lining of the womb, preventing a fertilised egg from being able attach to it and grow into a foetus.
• They prevent sperm from entering a woman’s womb by thickening the mucus at the neck of her womb, keeping the sperm in her vagina until it is naturally washed away by her vaginal discharge.

Femodette is a monophasic contraceptive, which means that the tablets you take all contain the same amount of active ingredients. This differs from ‘phasic’ contraceptives, where a woman takes different amounts of hormones on different days during her menstrual cycle.

Femodette is considered to be a low-strength preparation because it contains smaller amounts of oestrogen, but it still works as well as higher strength contraceptives. It is just as effective at thinning the womb lining to prevent egg implantation as higher strength pills.

Low strength preparations are combined hormonal contraceptives that contain ethinyl estradiol in 20/30 µg doses, which are known to be better for women who have a higher risk of circulatory disease. They generally have fewer or less severe side effects.

Low-dose pills like Femodette tend to have fewer side effects, and a lower risk of blood clots. So, they are generally better if you are prone to getting side effects on the pill, like headaches or water retention.

Unfortunately, there are some disadvantages to taking low dose CHCs like femodette. These include a bigger risk of breakthrough bleeding (unexpected bleeding from the vagina) or vaginal dryness. This is due to the lower oestrogen levels in the medication. These symptoms can sometimes settle down in time, but can be an ongoing nuisance for some women.

Yes, it is possible for Femodette to improve acne, make your bleeding lighter, and reduce or stop cramps.

As with other combined hormonal contraceptives, Femodette tends to make you get less irregular periods and generally less painful too. It may also help reduce any pre-menstrual symptoms you experience, like stomach upsets or bloating. Femodette improves or clears acne in some women who take it.

Combined hormonal contraceptives may reduce the risk of developing ovarian cancer, or cancer of the womb, if used for a long time. Some research has also shown that taking Femodette does not change a person’s body weight or blood pressure. However, this research often only includes women who have taken low strength combined hormonal contraceptives, like Femodette, for less than a year. This means that we do not know if Femodette causes changes in body weight or blood pressure when you take it for several years. You should speak to your doctor if you think Femodette might be changing your body weight or blood pressure.

The active ingredients in Femodette can slightly increase blood sugar levels and the amount of insulin (a chemical that controls blood sugar) your body produces.

If you have been pregnant and developed gestational diabetes (diabetes caused by being pregnancy), you have an increased risk of developing type 2 diabetes in the future. However, low-strength CHCs like Femodette do not increase this risk, whether or not you breastfeed after giving birth.

As with other combined hormonal contraceptives, there is a slightly increased risk of blood clotting (thrombosis) when using Femodette.

However, this side effect does not tend to affect women unless they are already at risk of forming blood clots due to their lifestyle or a medical condition they already have.

Some things that increase your risk of developing blood clots include:

• Smoking (or having stopped smoking in the past year).
• Drinking large amounts of alcohol
• Being immobile.
• Having diabetes.
• High blood pressure.
• High cholesterol.

If you do have an increased risk of forming blood clots, you should seek advice from your doctor as to whether Femodette is suitable for you to take.

Although mood swings are commonly thought to be a side effect of taking hormonal contraceptives, the evidence doesn’t show this is definitely true.

If you feel that you are having sudden changes in mood, it is best to keep a record of this and to speak to your doctor to figure out whether your medication is the cause of your mood changes.

You might be particularly sensitive to the effects of combined hormonal contraceptives on your mood if you already have a mental health condition. Therefore, ensure you speak to your doctor if you feel your contraceptive is making any of your symptoms worse.

If you think you are pregnant., you should also speak to your doctor before taking Femodette if you are breastfeeding, or have given birth in the last 6 months.

It is best to always follow the advice of your doctor when taking any medication. Try to let them know immediately if you think you might be pregnant while you are taking Femodette. If you take a pregnancy test or a doctor agrees you're pregnant, stop taking Femodette immediately and speak to them about your pregnancy.

Although taking CHCs during early pregnancy has not been found to cause any harm to unborn babies, if you keep taking your contraceptive you may be at risk of experiencing complications (health problems for you and the baby) later on during your pregnancy.

It is also important that you tell your doctor if you have given birth within the past 6 months. This is because it takes approximately 6 months for your hormones to settle down from your pregnancy. Your hormone levels after giving birth can affect the contraceptive your doctor gives you, and might cause extra health risks that your doctor needs to check you for before prescribing you your contraceptive. Your doctor will need to know if you have given birth in the past couple of months because this increases your chance of forming blood clots. Femodette cannot be used for the first few weeks after giving birth.

Low dose combined hormonal contraceptives can be used while breastfeeding. They have not been associated with reduced milk supply or harm to newborn babies, or mothers, who are stopping breastfeeding after 4-6 weeks postpartum. However, health guidelines recommend that breastfeeding mothers do not take combined hormonal contraceptives until 6 weeks after delivery, to ensure milk supply is not affected. You should inform your doctor if you are breastfeeding, to ensure you do not take Femodette earlier than is recommended.

Femodette is taken once a day for 21 days. You must then take a break from the tablets for 7 days in a row to allow you to have your period, before starting another 21 days of taking Femodette.

You should take your Femodette pill at the same time every day. If you begin taking Femodette on the first day of your period (the day that you bleed), you will be protected from pregnancy straight away. If you begin mid-cycle, you will need to use additional contraception, such as condoms, for 7 days or more.

If you miss a tablet, it should be taken as soon as possible, as long as you are not more than 12 hours late taking it. You should only take the tablet you have missed that day. However, if you are more than 12 hours late taking your Femodette pill, or you have vomited or had diarrhoea, you should use additional methods of contraception, such as condoms, for 7 days while taking Femodette.

It is good to have a way of reminding yourself to take your pill, such as an alarm on you mobile phone or watch. You can also keep your pills visible so that you take them as part of your morning routine (such as next to your coffee mug). There are also lots of mobile phone apps available to download which will remind you to take your pill, and it is good to follow each day labelled on your pill packet so that you can easily check you have taken it.

Uncommon side effects include:

• Acne.
• Vomiting.
• Stomach upsets.
• Fluid retention.
• Migraine.
• Breast enlargement.
• Skin rash, with or without itchiness.
• Loss of interest in sex.

Rare side effects include:

• Irritation when using contact lenses.
• Losing weight.
• Increased interest in sex.
• Vaginal or breast discharge.

Other side effects can include:

• Breakthrough bleeding or spotting.
• Chloasma (brown or yellow skin patches).
• Increased caffeine clearance (cause caffeine to leave the body faster).

Breakthrough bleeding or spotting is where you bleed from your vagina part-way through your period, when you would not normally bleed. This usually occurs during the first few months of starting Femodette and is usually nothing to worry about. However if you are bleeding, it is best to speak to your doctor, especially if this lasts longer than the first three months of taking it.

Sometimes bleeding can be caused by your contraceptive not having effect, such as forgetting to take your pill. Even so, your doctor may need to check that you don’t have an infection or other problems in your vagina or cervix that are causing the bleeding.

Chloasma is brown or yellow patches appearing on your skin, and can continue after the first few months of taking Femodette. It is able to be reduced by avoiding too much exposure to sunlight or UV lamps.

The active ingredients in Femodette have also been found to increase the clearance of caffeine from your body (how fast it gets removed). This may affect mood, or cause feelings of tiredness, if you are used to ingesting large amounts of caffeine.

You should go to your nearest hospital’s emergency department immediately if you have:

• Signs of breathing problems, blood flow problems, or blood clots, such as:
• Sudden or severe chest pain.
• Sudden breathlessness.
• A cough that produces blood-stained phlegm.
• Severe stomach pain.
• Severe pain or unexplained swelling in the calf of one leg.
• Signs you are having a stroke or transient ischemic attack (temporary stroke symptoms), with or without a severe headache or migraine, for example:
• You collapse.
• You feel sudden numbness or weakness in one side or all of your body.
• Weakness in your face.
• You have suddenly lost some or all of your sight, or your vision is blurred.
• You feel confused, have difficulty understanding people, or cannot find the words to tell people how you feel.
• Sudden dizziness or unsteadiness.
• Signs you are having an epileptic seizure, and you have not had a seizure before, are classed as being seizure free, or your seizure differs from how it usually is. Epileptic seizures affect people in different ways. Some signs of an epileptic seizure include:
• Hearing, smelling, or tasting something that isn’t there.
• Losing some of your sight, or it becoming blurry.
• Odd feelings of places or objects seeming familiar when they aren’t, experiencing panic, or pleasant feelings which seem odd.
• Feeling dizzy or sick.
• Feeling confused, ‘spaced out’, day dreamy, or having a ‘blackout’.
• Appearing to faint or pass out.
• Feeling detached from your body.
• Having difficulty talking, breathing, swallowing or controlling your body.
• Uncontrollable tremors, muscle tensions, or repeated movements (these may appear like odd behaviours to other people, or you may repeat a behaviour you were doing just before the seizure began).
• Convulsions (becoming unconscious, your body becoming rigid, and then fast jerking movements).
• Feeling confused, lightheaded, or have memory loss.
• Feeling sad, upset, or anxious.
• Having weakness in one side of your body.
• Feeling tired or exhausted.
• Having an urge to use the toilet, or lose control of your bladder or bowel.
• Biting your own tongue without control.

You should speak to a doctor without delay if you have:

• An unusually severe or prolonged headache or migraine, especially if:
• You have never had a headache like this before.
• It is getting progressively worse.
• You can see things that aren’t there, such as flashing lights.
• You cannot hear properly, or can hear noises that don’t exist.
• You feel a numbness in part of your body.
• You faint.
• Uncontrolled high blood pressure (160/95 or above).
• Hepatitis.
• Jaundice (discolouring of the skin or eyes).
• Liver enlargement.
• A leg injury.
• A lengthy time span where you are immobile, such as following surgery.

If you experience any side effects which you think are caused by taking Femodette, you should seek advice from your doctor. Most of the time, side effects are nothing to worry about. They usually settle down after a few months of taking Femodette, but if you are worried you should get in touch with:

• Your doctor.
• The 111 advice line.
• Your nearest hospital – if you feel it is an emergency.

Just because you have existing health problems doesn't mean you can't take Femodette. There are some health conditions that mean it isn't safe to take Femodette, but a consultation with a doctor, nurse, or online doctor service will help you find out if Femodette is right for you.

Femodette is contraindicated (not safe to use) for women with the following conditions:

• Thrombotic disorders.
• Sickle cell anaemia.
• Lipid metabolic disorders.
• Liver disease.
• A history of liver tumour.
• Breast cancer.
• Endometrial cancer.
• A history of deep vein thrombosis (blood clot in your leg), pulmonary embolus (blood clot in your lungs) or blood clots in other organs.
• A disorder affecting your blood clotting.
• A history of heart attack or stroke.
• A history of angina pectoris or a transient ischaemic attack (temporary stroke symptoms).
• Very high blood pressure.
• Very high levels of cholesterol or triglycerides.
• Hyperhomocysteinemia.
• A history of migraine with ‘aura’.
• An allergy or sensitivity to any of the ingredients in Femodette.
• A close family member (such as sibling or parent) that had a blood clot at a young age.

Femodette may not be suitable for women with the following conditions:

• A high risk of developing breast cancer.
• Awaiting an operation which will make you immobile for a period of time afterwards.
• Crohn's disease or ulcerative colitis.
• Systemic lupus erythematosus.
• Haemolytic uraemic syndrome.
• Pancreatitis.
• Having recently given birth.
• Superficial thrombophlebitis.
• Varicose veins.
• Diabetes.
• A personal history or family history of heart problems or circulatory problems.
• A personal history or family history of problems with blood clotting.
• Porphyria.
• If you are overweight.
• If you have migraines.
• If you have an illness which worsened during pregnancy, or when previously using a combined hormonal contraceptive.
• If you are a moderately heavy smoker – especially if you over the age of 35.

Femodette isn't compatible with some medications so it's important that a healthcare professional reviews you existing medications before prescribing your contraceptive pill.

Femodette can interact with the following medications or herbal remedies:

• Carbamazepine.
• Eslicarbazepine.
• Nevirapine.
• Oxcarbazepine.
• Phenytoin.
• Phenobarbital.
• Primidone.
• Ritonavir.
• St John's Wort.
• Topiramate.
• Rifabutin.
• Rifampicin.

If you are taking any of these, you should use an additional barrier form of contraception (eg, condoms or diaphragm) and discuss your contraception with you doctor. This is because the Femodette may not be able to prevent pregnancy while using these other medications or herbal remedies, and for some time afterwards.

Published 23/06/17

Last Reviewed: 26/06/17

Edited by: Edward Lees-Manning