The Hana contraceptive pill

Hana is a type of contraceptive pill you can take every day to prevent pregnancy. It’s known as a mini pill or progesterone-only pill because it contains the active ingredient desogestrel, a type of progesterone and a synthetic version of the female sex hormone. Each Hana pill contains 75 micrograms (mcg) of desogestrel and is manufactured by Laboratoire HRA Pharma SAS.

Hana is one of the first contraceptives available in the UK without a prescription. That means you can buy Hana over the counter or from a reputable online doctor service, like ZAVA. It’s suitable for most people, including those who cannot take combined contraceptive pills for reasons like having high blood pressure and being overweight, or being a smoker over 35.

Hana works in 3 ways to prevent pregnancy by:

• stopping the release of an egg (ovulation), meaning there is no egg for sperm to fertilise
• thickening the mucus in the cervix, lowering the chances of sperm entering the womb
• thinning the womb lining, so even if ovulation did occur, there’s less chance an egg will attach to it

Because it works in 3 ways to prevent pregnancy, it is up to 99% effective if taken according to the manufacturer's instructions – every day, at the same time.

Hana can prevent pregnancy for as long as you need to take it for, and its effects will last until you stop your treatment. This means you can get pregnant as soon as you stop taking Hana. However, it can take several months for your menstrual cycle and hormones to go back to how they were before.

How long does Hana take to work?

Hana works straight away if you take your first pill on day 1 of your menstrual cycle, which is the first day of your period. It’s recommended to start Hana like this if you can, this way, you will not need another form of contraception to prevent pregnancy when you start taking it.

You can find more information on how long it takes Hana to work in different situations in this table:

Hana is more than 99% effective at preventing pregnancy if it is taken correctly. It is important to make sure you take the Hana mini pill at the same time every day and without a break between packs.

If you do not take it correctly all the time, it’s more likely to be around 91% effective. Hana can be less effective if you:

• miss your pill
• take it at different times each day
• vomit and/or have diarrhoea, especially within a few hours of taking it or for more than a day
• use ulipristal acetate (emergency contraception, also known as ellaOne) at the same time
• use certain medications and herbal remedies at the same time, such as St John’s wort

Take 1 Hana pill every day at the same time, and do not take a break in between packs.

Each Hana pack contains 28 pills with the days of the week printed on the pack and arrows showing the order in which to take the tablets. It’s recommended to take Hana as follows:

1. Every time you start a new pack, take a pill that is labelled with the correct day of the week. So, if you are taking the first tablet in the pack on a Monday, take a pill labelled ‘Mon’. You should not start with just any pill as this may increase the chances of forgetting to take the Hana pill or cause confusion.
2. Take 1 pill a day until the pack is empty. You should swallow the pill whole, and you can take it with some water if you need to.
3. Start a new pack of Hana the next day. You do not have a break between packs when taking Hana or need to wait for a bleed.

Taking Hana at the same time you do something else, like brushing your teeth, can make it easier to remember every day. We also recommend taking it at a time you know you will be able to every day, or setting an alarm or using a pill reminder app if you find it difficult to remember when to take it.

➤ Hana can prevent pregnancy but not sexually-transmitted infections (STIs). If you do not use another form of contraception, you could be at risk of catching an STI, so it’s important to get regularly tested. You can do this with an at-home STI test kit, or at your local sexual health clinic.

What if I miss a dose of Hana?

Missing a Hana pill can reduce its effectiveness. Here’s what to do if you miss a dose of Hana:

Within 12 hours

If you realise you have missed your Hana pill within the 12-hour window (within 12 hours from the time you usually take it), take the delayed pill straight away. Then take your next pill as usual, even if this means taking 2 pills in a day. Your protection will still be effective.

Over 12 hours

If you are over 12 hours late, leave any missed pills and immediately take the most recently missed one, then continue taking Hana as normal. Use additional contraception for 7 days, such as condoms.

Within the first week of taking Hana

If you miss 1 or more pills in the very first week of taking Hana and have had sex the week before, the risk of getting pregnant is higher than at any other time in your cycle. Speak to a doctor or pharmacist for advice straight away, as you may need to use emergency contraception (the morning after pill).

➤ Find more detailed information on what to do if you forget to take the pill.

What if I take too much Hana?

There should be no serious harmful effects from taking too much Hana. You may get some side effects like feeling or being sick, or a slight change in vaginal bleeding. If you’re concerned after taking more Hana pills than prescribed, speak to your doctor or pharmacist.

What if I throw up after taking Hana?

If you vomit within 3 to 4 hours of taking Hana, it counts as missing a pill. In this case, you should take another Hana pill. If you’re not sick again, you can resume taking Hana as normal.

If you’re ill with frequent vomiting and/or have diarrhoea, continue to take your pill as normal, but use additional protection if you have sex throughout your illness and for 7 days after.

The contraceptive pill is available to buy from trusted online doctor services like ZAVA. These are regulated services run by registered doctors who can make sure your contraception is right for you.

Some contraceptive pill brands, like Hana, are also available to buy over the counter from most UK pharmacies. You may also be able to get Hana on the NHS from your doctor or at a sexual health clinic.

Can I buy Hana online?

Yes, the Hana daily contraceptive pill is available at ZAVA.

You can request Hana in 3 simple steps:

1. Simply fill out a short health questionnaire.
2. One of our doctors will review your responses and confirm your suitability.
3. Your pill will be discreetly delivered by Royal Mail to an address of your choice or you can choose to collect it from your local Post Office.

Can I buy Hana over the counter?

Yes, Hana is one of the few oral contraceptive pills available over the counter. You can get it at most UK pharmacies as well as online. You’ll still need to answer a few questions to get it over the counter, as the pharmacist will need to make sure it’s safe and suitable based on your medical history.

Can I get Hana on the NHS?

You may be able to request Hana from your GP after having a contraceptive consultation.

NHS guidelines recommend that GPs offer progesterone-only pills that contain 75mcg of desogestrel first, which is the same active ingredient and dose as Hana. However, as Hana is a branded pill, a generic version may be offered instead. You can also get Hana by visiting a local NHS pharmacy.

Like all medications, the Hana contraceptive pill can cause side effects, however, not everyone will experience them. Speak to your doctor or pharmacist if your side effects are severe or persistent.

Common Hana side effects, which affect approximately 1 in 10 people, include:

• amenorrhoea (where you stop having periods)
• irregular periods
• altered or depressed mood
• decreased sex drive
• headaches
• feeling sick (nausea)
• acne
• breast pain
• increased body weight

Changes to your period or bleeding can sometimes go away within a few months of taking Hana. Speak to your doctor or pharmacist if you’re bleeding more frequently or heavily than you can manage and this is not calming down, or you repeatedly have bleeding triggered by sex.

Uncommon Hana side effects, which affect approximately 1 in 100 people, include:

• vaginal infection
• tiredness
• being sick (vomiting)
• painful periods
• difficulty wearing contact lenses
• ovarian cysts
• hair loss

Rare Hana side effects, which affect approximately 1 in 1,000 people, include:

• rash
• hives
• painful blue-red skin lumps (erythema nodosum)
• breast secretion or leakage

There are also some serious and rare side effects of Hana, which require you to call 999 or get to A&E straight away. These include:

• a severe allergic reaction, with symptoms like a swollen face, lips, tongue, and/or throat, difficulty swallowing or breathing, and dizziness
• an ectopic pregnancy (pregnancy outside of the womb), with symptoms like sudden and severe pain in the stomach or lower abdomen, with or without vaginal bleeding
• blood clots, with symptoms like swelling, redness, or pain in a limb, or chest pain, breathlessness, and coughing up blood

How long do Hana side effects last?

Side effects from Hana can last anywhere from a few days to a few months, as your body adjusts to the medication.

“If you can manage your side effects, we recommend you to continue taking Hana if you still need a contraceptive method. However, if your side effects are affecting you too much, speak with your doctor or pharmacist about an alternative. You could also get side effects when switching to another contraceptive method that contains hormones, so sometimes it’s better to see if they get better on their own.” – Dr Zoe Miller, Medical Editor.

What to do if you get Hana side effects

Mild side effects are common and should subside. We suggest waiting for your body to adjust, and in the meantime for:

• nausea or vomiting – take the pill at night and with food
• spotting/irregular periods – take your pill at the same time each day and use pantyliners until it becomes more regular or stops
• headaches – take painkillers like paracetamol or ibuprofen
• breast tenderness – wear a supportive bra, apply a warm compress, and take painkillers
• acne – practice good skin care and speak to your doctor if this is severe or long-lasting
• increased body weight – eat a healthy, balanced diet and get plenty of exercise each week (around 150 minutes per week)
• vaginal infection – speak to your doctor or pharmacist to get the correct treatment

The Hana contraceptive pill may not be suitable for some people, for instance, because of allergies, certain medications, or certain medical conditions.

Hana and other medical conditions

Do not take Hana if you have:

• a type of cancer which is affected by sex-steroid hormones
• a blood clot in your legs called deep vein thrombosis or lungs (pulmonary embolism)
• jaundice or severe liver disease, or a history of either of these unless your liver function has returned to normal
• unexplained vaginal bleeding
• repeatedly experienced bleeding after sex
• an allergy to desogestrel or any other ingredients of Hana
• taken a positive pregnancy test, or think that you may be pregnant
• not started your periods yet

You should also let your pharmacist or doctor know if you have:

• ever had a blood clot in your legs called deep vein thrombosis or lungs (pulmonary embolism)
• ever had cancer that is affected by progesterone hormones
• high blood pressure – Hana may be stopped if your blood pressure remains high during treatment
• diabetes
• epilepsy
• tuberculosis
• chloasma
• liver cancer or liver problems

If any of these apply to you, you may still be able to take Hana but your doctor may want to see you for more regular reviews.

The Hana pill also contains lactose (milk sugar). If you are allergic or intolerant to lactose, speak to a doctor before taking Hana.

The contraceptive pill and breast cancer

The risk of breast cancer is slightly higher in people taking the contraceptive pill and increases with age. More research is needed into progesterone-only pills like Hana, though it’s thought that the risk is similar or lower to that of the combined pill.

For example, out of 10,000 people taking the contraceptive pill for up to 5 years:

• approximately 1 extra case is reported when it’s stopped before age 20
• approximately 20 extra cases are reported when it’s stopped before age 40

The contraceptive pill and blood clots

The risk of a blood clot is higher in people on contraceptive pills, but no higher than the risk in pregnant women. Mini pills like Hana are thought to be lower risk compared to combined pills, however, more research is needed.

Before you take Hana, a healthcare professional will make sure that your risk of blood clots is low. It is important to inform your doctor of your medical history, and any history of blood clots in your family.

If you’re due to have surgery or be immobile for any length of time, speak to your doctor, as you may need to stop taking Hana during this time.

Hana and other medications

Other medications and herbal remedies can interfere with Hana and stop it from working properly. They may cause contraceptive failure, unexpected bleeding, or increase the levels of Hana in your bloodstream which can increase the chance of side effects.

These include treatments for:

• epilepsy, such as primidone, phenytoin, and barbiturates
• tuberculosis, such as rifampicin and rifabutin
• HIV, such as efavirenz
• fungal infections, such as griseofulvin
• pulmonary arterial hypertension, such as bosentan
• mental health, such as the herbal remedy St John’s wort
• bacterial infections, such as clarithromycin and erythromycin
• high blood pressure, angina, or certain abnormal heart rhythm, such as diltiazem
• hepatitis C infections, such as boceprevir and telaprevir

If you’re using any of these for short-term treatment, you may continue taking Hana under the supervision of a doctor or pharmacist. You must use additional contraception every time you have sex and until 28 days after stopping the last dose of the other medicine or herbal remedy. If you take them long-term, Hana may not be suitable for you.

If you already take Hana, speak to your doctor before starting any other medications or herbal remedies.

Taking emergency contraception

If you use a morning after pill containing ulipristal acetate (ellaOne) during your cycle, you must stop taking Hana and wait 5 days before taking it again. You must also use additional barrier contraception if you have sex during these 5 days, as well as for the first 7 days of taking Hana (for a total of 12 days).

Taking Hana and ulipristal acetate together can alter the effect of both these medications, resulting in reduced contraceptive effect and increased risk of pregnancy.

Hana during pregnancy and breastfeeding

Do not use Hana if you’re pregnant, or think you might be. Take a pregnancy test if your period is late and you’ve missed any pills in the last month, or if you have any other signs of pregnancy. If you become pregnant, stop taking Hana straight away.

Hana may be used while you’re breastfeeding and research shows it does not appear to influence the production or the quality of breastmilk, or affect the baby's health.

If you’re not sure if Hana is right for you, there are other types of progesterone-only contraceptive pills available from ZAVA or your GP, which may be more suitable for you.

Hana alternatives include:

• Cerelle (desogestrel)
• Cerazette (desogestrel)
• Zeletta (desogestrel)
• Norgeston (levonorgestrel)
• Noriday (norethisterone)

➤ If you’re still not sure, our guide on which is the best contraceptive pill for me explores the contraceptive options available so that you can make your decision with confidence.

Hana vs Lovima

Hana and Lovima are almost identical, as they are both mini pills containing 75mcg of desogestrel. The main difference is that Lovima contains the inactive ingredient soybean oil, so it’s unsuitable for people with peanut or soya allergies. Hana does not contain soybean oil so it is a safe alternative.

Hana vs Cerazette

Hana and Cerazette are very similar, both are mini pills that contain 75mcg of desogestrel. The main difference between them is that Hana is available over the counter, while Cerazette requires a prescription.

How should Hana be stored?

Keep Hana in a secure place out of reach of children and do not store above 30°C.

Hana should not be taken after the expiry date which refers to the last day of the month. You must not take Hana after 3 months from the date of first opening the sachet. Ask your pharmacist how to throw away medications you do not use to help protect the environment.

In which pack sizes is Hana available?

Hana comes in pack sizes of 1 or 3 blister packs containing 28 pills each.

What does Hana look like?

Hana looks like a small, spherical, white, film-coated tablet.

Can I take Hana while breastfeeding?

Yes, Hana is safe to take while breastfeeding as long as you have not been advised not to take a progesterone-only pill by a medical professional.

Does Hana affect your periods?

A common side effect of progesterone-only pills is an altered menstrual cycle, meaning your period may stop or bleeding may become lighter. Despite this, people may also experience heavier bleeding, but everybody is different.

A change in the menstrual cycle usually settles down after a few months once your body is used to the Hana pill. If you’re concerned about any of these changes, speak to your doctor or pharmacist.