Levest

Levest is a combined contraceptive pill, also known as ‘the pill’. Combined pills contain synthetic oestrogen and progesterone hormones. This is different to the progesterone only pill, or mini pill. These active ingredients mimic the effects of your body’s natural sex hormones.

When taken every day around the same time, Levest is an effective contraceptive pill. Each pill contains the same amount of hormones. By taking a pill every day, Levest stops your ovaries from releasing an egg (known as ovulation).

When you take Levest, you will take a pill for 21 days followed by a 7 day pill free break. During this break, you may experience some withdrawal bleeding.

This bleeding will be lighter and less painful than your normal periods. For this reason, Levest can also be used to manage painful periods or irregular menstrual bleeding.

You can take 1 Levest pill at the same time each day for 21 days. You can take the pill with or without food.

Taking Levest for the first time

If you have regular periods and start taking Levest during the first 5 days of your period, you will have contraceptive protection from the first pill. If you start at any other time in your cycle, use extra protection such as condoms for the first 7 days of use.

The back of each blister strip shows the days of the week with arrows. You should follow the direction of the arrows when taking Levest. This is to make it easier for you to remember if you have taken a pill that day.

Once you have taken all 21 pills, you can have a 4 or 7 day break. You should start the next blister strip on the eighth day.

During your 7 day pill break, you should expect a withdrawal bleed. You should start your next blister strip even if the bleeding has not stopped. If you start the next strip at the right time you will be protected against pregnancy during the pill break.

Newer ways of taking the pill mean you can take Levest every day without ever taking a break between strips. You can also choose to take a 4 to 7 day break if you have any bleeding, providing you have taken the previous 7 pills as instructed. Some women may choose to run 3 strips of Levest back to back then take a 4 or 7 day break at the end of the third strip.

What if I miss a pill?

If you have missed a pill, check when you were supposed to take the pill. If it has been:

• less than 24 hours, take the missed pill as soon as you remember. You should still have contraceptive protection.
• more than 24 hours, take the most recent missed pill immediately. This might mean taking 2 pills on the same day. If you do this you can carry on taking your pill as normal and no additional contraception is needed.

If you start your next strip more than 48 hours late following a 7 day break, or you miss 2 to 7 pills in the first week of your pack, then you might need emergency contraception.

The prescriber of your emergency contraception should let you know whether to continue your pill and how long to use condoms for as this depends on which emergency contraception you use. You’d need to take a pregnancy test 3 weeks after any episodes of unprotected sex.

Do I need to take emergency contraception?

If you miss

• 2 to 7 pills in week 2 or 3 of your strip of Levest, then you don’t need emergency contraception, providing you’ve taken the pills as instructed in the previous 7 days. You should continue your pill as normal, use condoms for the next 7 days and move straight to your next strip without a break if you missed pills in week 3.
• more than 7 pills at any point then emergency contraception would be recommended if you want to avoid pregnancy and you should chat to the prescriber of your emergency contraception about how best to restart your pill. You’d need to take a pregnancy test 3 weeks after any episodes of unprotected sex.

This advice might be different to the instructions in your pill pack as newer studies mean that guidelines on missed pills have been updated recently. If you have any questions about what to do after a missed pill it’s always best to contact your doctor or pharmacist for advice. Or you can contact us through your patient account.

For more advice, you can read our missed pill guide.

Levest works by preventing pregnancy from occurring in your body by balancing the natural hormones you produce.

The levels of your natural hormones will change throughout your menstrual cycle. By taking Levest daily, your body is given a steady dose of both oestrogen and progesterone. This puts a pause on your menstrual cycle for as long as you are taking Levest.

The active ingredients in Levest work to prevent pregnancy in different by:

• preventing ovulation
• thickening cervical mucus so sperm cannot reach the egg
• thinning the lining of the womb so an egg cannot grow in it

These effects are reversible. If you stop taking Levest, your chance of getting pregnant goes back to normal.

Remember that Levest does not protect against sexually transmitted infections (STIs). Only condoms can protect you against STIs. Contact a doctor or visit a sexual health clinic if you think you may have an STI. You can also request STI test kits from ZAVA.

If you take Levest as directed, the pill can be up to 99% effective in preventing pregnancy. This efficacy level might be reduced if you miss a pill or take your daily pill at a different time than usual.

The effectiveness of Levest can be reduced if you vomit or have diarrhoea when taking the pill. You should use an additional method of contraception while you are unwell and for the following 7 days if you plan on having sex. You should contact your doctor or chemist if you have vomiting or diarrhoea less than 4 hours after taking a pill to check if emergency contraception is needed.

If you use condoms while taking Levest, your chances of pregnancy will be extremely low.

The side effects of Levest are not usually long term and some will resolve within a few hours after taking a pill. Some side effects might take a couple of months to disappear. This is because your body is getting used to the changing levels of hormones.

If your side effects are concerning you, speak to your doctor or pharmacist.

Common side effects include:

• feeling sick
• headaches
• low mood or mood swings
• tender or sore breasts

Uncommon side effects include:

• being sick or having diarrhoea
• migraine
• fluid retention
• loss of interest in sex
• increase in breast size
• skin rash

If you develop migraines whilst using Levest it’s important to contact your doctor and change to a progesterone only method of contraception as soon as possible to avoid serious side effects. It’s also important to discuss any breast symptoms with a doctor.

Though it’s listed as a side effect by the manufacturer, more recent studies have found that there is no link between Levest and weight gain.

Remember that uncommon side effects occur in less than 1 in 100 people. This means if 200 people took Levest, less than 2 people would experience these side effects.

When taking a combined contraceptive pill like Levest there is a small risk of developing a blood clot.

If you are not taking any hormonal birth control, your risk of blood clots is around 2 in 10,000 women. If you take Levest, your risk increases slightly to around 5 to 7 in 10,000. This shows that the risk of blood clots is very small, but you should still be aware of the symptoms.

If you have any of these symptoms after taking Levest, call 999 immediately:

• swelling or redness in your leg
• shortness of breath
• chest pain
• fainting
• coughing up blood

If you notice any other severe side effects please contact a doctor immediately.

For further information on side effects, you can read the patient information leaflet.

Levest is a safe and effective pill for many women. Your doctor will need to monitor your weight and blood pressure on an annual basis.

You should not take Levest if you:

• are pregnant or think you could be pregnant
• are breastfeeding a baby less than 6 weeks old
• are allergic to ethinylestradiol, levonorgestrel or any other ingredients in Levest
• have had a blood clot in your legs, lungs or anywhere else in your body
• have a condition that increases your risk of blood clots
• have had a stroke or heart attack in the past or have angina (chest pain)
• have migraine with aura
• have had breast cancer
• are taking certain medications which interact with Levest

If you have any underlying health conditions, speak to your doctor to find out if Levest is suitable for you. You can also message us through your patient account. This might include uncontrolled diabetes, severe high blood pressure or a high level of cholesterol (fat) in your blood.

Speak to your doctor if you:

• are overweight
• are over 35
• smoke
• will be off your feet for a long duration, such as after having an operation
• have a condition affecting your bowel or stomach
• have systemic lupus erythematosus (SLE)
• have a history of high blood pressure
• have had an organ transplant
• have a family history of blood clots
• have conditions affecting your heart
• have gallbladder disease
• have liver disease
• have recently given birth
• are breastfeeding a baby over 6 weeks old

Your doctor will be able to check if Levest is suitable for you to take. If not, they may recommend a different type of contraceptive pill, such as the mini pill.

Levest may interact with some medications, including:

• epilepsy treatment, such as carbamazepine or phenytoin
• treatment for HIV, such as ritonavir
• griseofulvin, an antifungal medication
• some antibiotics, like rifampicin
• herbal remedies, such as St John’s wort for low mood
• ellaOne, the morning after pill

Levest may make these, and other medications, less effective or vice versa. Levest can also be affected by drugs that cause diarrhoea or vomiting, such as laxatives. Speak to your doctor or pharmacist if you are taking any medications or any over the counter products.

You can find a variety of different contraceptive pills at ZAVA. If taking Levest has given you side effects, you can try another type of combined pill. It’s best to contact a doctor for advice on which pill to try next. These could include Lucette or Brevinor.

There are alternative contraceptive methods to taking Levest, including:

• the progesterone only pill or mini pill, such as Cerelle or Noriday
• using a non-hormonal barrier method like condoms or a diaphragm
• long acting reversible contraceptives (LARCs) such as the hormonal implant or coil

You can find out more about these methods in our guide to types of contraception.

If you need emergency contraception, you may need the morning after pill. The morning after pill is taken after you have had unprotected sex, or if your contraceptive methods have failed.