Loestrin

In October 2019 Galen Pharma announced that Loestrin had been discontinued.

This is not because Loestrin was unsafe or ineffective, but instead because the producers were not able to meet demand and therefore decided to stop making it.

There’s no like-for-like pill with the same hormones in the same doses as Loestrin, but our doctors have come up with a list of alternatives with the same amount of oestrogen as Loestrin 20 and 30. If you’re already using Loestrin, we recommend that you switch to another pill as soon as you can to avoid running out.

Good alternatives for Loestrin 20 are:

• Millinette 20
• Mercilon
• Gedarel
• Sunya
• Femodette

Good alternatives for Loestrin 30 are:

• Microgynon 30
• Millinette 30
• Ovranette
• Rigevidon
• Logynon

It’s a good idea to finish your current pack of Loestrin before you make the switch, just to make sure you take the right pills at the right time and there’s no gap in your contraceptive protection. We suggest that you always check with a doctor before switching pills, to make your contraception as safe as possible.

Loestrin is a type of combined oral contraceptive pill, known simply as ‘the Pill’. It comes in strips of 21 pills. They are marked by the days of the week so you can keep track of when to take them.

Loestrin contains artificial versions of the female sex hormones progesterone and oestrogen (chemicals responsible for controlling your periods). They're also known as norethisterone acetate and ethinylestradiol.

Loestrin stops pregnancy in three ways, by:

• Preventing ovulation (an egg being released for pregnancy).
• Thickening the fluid in your cervix (entrance to the womb), making it difficult for sperm to swim through and enter the womb.
• Thinning the lining of your womb, so that a fertilised egg cannot grow there.

Loestrin 20 and Loestrin 30 contain different amounts of oestrogen. The numbers refer to the amount of ethinylestradiol in micrograms (µg). Both contain the same amount of norethisterone acetate – 1mg.

The reason these 2 doses exist is not because one has a stronger hormonal effect than the other, and they both have the same success rate for preventing pregnancy. The difference in oestrogen levels is because some people react differently to different doses.

A lower dose of oestrogen might help reduce some of the unwanted side effects, but may have a higher risk of irregular bleeding. In the same way, a higher dose might help increase some of the other health advantages besides the contraceptive effect.

You can only take Loestrin if a nurse or doctor has prescribed it to you. You will only be prescribed Loestrin if your nurse or doctor thinks it is a suitable choice for you, based on your personal circumstances.

It's most commonly taken by women who are sexually active, but do not wish to become pregnant. However, pills like Loestrin can have a number of other health benefits.

They can improve:

• Spots (acne)
• Cramps and period pain (dysmenorrhea)
• The effects of premenstrual syndrome (PMS)
• Heavy menstrual bleeding (menorrhagia)
• Symptoms of PCOS (polycystic ovary syndrome)

And they can also reduce the risk of cancer in the following areas:

• Ovaries (ovarian cancer)
• Womb (endometrial cancer)
• Rectum or colon (bowel, colon, or colorectal cancer)

Not everyone can take Loestrin. Sometimes Loestrin is contraindicated – meaning you may not be prescribed it if you:

• are pregnant or gave birth less than 6 weeks ago
• are hypersensitive (allergic) to its ingredients
• suffer from certain genetic blood clotting conditions
• have a personal or family history of breast cancer
• have or have had blood clots, or have a family member who has had them
• have high blood pressure, ischaemic heart disease or atrial fibrillation
• are obese
• have a history of migraines with aura, strokes, or transient ischemic attacks (TIAs)
• are over 35 and smoke (or have smoked in the last year)
• are aged 50 or over

Some women may not be able to take Loestrin if they suffer from:

• diabetes or high cholesterol
• liver or gallbladder problems
• kidney problems
• certain conditions affecting the heart muscles or valves
• SLE
• immobility
• or have had major surgery, weight loss surgery or a transplant

A doctor, nurse, or online doctor service will be able to tell you if is safe for you to take Loestrin. Please always tell your doctor about any existing or new health conditions.

You can start taking Loestrin at any time throughout your cycle, as long as you’re not pregnant.

If you are taking Loestrin for the first time and have regular periods, it’s a good idea to take your first pill on days 1 to 5 of your period. This will protect you from pregnancy immediately. If you start it at any other time in your cycle, use condoms for the first 7 days to protect yourself from pregnancy.

You can take your Loestrin pill at any time of the day, but it’s recommended that you take it at about the same time every day. Set an alarm to remind you if you have trouble remembering to take your pill. There are also pill reminder apps available for your smartphone.

Remember that a good routine can reduce your risk of pregnancy even more. When taken correctly, Loestrin is more than 99% effective. But this can be difficult to remember to do on a day-to-day basis, so it becomes only 91% effective: e.g. 9 in 100 women will become pregnant in the first year of using combined pills like Loestrin.

The combined pill is more effective than condoms and diaphragms but with typical use is less effective at preventing pregnancy than long-acting reversible contraceptive methods (LARC) including the progesterone-only injection and implant, the copper IUD, and the progesterone IUS.

You can only get oral contraceptive pills with a prescription from a licensed nurse or doctor. To get a prescription, you can either visit your local GP surgery or sexual health clinic, or order a repeat prescription online using a registered website like the ZAVA Online Doctor Service.

It can be a problem if you’re sick with vomiting or diarrhoea within 4 hours of taking your Loestrin pill. In this case, the ingredients might not have been properly absorbed into your body and you could be at risk of pregnancy.

Take another pill from a spare strip as soon as you can, and continue taking it as usual. Use condoms if you are having sex during this time, and for 7 days after you recover from your illness.

In addition to the side effects discussed earlier, Loestrin can cause:

• vomiting and bloating
• fluid retention
• chloasma (brown patches of skin commonly on the face)
• cervical erosion and changes in cervical discharge (benign changes to the neck of the womb)
• cholestatic jaundice (if you develop yellowing of your skin or eyes stop the pill, use condoms and see your GP promptly)
• migraines (if you develop these stop the pill, use condoms and see your GP promptly)
• rashes
• rise in blood pressure
• vaginal thrush infections
• intolerance to contact lenses

As with all combined hormonal contraception, there’s a small increased risk of blood clots in women taking Loestrin (it’s between 3 and 3.5 times the risk of non pregnant women who are not using hormonal contraception).

There’s also a very small increased risk of breast and cervical cancer. Although these risks are very low overall, if you have any leg pain or swelling, chest pain, shortness of breath, or cough up any blood, see a doctor immediately. If you notice any breast lumps, nipple discharge, breast pain, breast skin changes, bleeding after sex or between periods, or pain during sex, you should see your GP promptly for review.

There’s no definite answer to this. Some users will notice their acne improves while they take Loestrin, but other people report acne as a side effect.

No, the oral contraceptive pill will not protect you against STDs (sexually transmitted diseases). Condoms are the most reliable method for preventing STDs when you have sex.

Yes, you can delay your monthly period with Loestrin. This is completely safe to do, and is a useful option for many women.

To delay your period, simply start your next strip of pills straight after finishing your current strip. Do not take a 7-day break period in-between. You can do this for up to three months at a time. This break is required so there is an opportunity for your womb lining to be removed.

There have been no health or contraceptive differences found in studies of breaking or not breaking the contraceptive cycle.

It might do as mood swings, anxiety or depression are potential side effects of oral contraceptive pills. If you have a history of any of these conditions, you should discuss this with a doctor. You may still take Loestrin but you need to consider the additional effect it may have on your mental health.

No, definitely not when breastfeeding a baby less than 6 weeks old. Consult your family-planning nurse or doctor who can advise you on this when breastfeeding beyond 6 weeks. You can also consider alternative contraception methods.

Yes it probably will. Taking Loestrin will probably have some effect on your periods. Many women report that their periods get lighter and less painful when using it, but this won’t apply to everyone. Up to 20% of women may have irregular bleeding in the first 3 months, but if this continues beyond 3 months you should see your doctor.

You can start taking combined oral contraceptive pills Loestrin from 21 days after you give birth, as long as your doctor agrees that it is safe to do so, and if you are not breastfeeding.

You should only take one Loestrin tablet per day. You should swallow it with water as required. Do not chew or crush the tablet.

Try to take your pill at around the same time every day, eg before bed. If you forget to take a pill, take it as soon as you remember, even if this means taking 2 pills in one day. If you take a pill more than 24 hours late you may need to use condoms for 7 days and may need emergency contraception if you have had unprotected sex. Always read the instructions in the pill packet or discuss with your doctor or nurse for further advice if you miss any pills.

Take one pill per day for 21 days, until the strip is finished. After 21 days, traditionally women would have a 7-day break before re-starting the next packet. You will likely have a withdrawal bleed and are still protected against pregnancy during this break period.

Newer pill-taking regimes which are outside the manufacturer’s license but are commonly used include:

• a shorter break between packs (4 days)
• taking 3 packs (9 weeks) back to back before having a 4 or 7 day break
• taking a pill every day until you have 4 days of bleeding in a row, then having a 4 day break
• or taking a pill every day with no break between packs even if bleeding occurs

Shortening the hormone-free interval is thought to reduce the risk of unwanted pregnancy and may decrease side effects experienced in the hormone-free period. But, irregular bleeding is more common.

Common side effects of the contraceptive pill:

• Nausea
• Headaches
• Dizziness
• Mood swings, depression, or anxiety
• Sore breasts
• Low libido (lack of desire for sex)
• Change to bleeding pattern (mainly in the first 3 months of use)

Although weight gain is commonly listed by manufacturers as a side effect of combined hormonal contraception, there's no clear evidence that it's associated with taking the pill.