Microgynon Pill

What is Microgynon?

Microgynon 30 ED is a combined oral contraceptive pill containing two synthetic female hormones: levonorgestrel (a progestogen) and ethinylestradiol (an oestrogen). It belongs to the pharmacological class of combined hormonal contraceptives (CHCs), which are among the most reliable reversible contraceptive methods when used correctly.

Mechanism of Action

Microgynon prevents pregnancy through three complementary mechanisms:

1. Ovulation suppression: The hormones prevent the release of an egg from the ovaries each month
2. Cervical mucus thickening: Makes the mucus in the cervix thicker, creating a barrier that sperm cannot easily penetrate
3. Endometrial thinning: Prevents the womb lining from thickening sufficiently for a fertilised egg to implant

Think of Microgynon as a three-layered security system for contraception. If one mechanism isn't 100% effective (which is rare), the other two provide backup protection. This multi-target approach explains its high efficacy rate of over 99% with perfect use.

Biological Pathway

The hormones in Microgynon work by mimicking the natural hormones oestrogen and progesterone. They act on the hypothalamus-pituitary-ovarian axis to suppress the production of follicle-stimulating hormone (FSH) and luteinising hormone (LH). Without the LH surge that normally triggers ovulation, the ovaries don't release an egg. Simultaneously, the progestogen component directly affects the cervical glands and endometrium to create additional contraceptive barriers.

What is Microgynon Used For?

Microgynon 30 ED has one primary licensed indication but offers several additional benefits:

Approved Indication

• Contraception: Prevention of pregnancy in women of reproductive age

Additional Benefits

• Regulation of menstrual cycles
• Reduction of menstrual blood loss (making periods lighter)
• Decrease in menstrual pain (dysmenorrhoea)
• Improvement of premenstrual symptoms
• Reduction in risk of ovarian and endometrial cancers with long-term use

Target Patient Population

Microgynon is suitable for most healthy women of reproductive age who:

• Want reliable, reversible contraception
• Can remember to take a pill at the same time daily
• Have no contraindications to combined hormonal contraception
• Are non-smokers under 35, or smokers under 35 who will quit
• Have a BMI under 30 kg/m² (or under 35 with clinical assessment)

Before Using Microgynon

Before starting Microgynon, a comprehensive medical assessment is essential to ensure safety and suitability. This aligns with guidance from NHS Inform Scotland on combined pill use.

Medical History Assessment Checklist

Your clinician will assess the following during consultation:

• Personal or family history of blood clots (venous thromboembolism)
• History of migraine, especially migraine with aura
• Cardiovascular conditions (high blood pressure, heart disease)
• Liver disorders or liver tumours
• Breast cancer or other hormone-sensitive cancers
• Diabetes with vascular complications
• Unexplained vaginal bleeding
• Smoking status and age
• BMI calculation
• Current medications and supplements
• Pregnancy status and breastfeeding

Required Baseline Tests

Before prescribing Microgynon, your doctor may recommend:

• Blood pressure measurement - essential before starting and regularly during use
• Pregnancy test if there's any possibility of pregnancy
• Cervical screening - should be up-to-date according to NHS guidelines
• Breast examination - clinical examination if indicated by history
• Liver function tests - if liver disease is suspected
• Lipid profile - if there's a family history of lipid disorders

Microgynon Contraindications

Absolute Contraindications (Must Not Use)

Microgynon must NOT be used if you have any of the following conditions:

• Current or history of venous thromboembolism (VTE): Deep vein thrombosis (DVT), pulmonary embolism (PE)
• Current or history of arterial thromboembolism (ATE): Stroke, myocardial infarction, angina
• Migraine with aura (at any time in your life)
• Current or history of breast cancer or other hormone-dependent cancers
• Severe liver disease or liver tumours (benign or malignant)
• Uncontrolled hypertension (≥160/100 mmHg)
• Diabetes with vascular complications (nephropathy, retinopathy, neuropathy)
• Major surgery with prolonged immobilisation (must stop 4 weeks before)
• Known thrombophilia (Factor V Leiden, protein C/S deficiency, antiphospholipid antibodies)
• Pregnancy or suspected pregnancy
• Undiagnosed abnormal genital bleeding
• Allergy to any component of Microgynon

Relative Contraindications (Use With Extreme Caution)

• Smoking, especially if ≥35 years old
• Obesity (BMI ≥30 kg/m²)
• Migraine without aura (if new/worsening on pill)
• Controlled hypertension (140-159/90-99 mmHg)
• Gallbladder disease
• Mild liver impairment
• Systemic lupus erythematosus
• Inflammatory bowel disease (Crohn's, ulcerative colitis)
• Sickle cell disease
• Postpartum period (first 21 days after delivery)

Special Population Considerations

Elderly Patients

Microgynon is not indicated for postmenopausal women. For perimenopausal women considering contraception, the benefits and risks should be carefully evaluated, with particular attention to cardiovascular risk factors which increase with age.

Renal Impairment

No dosage adjustment is needed for mild to moderate renal impairment. However, severe renal impairment or acute renal failure may increase thrombosis risk. Use with caution and monitor blood pressure regularly.

Hepatic Impairment

• Mild impairment: Use with caution; monitor liver function
• Moderate to severe impairment: Contraindicated
• History of cholestatic jaundice: Avoid if related to previous COC use or pregnancy
• Liver tumours: Absolute contraindication

Paediatric/Adolescent Population

Microgynon can be used from menarche (first period) onwards. For adolescents, consider:

• Ability to adhere to daily pill regimen
• Bone mineral density (COCs may slightly reduce peak bone mass accrual)
• Growth and development (generally not affected)
• Counseling on STI protection (condom use essential if sexually active)

Microgynon and Other Medicines

High-Risk Medication Combinations

The following medications can reduce Microgynon's effectiveness or increase side effects:

Medications That Reduce Contraceptive Effectiveness

• Enzyme-inducing drugs:
  • Antiepileptics: Carbamazepine, phenytoin, primidone, barbiturates, topiramate (>200mg/day)
  • Antiretrovirals: Efavirenz, nevirapine, ritonavir
  • Antibiotics: Rifampicin, rifabutin
  • Herbal remedies: St John's Wort (Hypericum perforatum)
  • Others: Modafinil, bosentan, griseofulvin

Action required: If taking any enzyme-inducers, use additional barrier contraception (condoms) throughout treatment and for 28 days after stopping the interacting drug. Your doctor may recommend a higher-dose pill or alternative contraception.

Medications That Increase Side Effects

• Hepatitis C protease inhibitors: Ombitasvir/paritaprevir/ritonavir, dasabuvir, glecaprevir/pibrentasvir, sofosbuvir/velpatasvir/voxilaprevir - absolute contraindication
• Other liver-metabolized drugs: May have increased levels due to enzyme inhibition

Timing Recommendations

Pregnancy & Breastfeeding

Pregnancy

• Microgynon is not indicated for use during pregnancy
• If pregnancy is suspected, perform a pregnancy test before continuing
• Extensive epidemiological studies have shown no increased risk of birth defects in babies exposed to COCs during early pregnancy
• However, COCs are not recommended during pregnancy as they offer no benefit and may have theoretical risks

Contraception Requirements When Stopping for Pregnancy

If you stop Microgynon to try to conceive:

1. Use alternative contraception (condoms) until you have a natural period
2. Your fertility returns quickly - some women ovulate within 2-4 weeks of stopping
3. Your doctor can use your last natural period to date any pregnancy accurately
4. No need to wait several months before trying to conceive

Breastfeeding

• Small amounts of hormones pass into breast milk (≈0.02-0.1% of maternal dose)
• Possible effects on milk production (may reduce volume)
• Long-term effects on nursing infant not fully established
• UKMEC Category 3 (theoretical or proven risks usually outweigh advantages) for breastfeeding <6 weeks
• UKMEC Category 2 (advantages generally outweigh risks) for breastfeeding ≥6 weeks

Alternative Contraception While Breastfeeding

• Progestogen-only pill (POP/mini-pill) - first choice
• Progestogen-only implant or injection
• Intrauterine device (IUD or IUS)
• Barrier methods (condoms, diaphragm)

Driving & Machine Operation

Microgynon has no known effect on the ability to drive or operate machinery. Clinical trials and post-marketing experience have shown no impairment of cognitive or motor functions.

Warning Signs to Watch For

While Microgynon itself doesn't impair driving, certain side effects might:

• Migraine or severe headaches: If you experience these, do not drive until symptoms resolve
• Visual disturbances: Especially if experiencing migraine with aura symptoms
• Dizziness or lightheadedness: Reported by some users, particularly when starting treatment
• Mood changes or depression: Can affect concentration and reaction times

Microgynon Ingredients

Active Ingredients

• Levonorgestrel: 150 micrograms per active tablet
  • A synthetic progestogen derived from 19-nortestosterone
  • Highly potent with strong progestogenic activity
  • Primary contraceptive action through ovulation suppression
• Ethinylestradiol: 30 micrograms per active tablet
  • A synthetic oestrogen derived from estradiol
  • Stabilises endometrium and provides cycle control
  • Enhances the contraceptive effect of levonorgestrel

Excipients (Inactive Ingredients)

How to Use Microgynon

For effective contraception, Microgynon must be taken correctly every day without interruption.

Step-by-Step Administration Guide

1. Choose your starting day: Select the self-adhesive strip that starts with your chosen starting day (e.g., if starting Wednesday, use strip beginning "Wed")
2. Attach to memo-strip: Stick the day strip along the top of the foil memo-strip so the first day aligns with the pill marked "start"
3. Daily routine: Take one pill at the same time each day, following the arrow direction
4. Complete the strip: Take all 28 pills (21 active beige pills + 7 inactive white pills)
5. Immediately start next pack: Begin your next strip the very next day without any break

Microgynon Dosage Guidelines

Microgynon 30 ED has a fixed-dose regimen - all active tablets contain the same hormone amounts.

Standard Dosage

• Active tablets: 21 beige tablets each containing 150μg levonorgestrel + 30μg ethinylestradiol
• Inactive tablets: 7 white placebo tablets containing no active ingredients
• Schedule: One tablet daily without interruption
• Timing: Preferably at the same time each day (within a 12-hour window)

Titration Schedule

Microgynon does not require titration - the full dose starts from day one. However, different starting protocols apply based on your situation:

Administration Instructions

Correct Administration Technique

1. Swallow whole: Take each tablet whole with water if needed. Do not chew or crush.
2. Timing consistency: Take at approximately the same time each day. A 12-hour window is acceptable, but consistency improves effectiveness.
3. With or without food: Can be taken with or without food. Taking with food may reduce nausea if experienced.
4. Missed pill rules: Understand the 12-hour rule (see Missed Dose section).
5. Continuous strips: Start each new strip immediately after finishing the previous one - no break between packs.

Special Administration Considerations

For Difficulty Swallowing

Microgynon tablets should not be chewed or crushed as this may affect the controlled release of hormones. If you have difficulty swallowing tablets:

• Practice swallowing with smaller sweets or bread first
• Take with plenty of water (at least 200ml)
• Tilt head forward slightly (chin toward chest) when swallowing
• Consider alternative contraceptive methods if unable to swallow tablets

Travel Across Time Zones

When travelling:

• Continue taking at your usual "home time" if possible
• If adjusting to local time, adjust gradually over 2-3 days
• Never extend the pill-free interval beyond 7 days
• For long-haul flights (>4 hours), stay hydrated and move regularly to reduce thrombosis risk

Missed Dose Management

Correct management of missed pills is crucial for maintaining contraceptive protection.

Time-Based Guidance

Overdose Information

Symptoms of Overdose

Accidental ingestion of multiple Microgynon tablets is unlikely to cause serious harm in adults but may cause:

• Nausea and vomiting
• Vaginal bleeding (including in girls who haven't started periods)
• Breast tenderness
• Dizziness
• Fatigue

Management Protocol

1. No specific antidote exists for combined hormonal contraceptive overdose
2. Symptomatic treatment: Manage nausea/vomiting with antiemetics if severe
3. Monitoring: Observe for several hours; symptoms usually resolve within 24 hours
4. Children: If a child ingests Microgynon, seek medical advice even if asymptomatic
5. Pregnancy test: Consider if overdose occurs in woman of childbearing potential

When to Seek Medical Attention

Contact a doctor or visit A&E if:

• A child has ingested any amount
• Severe vomiting prevents keeping fluids down
• Vaginal bleeding is heavy or persistent
• You experience severe abdominal pain
• Symptoms persist beyond 48 hours

Possible Side Effects

Like all medicines, Microgynon can cause side effects, although not everyone experiences them. Side effects are categorised by frequency based on clinical trial data and post-marketing experience.

Frequency-Based Categorisation

Very Common (≥1 in 10 users)

• Headache (including migraine)
• Nausea
• Breast pain/tenderness
• Mood changes (depressed mood, mood swings)
• Weight increase

Common (≥1 in 100 to <1 in 10)

• Vomiting
• Diarrhoea
• Acne
• Libido decreased
• Breakthrough bleeding/spotting
• Fluid retention
• Contact lens intolerance

Uncommon (≥1 in 1,000 to <1 in 100)

• Vaginal candidiasis
• Breast enlargement
• Hypertension
• Chloasma (skin discolouration)
• Galactorrhoea (milk secretion)

Rare (≥1 in 10,000 to <1 in 1,000)

• Venous thromboembolism (blood clots in veins)
• Arterial thromboembolism (blood clots in arteries)
• Hepatitis
• Gallbladder disease
• Crohn's disease/ulcerative colitis exacerbation
• Systemic lupus erythematosus exacerbation

How to Store Microgynon

Storage Conditions

• Temperature: Store below 25°C
• Environment: Keep in original packaging to protect from moisture
• Location: Store in a dry place away from direct sunlight
• Access: Keep out of sight and reach of children

Expiry Information

• Do not use after the expiry date printed on the strip after "EXP"
• The expiry date refers to the last day of that month
• Once opened, use within the expiry period
• Do not use if packaging is damaged or tablets appear abnormal

Disposal Protocol

• Do not dispose of medications in wastewater or household waste
• Return unused or expired medications to your pharmacy for safe disposal
• Proper disposal helps protect the environment
• Remove or obscure personal information from packaging before disposal

Pack Information

Pack Sizes Available

• 1 x 28-day ED pack (21 active + 7 inactive tablets)
• 3 x 28-day ED packs (84 active + 28 inactive tablets total)
• Presentation: Blister strips in cardboard carton
• Not all pack sizes may be marketed at all times

Pack Contents

• 21 beige sugar-coated active tablets (containing hormones)
• 7 larger white inactive tablets (placebo, no hormones)
• 3 foil memo-strips with self-adhesive day strips
• Patient information leaflet (PIL)

Manufacturer Details

• Marketing Authorisation Holder: Bayer plc, 400 South Oak Way, Reading, RG2 6AD, UK
• Manufacturer: Bayer AG, Müllerstraße 178, 13353 Berlin, Germany OR Bayer Weimar GmbH & Co KG, Weimar, Germany
• Product Licence Number: PL 0010/0094
• Legal Category: POM (Prescription Only Medicine)

Where Can I Buy Microgynon Online in the UK