Loestrin

At the beginning of October 2019 Galen Pharma gave an update explaining that Loestrin has been discontinued. There have been problems with supplies for a while now, so it’s unlikely that Loestrin will be available anywhere.

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 doctor team 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

• Millinette 30

• Ovranette

• Rigevidon

• Logynon

It’s a good idea if you go ahead and 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.

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Loestrin is a type of combined pill – in other words, it contains two of the female sex hormones; progesterone and oestrogen. Loestrin is supplied in 21-day strips which are marked with the days of the week so you can keep track of your usage. 

How it works – the combined oral contraceptive pill works mainly by stopping the ovaries from releasing an egg each month, also known as ovulation. The inclusion of progesterone in the pill also prevents pregnancy by making it more difficult for sperm to penetrate through the cervix to the uterus and fallopian tubes. It does this by thickening the cervical mucous. The pill also thins the lining of the womb (uterus) which makes it more difficult for a fertilised egg to attach to it. 

Taking the 7 day break – Loestrin requires you to take a 7-day break after you have taken one pill every day for 21 days. During the break, you will have a bleed which will be like that of a period. This bleed is what is known as a withdrawal bleed. The bleed happens because you stop taking the pill and so no you are not taking any hormones.

You may have heard of Loestrin 20 or Loestrin 30 – the difference between the two is the amount of oestrogen they contain. The number (20 or 30) refers to the amount of oestrogen in micrograms each pill contains, but both have the same amount of progesterone. The reason for the different levels of oestrogen is because some women react differently to different doses. Usually, a lower dose will help to reduce the occurrence of side effects whereas a higher dose may have other beneficial health effects as well as the contraceptive effect. 

You may also have heard of Lo Loestrin Fe – it contains just 10 micrograms of oestrogen. This is the lowest amount of daily oestrogen used in pregnancy prevention. Like Loestrin, Lo Loestrin Fe still contains both oestrogen and progesterone just in a low dose. Lo Loestrin Fe is an extended regimen pill, so it has 26 days of active pills and 2 days of reminder pills. It works like this:

• You take Lo Loestrin Fe every day, for 28 days

• Start by taking one blue pill every day for 24 days – these contain 1 milligram of progestin and 10 micrograms of oestrogen

• Then take one white pill for the next 2 days – these contain 10 micrograms of oestrogen

• Then take one brown pill for the next 2 days – these contain 75 milligrams of iron but no hormones

• Then start a new pack

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Reordering online – if you have already been prescribed Loestrin by your doctor, then you can reorder a repeat prescription direct from us using our online service. Simply complete one of our online questionnaires by answering some simple questions about your health. One of our doctors will review your answers and the medication you are requesting to confirm your suitability. Once confirmed, your Loestrin can be sent direct to your address or an address of your choice. 

Getting started – if you want to get started on Loestrin you can visit your doctor who will also determine your suitability. Your doctor will run a few simple tests such as your height, weight, body mass index (BMI) and your blood pressure as well as discuss your family medical history to see if Loestrin is right for you.

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How to take Loestrin – if you are using Loestrin 20 or 30, you will take one pill every day for 21 days. You will then have a 7-day break so no pills for 7 days. During this time, you may experience a withdrawal bleed. Once the 7 days is over, you begin taking the next cycle of 21-day pills.

You should aim to take your pill at the same time each day – it helps if you pick a time when you are most likely to remember. For example, if you go to bed at 10pm every night you may find it easy to remember to take your pill at 10pm. By taking your pill at the same time each day, you are increasing its effectiveness. If you are not good at remembering to take the pill, you could try setting an alarm on your phone as a reminder or download a pill reminder app.

You can start taking Loestrin at anytime throughout your cycle – if you are not already pregnant. If this is your first time taking Loestrin, it is probably best to take your first pill on the first day of your period. By doing this, you will be protected from pregnancy immediately. If you begin taking Loestrin at any other time during your cycle, you should use condoms for the first seven days to prevent pregnancy as well as taking your pill.

What should I do if I forget to take my pill? 

• If you are up to 24 hours late taking your pill then don’t worry, just take the pill as soon as you remember. You will still be protected from pregnancy. Once you have remembered to take the pill, carry on taking it as usual.

• If you are over 24 hours late taking your pill, you will still be protected from pregnancy. Take your pill as soon as you remember even if that means taking 2 pills in one day, but from then on continue taking your pill as normal. 

• If you forget more than one pill, then you have lost your contraceptive cover for the next 7 days and so should use condoms as well as a precaution.

What if I am ill after taking my pill? – if you have sickness or diarrhoea within 4 hours of taking your Loestrin pill then this can be a problem because it may not have been absorbed by your body yet. Therefore, you could be at risk of becoming pregnant. Take another pill from a spare strip as soon as you can and continue taking them as normal. You should use condoms when you have sex during this time and for seven days after you have recovered from your illness.

Some medications can affect the effectiveness of Loestrin – you should let your doctor know if you are taking:

• Epilepsy medicines such as:

• Carbamazepine

• Phenobarbital

• Phenytoin

• Primidone

• Infection medications like:

• Griseofulvin

• Rifampicin

• Herbal medicines – St John’s Wort

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Loestrin is a prescription only medication (POM) – so, you can only get it if a doctor or nurse has prescribed it to you. Based on your medical history, a doctor or nurse will determine your suitability for Loestrin. 

Who is it for?  – Loestrin is usually prescribed to women who are sexually active but don’t want to fall pregnant. But Loestrin can have other health benefits too, such as:

• Help with acne

• Improve the effects of pre-menstrual syndrome (PMS)

• Help control period cramps and pain

• Can help treat heavy periods

• Can help treat endometriosis

• Can treat non-cancerous growths in the womb

• Can reduce the risk of ovarian, womb and colon cancer

However, not everyone can take Loestrin – for example, you shouldn’t take Loestrin if:

• You are already pregnant or breastfeeding

• You are allergic to any of its ingredients

• You have high blood pressure

• You are overweight

• You have a history of migraines

• You have a history of strokes

• You have a history or family history of blood clots

• You have a personal or family history of breast or cervical cancer

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Loestrin side effects – as with all medication, Loestrin can have some side effects. These include:

• Thrush

• Rash

• Decreased mood

• High blood pressure

• Nausea

• Vomiting

• Headaches

• Painful breasts

• Increase in breast size

• Loss of interest in sex

• Water retention

• Changes to the shape of your cornea in your eye

• Less tolerant of carbohydrates

Serious side effects – you should consult your doctor if you notice any of the following side effects. These can be serious and may indicate that you have a blood clot:

• The first migraine you have ever had:

• Sight problems

• Throbbing headache

• Feeling sick

• Bad headaches which are worse than normal and occur more often

• You already suffered from migraines but they have got worse

• Chest or stomach pain

• Tingling or pain in any part of your body

• Difficulty breathing

• Painful breathing

• Unexplained cough

• Speech problems

• Feeling dizzy or faint

• Swelling of your vein

• Swollen or pain in a leg

• Sudden sight problems

• Yellowing of the skin or whites of the eyes

The pill and cancer – every female is at risk of breast cancer even if she does not take the pill. However, there is a slightly increased occurrence of breast cancer in women who take the pill compared to those who don’t. The increased risk may not be due to the pill, however, it could be that women who take the pill are examined more frequently and so it may be noticed earlier. Breast cancer risk increases with age. However, some studies have shown that breast cancer risk can be influenced by oral contraceptive formulations. The pill has been shown to be protective against ovary and endometrial cancer. 

The Pill and weight gain – studies have shown that the contraceptive pill doesn’t cause weight gain. Instead weight gain is natural as we get older and one study found that the only factor associated with weight gain was age. Plus, the same study found that there was no significant weight increase between women who did use the pill and those who did not.

The Pill and blood clots – women who take the combined oral contraceptive pill are a greater risk of blood clots than women who don’t take the pill. Blood clots can occur in the veins or the arteries and can result in a blockage which restricts the blood flow. 

Rarely, a blood clot can occur in the deep veins of the legs causing deep vein thrombosis. These clots can break, travel through the bloodstream and get stuck in the lungs (a pulmonary embolism); which is a very seriously, potentially fatal condition.

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Allergan USA. (2017). Lo Loestrin Fe. [online] Available at: https://www.loloestrin.com/-/media/feature/page/lolopatient/pdf/loloestrinfe-patientbrochure.ashx[accessed 4th August 2020].

Beaber, E. F. et al (2014). Recent oral contraceptive use by formulation and breast cancer risk among women 20-49 years of age. Cancer Res: 74(15).

FPA. (2017). Your guide to the combined pill. [online] Available at: https://www.fpa.org.uk/sites/default/files/the-combined-pill-your-guide.pdf [accessed 5th October 2018].

Galen Ltd. (2017). Package leaflet: information for the user: Loestrin 20 tablets, Loestrin 30 tablets.

Nakajima, S. T., Archer, D. F. and Ellman, H. (2007). Efficacy and safety of a new 24-Day oral contraceptive regimen of norethindrone acetate 1 mg/ethinyl estradiol 20 µg (Loestrin 24 Fe). Contraception; 75(1): 16-22. 

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