Use Enskyce birth control pills to prevent pregnancy

If you had problems with the estrogen side effects of combination pills in the past, Enskyce might be the right option for you, as it’s a low-estrogen pill.

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Reviewed by Dr Roy Kedem, MD

Information last reviewed 10/22/19


What is Enskyce?

Enskyce is a type of birth control pill that contains a lower-level of estrogen than most other combined oral contraceptives. Estrogen is a female sex hormone, too much of which can cause side effects such as breast tenderness, nausea, and headaches in susceptible women. If you experience these estrogen-related side effects from another pill, Enskyce may be a good option for you.

How does Enskyce work?

Enskyce is a combined contraceptive pill, which means that it contains synthetic versions of the female hormones estrogen and progesterone. Therefore, Enskyce alters the level of these hormones and helps to prevent pregnancy in three ways: 

  • Enskyce prevents ovulation (the release of an egg by the ovaries) by increasing the levels of progesterone in the body.
  • Enskyce helps to prevent fertilization of an egg - if one is released - by thickening the mucus (fluids) around the cervix and vagina, making it harder for sperm to pass through.
  • Enskyce also prevents implantation of a fertilized egg in the lining of the womb (the endometrium). While it is unlikely that an egg would be fertilized when taking Enskyce, if it were to happen, the egg would be unable to implant in the endometrium, as the hormonal changes caused by Enskyce prevent this from happening.

How effective is Enskyce?

Enskyce is 99% effective in preventing pregnancy. A more accurate success rate, which takes into account women who occasionally miss a pill, or are late taking their pill, is around 95%. Enskyce does not protect against STIs, nor does any other form of hormonal contraceptive. The only form of contraception to protect against STIs is condoms.


Active ingredients

Each pack of Enskyce contains both light orange and green pills. The light orange pills are the active pills and the green pills are placebo pills. The placebo pills do not contain any active ingredients, but are designed to remind you when you need to start the next pack. 

The active ingredients in the light orange Enskyce pills are 30mcg ethinyl estradiol (EE) and 0.15mg desogestrel. EE is the synthetic estrogen and desogestrel is the synthetic progesterone. Compared to standard combined contraceptive pills, Enskyce contains a lower-dose of synthetic estrogen, meaning that it should help you to avoid estrogen-related side effects such as headaches, nausea and breast tenderness.

Inactive ingredients

The light orange pills contain the following inactive ingredients: colloidal silicon dioxide, corn starch, hypromellose, lactose monohydrate, magnesium stearate, polyethylene glycol, povidone, stearic acid, talc, titanium dioxide and vitamin E.

The light green placebo pills contain the following inactive ingredients: corn starch, D&C Yellow No. 10 Aluminum Lake, FD&C Blue No. 2 carmine Aluminium Lake, FD&C Yellow No. 6 Aluminum Lake, hypromellose, lactose monohydrate, magnesium stearate, polyethylene glycol, talc and titanium dioxide.

Which ingredients can cause an allergic reaction?

While it is rare for oral birth control to cause a severe allergic reaction, the Yellow No. 6 dye and Carmine used in Enskyce have been suspected as cases of anaphylactic shock where other causes have not been identified. Symptoms of a severe allergic reaction include: dizziness, facial swelling, hives/rash, and trouble breathing. If you notice these symptoms, you should seek medical attention immediately. 


Enskyce dosage

The usual dosage of Enskyce is 1, active (orange) pill, containing 30 mcg ethinyl estradiol and 0.15 mg desogestrel, per day for the first 21 days of your 28-day cycle, followed by 1, inert (green) pill per day for the following 7 days.

How to start taking Enskyce

Always read the package instructions carefully before use, and never start taking Enskyce without first consulting a doctor. Enskyce usually comes in a 28-day blister pack containing 21 active pills and 7 inert pills, each marked with the days of the week. You can start Enskyce in one of two ways:

  • Sunday start: Take the first active pill, marked “Sunday”, on any Sunday, regardless of the number of days from your menstrual period. It is important to know that if you follow this method, you will not be protected from pregnancy for the first 7 days after starting the pill and will need to use an alternative method of contraception (e.g. condoms) in addition to taking Enskyce for the first 7 days.
  • Day-1 start:  Take the first active pill on the first day of your period and continue to take 1 pill every day from the pack. You will not need to use additional means of contraception if you follow this method.

How to take Enskyce

Take 1 pill per day at the same time each day. To make sure you don’t forget, try working it into your daily routine: for example, take a pill first thing in the morning after you brush your teeth. After you have finished the 21 active pills, move onto the inert pills the very next day, without a break. During these 7 days, you will experience withdrawal bleeding, which is a simulation of a natural period caused by a drop in the body's progesterone levels. Withdrawal bleeding may not last as long as your regular menstrual period. When you reach the end of the 28-day pack, start a new pack the next day, even if you are still bleeding. Make sure you have a new pack ready to start as soon as you finish the current one.

What do I do if I miss a pill?

If you miss 1 active, orange pill, take it as soon as you remember and then continue as normal, even if this means taking 2 pills in one day. If you miss 2 active pills in a row, take 2 as soon as you remember and then 2 the next day, before carrying on as normal. You should use an additional form of contraception for 7 days after missing a dose, as missing pills can reduce the effectiveness of Enskyce. You may experience some breakthrough bleeding or spotting in this event, but this is completely normal. If you  miss an inert (green) pill, just dispose of the missed dose and carry on as normal the next day. If you are unsure what to do in the event of a missed pill, contact your doctor or health worker for advice. 

Side Effects

Enskyce side effects

Common side effects of Enskyce usually disappear after the first few months of use as your body gets used to the new hormone levels. Common side effects include:

  • Nausea and vomiting
  • Breast tenderness
  • Headache
  • Bleeding between periods (i.e. spotting)
  • Difficulty wearing contact lenses.

Please note, that there are a number of other side effects you may experience when taking Enskyce. You should always read the patient information leaflet before taking any new medication, and you should ensure that you re-read the leaflet every time you get a new pack of pills in case the information has been updated. 

Due to the active ingredients in Enskyce, it is possible to experience severe side effects, some of which may be associated with blood clots or an allergic reaction. If you experience any of these side effects you should seek emergency medical attention.

  • Swelling of mouth, tongue, lips or throat
  • Hives
  • Severe headaches or migraines
  • Visual changes including double vision, blindness and other impairments.
  • Pain in the chest, jaw or left arm
  • Difficulty breathing
  • Fainting
  • Dizziness
  • Confusion
  • Slurred speech or lack of coordination
  • Profuse sweating


Do NOT take Enskyce if:

  • You are allergic to any of the active or inactive ingredients the medication
  • You are pregnant, think you might be pregnant, or are planning on becoming pregnant
  • You have a history or heart attack or stroke
  • You have, or have had, blood clots in the legs (thrombophlebitis), brain (stroke), lungs (pulmonary embolism) or eyes
  • You have a history of blood clots in the deep veins of your legs (DVT)
  • You have chest pain (angina pectoris)
  • You have known or suspected breast cancer or cancer of the lining of the uterus, cervix or vagina
  • You have unexplained vaginal bleeding
  • You have had jaundice (yellowing of the skin or whites of the eyes) during pregnancy or during previous use of a contraceptive medication
  • You have a liver tumor (benign or cancerous)
  • You are due to undergo major surgery with prolonged immobilization
  • You suffer from headaches with focal neurological symptoms 
  • You have been diagnosed with high blood pressure


You should tell your doctor and take particular care with Enskyce if any of the following apply to you:

  • You have breast nodules, fibrocystic disease of the breast or an abnormal mammogram
  • You have diabetes
  • You have elevated cholesterol or triglycerides
  • You have high blood pressure
  • You have migraines or other headaches
  • You have epilepsy
  • You have depression
  • You have gallbladder, heart or kidney disease
  • You have a history of irregular menstrual periods
  • You smoke. You are strongly advised not to smoke while using hormonal contraceptives.

Drug interactions

Before taking Enskyce, tell your doctor if you are taking or have recently taken any other medicines, including those purchased over the counter without a prescription. The following medicines may interfere with the effectiveness of Enskyce, or cause breakthrough bleeding:

  • Rifampin
  • Barbiturates such as phenobarbital, topiramate (Topamax), and phenytoin (Dilitan)
  • Anticonvulsants such as carbamazepine (Tegretol) and lamotrigine (Lamictal)
  • Phenylbutazone (Butazolidin)
  • Bosentan (Tracleer)
  • Certain antibiotics
  • St John’s Wort, an herbal remedy used to treat depression

Treatment Options

Alternatives to Enskyce

Low-estrogen oral contraceptives, such as Enskyce, are particularly suited to women who are sensitive to estrogens, as they help to reduce estrogen-sensitive side effects such as breast tenderness and headaches. However, there are many different types and brands of oral contraceptives containing different forms and doses of the hormones, and it is not uncommon to try a few before finding one that is right for you. Most women start off with a standard-dose combined oral contraceptive unless it is contraindicated by an existing health condition or prescription, in which case a progestogen-only pill (also known as the mini pill) may be better suited. The mini pill contains progestogen only and is taken in a continuous fashion, which means a monthly bleed does not occur.

Non-oral forms of hormonal contraceptive are also available and are useful if you struggle to remember to take your pills each day. Forms of non-oral hormonal contraceptives include implants (Implanon, Nexplanon), injections (Depo-Provera), and intrauterine devices (IUD, Mirena, ParaGard, Skyla, Liletta, Kyleena). In particular, IUDs are suited to women with certain existing health conditions, such as diabetes or hypertension, as it works locally on the reproductive system. To understand which type of contraceptives would be suitable for you, speak to your doctor or health worker.

If you don’t want to use hormonal contraceptives, you can rely on barrier methods instead. These include a cervical cap (FemCap) and condoms.  Barrier contraceptives, when used correctly,  are the only form of contraception to offer protection from STIs.   


Disclaimer: This is not medical advice. You and your physician will determine if and how you should take any medication prescribed to you following a medical consultation.

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