Low Ogestrel

What is Low Ogestrel?

Low Ogestrel is a type of combined oral contraceptive containing both a progesterone and an estrogen hormone. It contains a lower-dose of estrogen compared to standard pills, which helps to reduce estrogen-related side effects such as headaches, nausea and breast tenderness. Low Ogestrel is a non-continuous contraceptive pill, which means that you will have a monthly withdrawal bleed.

How does Low Ogestrel work?

Low Ogestrel works in three ways: it prevents ovulation (the release of an egg from the ovaries), preventing sperm from being able to fertilize an egg. It also thickens the mucus in the cervix, making it harder for sperm to reach the uterus in the event that an egg is released. Finally, Low Ogestrel alters the lining of the uterus to prevent a fertilized egg from being able to implant. Instead, the egg will not develop, and will instead be passed out of the body.

How effective is Low Orgestrel?

When taken correctly, Low Ogestrel is 99% effective in preventing pregnancy. The actual success rate of Low Ogestrel is around 97%, taking into account women who forget or miss a pill. 

Remember, Low Ogestre will not protect you from STIs, nor will any other hormonal contraceptive. The only contraceptive to offer some protection against STIs is condoms.  

Active ingredients

White Low Ogestrel tablets contains 30mcg of ethinyl estradiol (EE) and 0.3mg of norgestrel. These are synthetic versions of the female sex hormones, estrogen and progesterone respectively. The peach Low Ogestrel tablets are placebos to help you keep track of your pills. They do not contain any active ingredients. 

Inactive ingredients

The inactive ingredients in the white Low Ogestrel tablets are: croscarmellose sodium, lactose, magnesium stearate, microcrystalline cellulose, and povidone. The ingredients in the peach placebo tablets are: anhydrous lactose, FD&C Yellow No. 6 Lake, lactose monohydrate, magnesium stearate, and microcrystalline cellulose.  

Low Ogestrel dosage

Your doctor will decide on your dose depending on your personal requirements. The usual dose is 1 x tablet containing 30 mcg ethinyl estradiol and 0.3 mg Norgestrel for the first 21 days, and 1 x placebo pill for the following 7 days.

How to start taking Low Ogestrel

Make sure you read the package instructions carefully and never start taking Low Ogestrel without first consulting a doctor. Low Ogestrel comes in the form of 28-day blister packs, containing 21 white active tablets (containing the active hormones) and 7 peach inert tablets. The packs are accompanied by stick-on labels marked with the days of the week. You have two options of how to start Low Ogestrel:

• Day 1 Start: Start the first white active tablet on the first day of your period (day 1 of your menstrual cycle). Choose the stick-on label that begins with the day of the week on which your period started, and stick onto the current pack to help you remember.
• Sunday Start: Choose the stick-on label that starts with ‘Sunday’ and start with the first active pill on the first Sunday after your period starts, even if you are still bleeding. If you chose this method, make sure you use an alternative form of contraception, such as condoms, while you wait to begin Low Ogestrel.

How to take Low Ogestrel

You should take 1 pill at the same time each day. To help you remember, try and make this a part of your daily routine: for example, take your pill each morning when you brush your teeth. When you reach the end of the 21 active pills, move onto the inactive pills the next day. During these 7 days, you will experience a withdrawal bleed which simulates a natural period. This does not necessarily mean you will bleed for 7days. At the end of a 28 day pack, you should start a new pack the next day without leaving a break, so make sure you have your next pack ready.

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

If you forget to take one of the white, active pills, take it as soon as you remember and then continue with your next pill at the usual time. If you miss 2 active pills, take 2 on the day you remember and another 2 the next day, then continue as normal. You are advised to use additional, non-hormonal contraception, such as condoms, for the next 7 days to avoid becoming pregnant, as missing 2 pills in a row can reduce the effectiveness of Low Ogestrel. You may also experience some breakthrough bleeding in the event of missed pills. If you are unsure what to do about missed pills, contact your doctor or health worker for advice.

Low Ogestrel side effects

As with all medications, Low Ogestrel has several associated side effects. However, compared to birth control pills with a higher dose of estrogen, you can expect to experience less estrogen-related side effects.

Common side effects of Low Ogestrel include:

• Nausea and vomiting

• Headaches

• Feeling bloated

• Breast tenderness or soreness

• Swelling of the ankles or feet

• Weight changes

• Irregular periods or spotting (light bleeding between periods) - this is more common when you first start taking the pill.

If you experience any of the following serious side effects you should stop taking Low Ogestrel and speak to your doctor as soon as possible:

• Lumps in the breast

• Mood changes, including symptoms of depression or worsening of an existing mental health problem.

• Severe abdominal pain

• Dark urine

• Jaundice (yellowing of eyes or skin)

• Continuous spotting, that doesn’t resolve within the first month

• Sudden heavy bleeding

• Missed periods

It is also possible to experience a severe allergic reaction to Low Ogestrel. If you experience any of the following symptoms you should seek emergency medical attention:

• Breathing difficulties

• Swelling of the face, lips, tongue or throat

• Hives

As with all medications, there are risks you should be aware of. Low Ogestrel can cause dangerous side effects related to blood clots. These include strokes, heart attacks, pulmonary embolisms and others. Therefore, you should seek immediate medical attention if you experience any of the following symptoms:

• Pain in your chest, jaw or left arm

• Weakness on one side of your body

• Shortness of breath or rapid breathing

• Sudden dizziness or fainting

• Confusion

• Slurred speech

• Severe headaches

• Migraines

• Headaches with vision changes or a lack of coordination

• Unusual levels of sweating

• Vision changes including double vision, visual impairments and blindness.

Contraindications and Precautions

Do NOT take Low Ogestrel if:

• 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 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
• You have chest pain (angina pectoris)
• You have known or suspected breast cancer or cancer of the uterus lining, 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 tumour (benign or cancerous)

In addition, tell your doctor and take particular care if any of the following apply to you:

• You have breast nodules, fibrocystic disease of the breast, an abnormal breast x-ray or 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 Low Ogestrel, tell your doctor if you are taking or have recently taken any other medications, including those purchased over the counter without a prescription. The following medications may interfere with the effectiveness of Low Ogestrel:

• Rifampin
• Epilepsy medications, including barbiturates such as phenobarbital and phenytoin
• Phenylbutazone

Antibiotics can decrease the effectiveness of oral contraceptives. A backup contraceptive method, such as condoms, should be used if you are taking antibiotics.

Alternatives to Low Ogestrel

There are many different types of hormonal contraception and women often have to try a few before finding one that is right for them. Different pills contain different forms of progestogen and/or estrogen, and some women find that they are more sensitive to different types. Low Ogestrel has the advantage of containing a lower dose of oestrogen, and is therefore suitable for women who are particularly sensitive to estrogens. Alternatively, the progestogen-only pill, also known as the mini pill, does not contain any estrogen. This pill is continuous, meaning it does not allow a break for a monthly bleed. Some types of progestogen-only pill can also be taken by women who are breastfeeding. 

If you do not wish to take a pill each day, you can try a form of hormonal contraception that is not taken orally. These include the implant (Implanon, Nexplanon), the shot (Depo-Provera), and the intrauterine device (IUD, Mirena, ParaGard, Skyla, Liletta, Kyleena). The IUD in particular is suited to women with certain contradictory health conditions, such as diabetes or hypertension, as it works locally to the reproductive system. For advice on which type of contraceptive might be best for you, speak to your doctor or health worker.

If you choose not to use hormonal methods of contraception at all, you will need to rely on barrier methods. These include the cervical cap (FemCap) and male and female condoms. Remember, the male condom is the only form of contraception to offer some protection against STIs.