Microgestin FE 1/20 is a low-estrogen birth control pill with an iron supplement included. Low-estrogen birth control pills are helpful if you experience high levels of estrogen-related side effects (nausea, breast tenderness, headaches etc.). With the extra iron supplement, Microgestin FE is also a good option for people who are susceptible to iron deficiency anaemia.
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Reviewed by Dr Yasmin Aghajan, MD
Information last reviewed 07/17/19
Microgestin FE is a type of low-estrogen birth control pill. This means that it contains progesterone and a low-dose of estrogen compared to standard combined oral contraceptive pills. The lower levels of estrogen, make Microgestin FE a good option for people who experience strong estrogen-related side effects, such as headaches, breast tenderness and nausea. In addition to the hormones, a pack of Microgestin FE also contains seven iron supplements that you take during the break between active pills when you have your period. These iron tablets are a helpful way to avoid the iron-deficiency anemia that can occur around your period. Whilst the primary use of Microgestin FE is birth control, it can also be prescribed to treat acne, endometriosis, period pains and PMS (premenstrual syndrome) amongst other conditions.
Microgestin FE contains both birth control pills and iron supplements. The birth control pills work to help you avoid pregnancy in the following ways:
The iron supplements work by increasing your iron levels during your period. Iron-deficiency can be caused by heavy periods, other blood loss or by not getting enough iron in your diet. The supplements help to avoid anemia by giving your iron a boost when you’ll be losing iron during your period.
When taken correctly, Microgestin FE is 99% effective against pregnancy, which is slightly higher than the effectiveness of condoms. In fact, it has been shown that the effectiveness of Microgestin FE remains more than 97% in the event that a single pill is missed. However, it is important to take every pill, around the same time each day, to get the maximum effect.
It is important to note that Microgestin FE does NOT offer protection against STIs, nor does any other form of hormonal contraceptive. Only barrier contraceptive methods (condoms) can provide protection against STIs when used correctly.
Microgestin FE contains an iron supplement called ferrous fumarate which helps to replenish the iron lost during your monthly bleed. These are contained in the 7 placebo pills at the end of each pack. This helps to prevent iron-deficiency anemia which can be caused by heavy periods. They only contain small amounts of iron however, not enough to treat a diagnosed anemic condition. In this case you’d be prescribed iron tablets from your doctor.
Microgestin FE birth control pills are white, but the pack also includes brown tablets which are iron supplements. The active ingredients in the white birth control pills are 20mcg ethinyl estradiol (EE) and 1mg norethindrone. The active ingredient in the iron tablets is ferrous fumarate.
The birth control pills contain the following inactive ingredients:
Magnesium stearate, microcrystalline cellulose, povidone, anhydrous lactose, polacrilin potassium, alcohol.
The inactive ingredients in the iron supplements are:
Sodium starch glycolate type A corn, microcrystalline cellulose, magnesium stearate.
The usual dosage of Microgestin FE is 1 x active tablet (containing 20 mcg ethinyl estradiol and 1 mg norethindrone) each day for the first 21 days, and then 1 x inactive tablet containing an iron supplement for the following 7 days.
Before starting taking Microgestin FE, make sure you read the package instructions carefully and never start taking it without first consulting a doctor. Microgestin FE comes in the form of 28-day blister packs, containing 21 active tablets (containing the active hormones) and 7 inert tablets, and marked with the days of the week. When you start taking Microgestin FE, you have 2 options:
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.
If you forget to take your pill, you should take it as soon as you remember and then continue with your next dose at the usual time. If you miss 2 pills in a row, take both at the same time, as soon as you remember, and another 2 the following day. In this case, you will need to use an additional means of birth control, such as condoms, to ensure that you are fully protected from pregnancy. Missed pills may result in spotting or breakthrough bleeding, but this is normal and nothing to worry about.
You can stop taking Microgestin FE at anytime without the need to consult your doctor. If you stop it midway through a pack of pills this will disrupt your cycle so it will be difficult to tell when your next period will be. If you are planning to switch to another pill, make sure you follow the instructions on your new pill as you may need to finish your current pack first. After coming off the pill, your fertility will return right away so if you are not planning on getting pregnant, you will need to use another type of contraception.
Common side effects of Microgestin FE include:
Irregular vaginal bleeding:
You may experience other side effects not included on this list. You should always read the patient information leaflet before taking any medication, to ensure that you are aware of the side effects, complications and when to go to your doctor.
In rare cases, people do experience dangerous side effects from Microgestin FE. It is possible to have an allergic reaction to Microgestin FE and it can also increase your risk of a blood clot. Blood clots can cause strokes, heart attacks and a range of other life-threatening conditions. It is important that you are aware of the symptoms below and that you seek emergency medical attention if you experience any of them.
Do NOT take Microgestin FE if:
Before taking Microgestin FE, inform your doctor and take particular care if:
Before taking Microgestin FE, inform your doctor if you are currently 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 Microgestin FE:
There are many different types of hormonal birth control, and it is not uncommon to try a few forms before you find the one that is best for you. The pills differ in the form and amounts of progestogen and/or estrogen they contain and some women are sensitive to certain forms than others. Low-estrogen pills such as Microgestin FE are especially well-suited to women who are sensitive to estrogen. Another equally suited option is the progestogen-only pill, or mini pill. In contrast to Microgestin FE, the mini pill is taken in a continuous manner, which means that there is no gap for a withdrawal bleed to occur. This pill can also be used in breastfeeding mothers.
Alternatively, you may wish to try a form of hormonal contraception that is not taken orally and does not need to be administered on a daily basis. These include injections (Depo-Provera), implants (Implanon, Nexplanon), and intrauterine devices (IUD, Skyla, ParaGard, Kyleena, Mirena, Liletta). IUDs are especially suitable for women with pre-existing conditions such as hypertension and diabetes, as these devices act directly on the reproductive system. Speak to your doctor or health worker to learn more about your options.
If you do not wish to use hormonal contraceptives at all, you may consider barrier contraceptive methods. These include the cervical cap (FemCap) and male and female condoms. When used correctly, condoms are the only form of contraception that offer protection against STIs.
Microgestin FE is widely considered to be a safe and effective means of preventing pregnancy. Hormonal contraceptives in general carry a very slight increase in the risk of developing serious health complications, including blood clots, heart disease, gallbladder disease, liver tumours, and estrogen-sensitive cancers, such as breast cancer, cervical cancer, and endometrial cancer. The benefits of hormonal contraceptives outweigh these slight risks, but women who have a personal or family history of these conditions should consult a doctor before taking hormonal contraceptives, as they may not be suitable for them. See ‘Contraindications’ above for more information.
Microgestin FE is a combined contraceptive pill that allows for a monthly withdrawal bleed, which simulates a natural period. This will occur during the 7 days you are taking the inactive pills, but will not necessarily last for the full 7 days. Make sure to take all 7 pills, even if your bleeding has stopped, before continuing onto the active pills.
Microgestin FE will NOT protect you from STIs, nor will any other form of hormonal contraceptive. The only contraceptive that offers partial protection from STIs is male condoms.
While oral contraceptives are primarily designed to prevent pregnancy, they are also sometimes prescribed to treat acne and irregular, painful or heavy periods. In addition, oral contraceptives can help decrease the incidence of ovarian cysts and lower the risk of ectopic pregnancy, in which the fertilized egg attaches outside of the uterus. Hormonal contraceptives are also thought to help protect from ovarian and uterine cancer.
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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