Microgestin FE 1/20

What is Microgestin FE 1/20?

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 anaemia 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. 

How does Microgestin FE 1/20 work?

Microgestin FE contains both birth control pills and iron supplements. The birth control pills work to help you avoid pregnancy in the following ways:

• They prevent ovulation, so there is no egg for sperm to fertilize.
• They thicken the mucus around the cervix and vagina, so that sperm cannot easily pass through it to fertilize an egg if an egg was released.
• They alter the lining of the womb/uterus (the endometrium) so that a fertilized egg would be unable to implant and would therefore just pass naturally out of the body, without continuing into a pregnancy. 

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 anaemia by giving your iron a boost when you’ll be losing iron during your period. 

How effective is Microgestin FE?

When taken correctly, Microgestin FE is 99% effective against pregnancy, about the same success rate as condoms. It is estimated that Microgestin FE remains more than 97% effective in the event that women forget to take a pill.

Remember, Microgestin FE does NOT offer protection against STIs, nor does any other form of hormonal contraceptive. The only form of contraceptive to offer some protection against STIs is condoms.  

Microgestin FE and iron-deficiency anaemia

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 anaemia 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. 

Active ingredients

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. 

Inactive ingredients

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.

Microgestin FE dosage

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.

How to start Microgestin FE

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:

• Day 1 Start: Start with the first active tablet labeled with the day of the week on which your period starts (day 1 of your menstrual cycle).
• Sunday Start: Take the first tablet in the pack, an active tablet marked as ‘Sunday’, on the first Sunday after the start of your period. If you choose this method, you will need to use an alternative form of contraception, such as condoms, for the first 7 days of your treatment.

How to take Microgestin FE

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 should I do if I forget to take my pill?

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.

How to stop taking Microgestin FE

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. 

Microgestin side effects

Common side effects of Microgestin FE include:

• Irregular vaginal bleeding:

  • Spotting
  • Breakthrough bleeding
• Difficulty wearing contact lenses
• Swelling of:
  • Fingers
  • Ankles
  • Feet
• Skin changes:
  • Rash
  • Darkening of the skin, especially on the face
  • Hair loss
• Appetite changes
• Mood changes:
  • Anxiety
  • Depression
• Lightheadedness
• Headaches
• Increased likelihood of bacterial or fungal vaginal infections

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.

• Symptoms of an allergic reaction:
  • Breathing difficulties
  • Swelling of the mouth, lips, tongue, throat, face
  • Hives or rash
• Symptoms of a blood clot:
  • Difficulty breathing
  • Fainting & dizziness
  • Pain in the chest, jaw or left arm
  • Confusion, slurred speech & lack of coordination
  • Migraine or sudden/severe headache
  • Visual changes including double vision & full or partial blindness
  • Profuse sweating

Contraindications

Do NOT take Microgestin FE if:

• You are pregnant, think you might be pregnant, or are trying to get pregnant
• You have a history of heart attack or stroke
• You have blood clots in the legs (thrombophlebitis), 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 are known to have or are suspected of having breast cancer, cancer of the lining of the uterus, or cervical cancer
• 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 the pill
• You have a benign or cancerous liver tumor

Before taking Microgestin FE, inform your doctor and take particular care if:

• You smoke. You are strongly advised not to smoke while taking the pill.
• You have breast nodules, fibrocystic disease of the breast, and abnormal breast x-ray or mammogram
• You have diabetes
• You have elevated cholesterol or triglycerides
• You have high blood pressure
• You suffer from migraines, other headaches, or epilepsy
• You suffer from depression
• You have gallbladder, heart or kidney problems
• You have a history of irregular menstrual periods

Drug interactions

Before taking Microgestin FE, inform 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 Microgestin FE:

• Rifampin
• Anticonvulsants, such as phenobarbital, phenytoin, and carbamazepine
• Troglitazone
• Antibiotics, in particular antimicrobials such as ampicillin, tetracycline and griseofulvin
• Atorvastatin
• HCV Combination Therapy
• Ascorbic acid
• Acetaminophen
• Phenylbutazone
• Hepatitis C drug combination containing ombitasvir/paritaprevir/ritonavir, without or without dasabuvir

Alternatives to Microgestin FE

There are many different types of hormonal birth control, and it is not unusual to try a few different ones before finding one that works for you; different pills may contain different forms of progestogen and/or estrogen, and some patients find that they are more sensitive to some types than others. Low-estrogen pill such as Microgestin FE are particularly suited to women who are sensitive to estrogens, as is the progestogen-only pill, or mini pill. This pill is continuous, meaning it does not allow a break for a monthly bleed, and can also be used by women who are breastfeeding. 

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 the implant (Implanon, Nexplanon), the shot (Depo-Provera), and the intrauterine device (IUD, Mirena, ParaGard, Skyla, Liletta, Kyleena). In particular, the IUD may be appropriate for women with contradictory health conditions, such as diabetes or hypertension, as it works locally to the reproductive system. Speak to your doctor or health worker for information and advice about these types of contraception.

If you do not wish to use hormonal contraceptives, you may choose to rely on barrier contraceptive methods. These include the cervical cap (FemCap) and Male and Female Condoms. It is worth noting that male condoms are the only form of contraception to offer protection against STIs.