Indications
Ethinylestradiol is a man-made form of the female hormone oestrogen. It is mostly used in combination with a progestogen:
- Combined oral contraceptive pills, to prevent pregnancy, and sometimes to regulate heavy or painful periods
- With Cyproterone Acetate, for moderate to severe acne and excess hair growth in women
- Alone, in some hormone treatments under specialist care
How It Works
In contraceptive pills it works with the progestogen to stop the ovaries releasing an egg each month, thickens the mucus at the neck of the womb so sperm cannot pass easily, and changes the womb lining.
Dosage and Administration
As a combined pill: take one tablet at about the same time every day, following the order and pill-free or inactive-tablet days shown on the pack. If a pill is missed, follow the missed-pill instructions in the leaflet, as extra protection may be needed. Other uses: as prescribed.
Interactions
- Rifampicin, Carbamazepine, Phenytoin, Phenobarbital, Topiramate, some HIV medicines and St John’s wort can make the pill less effective; a different or additional method of contraception is needed.
- It can lower Lamotrigine levels, which may lead to more fits.
- It can raise Ciclosporin levels.
- Some hepatitis C medicines can raise liver enzymes when taken with it.
Contraindications
- Past or present blood clot in a leg or lung, stroke or heart attack, or a known clotting disorder
- Migraine with aura (warning signs such as flashing lights)
- Smoking at age 35 or over
- High blood pressure that is not controlled, or diabetes with blood vessel damage
- Breast cancer or other hormone-sensitive cancer
- Severe liver disease or liver tumour
- Unexplained vaginal bleeding
- Pregnancy
Side Effects
Common: nausea, breast tenderness, headache, spotting between periods, mood changes and fluid retention. These often settle within the first few months.
Get urgent medical help for pain or swelling in one leg, sudden chest pain or breathlessness, coughing up blood, sudden weakness or numbness on one side of the body, difficulty speaking, a sudden severe headache or loss of vision, yellow skin or eyes, or severe stomach pain.
Pregnancy and Lactation
Do not use during pregnancy; stop and see a doctor if pregnancy is suspected. Taking it by accident in early pregnancy is not known to harm the baby. Combined pills can reduce breast milk supply and are usually avoided while breastfeeding, especially in the first 6 weeks after birth; a progestogen-only method is often preferred.
Precautions and Warnings
- Blood pressure should be checked before starting and regularly.
- Tell the doctor about smoking, obesity, migraine, diabetes, gallbladder or liver disease, or a family history of blood clots.
- It may need to be stopped before major surgery or long periods of immobility.
- Vomiting within 3 hours of a pill or severe diarrhoea can reduce protection.
- It does not protect against sexually transmitted infections.
Overdose
Taking several pills at once may cause nausea, vomiting and vaginal bleeding. Serious harm is unlikely, but seek medical advice, especially if a child has swallowed them.
Therapeutic Class
Oestrogen (female sex hormone); component of combined hormonal contraceptives.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.