Feeling more tired than usual? Can’t sleep at all? Wondering if it’s a side effect from the pill? Insomnia, tiredness and fatigue aren’t common side effects of contraceptive pills, but that doesn’t mean they’re not possible. Hormonal changes can impact how you sleep, and hormonal contraception alters the hormone levels in your body throughout your cycle. 

There are two types of hormonal contraceptive pills and they can affect people differently. A combined pill contains oestrogen and a progestogen, and mini-pills (also known as progestogen-only pills) contain – you guessed it – only progestogen. Hana® is a progestogen-only contraceptive pill that contains the active ingredient desogestrel.

Now, let’s get one thing straight: while insomnia isn’t explicitly listed as a known side effect for either pill type, tiredness and fatigue are possible side effects from the pill. If you’re wrestling with sleep issues that you suspect might be linked to your daily contraceptive – or if you’re concerned about potential sleep disruptions as you start to use a daily contraceptive pill – keep reading.

Insomnia is not thought to be a side effect of the pill. However, if you’re struggling with sleeplessness and suspect a connection to your pill use, it’s wise to have a chat with your GP or pharmacist.

If you started taking the pill recently, it’s also important to think about other lifestyle factors and changes that may have occurred around the time you started taking the pill, such as stress or changes to your routine.

Tiredness is an uncommon side effect of Hana®, this means it affects 1 in 100 people who use it. However, some of the more common side effects of starting new medication could potentially be tiring to deal with initially. If you feel this might be the case for you, it could help to speak to your GP about ways of dealing with those side effects.

Yes, there are links between progesterone and sleep. Progesterone is responsible for preparing the uterine lining for an egg to implant and grow, and it’s normal to feel a little extra tired after ovulating when progesterone levels in your body are at their highest (this would be roughly week 3 of a 4-week cycle).

However, desogestrel is a synthetic progestogen designed to be used as a contraceptive and it is not identical to the progesterone that your body produces. Progestogens affect the body’s progesterone receptors but carry out their own specific functions. In desogestrel’s case, these are stopping ovulation and thickening the mucus in the cervix to stop sperm from reaching the egg. Desogestrel does still carry some side effects, but the risk of tiredness and fatigue is low. It may affect up to 1 in 100 people

If you want help getting more sleep or to combat fatigue caused by birth control, you do have a few options. 

Making sure that you’re getting enough exercise, water and food are very important and could help you to stay healthy and deal with the effects of any sleeping problems caused by the pill. Going outside to see some (indirect) morning sunlight can also help you feel more energised throughout the day, as can managing stress and listening to your body so you’re not pushing yourself too hard.

You could consider what time you take the pill and whether that plays a role. If you take your daily contraceptive pill in the morning and feel exhausted all day, you could consider switching to taking it at night. If you take it in the evening and you’ve been struggling to sleep, maybe take it in the morning instead. As the pill is most effective when taken at the same time every day, you should use a barrier method of contraception if you have sex during the first 7 days of this change. 

If the symptoms you experience while taking the pill carry on for several weeks after you begin taking it, it could be a good idea to speak to your GP about it. They may recommend switching to a different method of contraception.

If you need to know more about side effects from the Hana® or want to know more about what time you should take the pill, check out our Ask Hana® section where we answer all of your questions about the progestogen-only pill. You can also visit our blog for features on sex, family planning, and much more.

Hana® 75µg film-coated tablets contains desogestrel and is an oral contraception for women of child bearing age to prevent pregnancy. Always read the instructions on the package leaflet carefully.

https://patient.info/doctor/progestogens 

https://bnf.nice.org.uk/drugs/progesterone/#side-effects 

https://bnf.nice.org.uk/drugs/desogestrel/#side-effects 

https://www.ncbi.nlm.nih.gov/books/NBK563211/

Hormonal contraceptives are methods of birth control that use synthetic versions of the naturally occurring female hormones oestrogen and/or progesterone to help prevent pregnancy.  

There are different types of hormonal contraceptives, such as contraceptive pills, patches, injections, implants, rings, and the IUS (intrauterine system). Some of them contain both oestrogen and progestogen (the synthetic version of progesterone), whilst others only contain progestogen.

Oestrogen and progesterone are hormones which play a crucial role in mammalian reproduction. 

Oestrogen has various functions including helping with bone growth and regulating our moods, but is best known for its role in female growth and reproductive development. It helps maintain the menstrual cycle and facilitates the preparation of the uterus for anticipated and actual pregnancy.

“Oestrogen plays a role in ovulation (when your ovaries release an egg) and thickens the lining of your uterus (endometrium) to prepare it for pregnancy,” says Dr. Hana Patel*, GP Expert Witness. “Oestrogen causes eggs to mature in ovaries once a girl hits puberty. These are then released at regular intervals during the menstrual cycle. It’s responsible for helping several organs function, including stimulating growth of the egg follicle in the ovaries, maintaining vaginal lubrication, maintaining the mucous membrane that lines the uterus, and the formation of breast tissue.

Oestrogen has a role outside the reproductive system too, with effects on bones, skin, hair, the brain, the heart and cholesterol levels.

Progesterone is a steroid hormone that helps prepare both male and female bodies for reproduction. In females, increased levels of progesterone signal the body to thicken the lining of the uterus and the body will continue to produce progesterone during pregnancy to support the development of the foetus. High levels of progesterone also prevents your body from ovulating when you’re pregnant

“Progesterone is produced by the ovaries, and is released in the second half of a woman’s menstrual cycle after ovulation,” says Dr Patel. “The main function of progesterone is to prepare the endometrium (lining of your uterus) for a fertilised egg to implant and grow. If a pregnancy doesn’t occur, the endometrium sheds during your menstrual period. If conception occurs, progesterone increases to support the pregnancy.”

Synthetic versions of these naturally occurring hormones are used in contraceptive pills to help prevent pregnancy. They can do this by preventing ovulation so no egg is released and sperm which has entered the body has nothing to fertilise, as well as thickening the mucus in the neck of the womb so it’s harder for sperm to reach an egg. 

Oestrogen in contraceptive pills helps prevent pregnancy by suppressing the production of follicle-stimulating hormone (FSH), which is responsible for stimulating the growth and maturation of eggs in the ovaries. By lowering the levels of FSH, oestrogen helps prevent the ovaries from ovulating (i.e. releasing an egg each month). 

Without ovulation, there is no egg available for sperm to fertilise, therefore pregnancy cannot occur. Oestrogen also has some other effects that make it harder for sperm to reach the egg, such as thickening the mucus in the cervix and thinning the lining of the womb. Oestrogen is usually combined with another hormone called progestogen in contraceptive pills, which has similar effects that prevent pregnancy.

Combined contraceptive pills contain both oestrogen and progestogen, and when used correctly they are over 99% effective at preventing pregnancy. Combined contraceptive pills are often (although not always) taken for 21 days, followed by a 7 day ‘break’ where you will usually take placebo pills in order to have a monthly bleed. There is no evidence that having a monthly bleed is medically necessary, but some people prefer to have it. If you are interested in starting a combined contraceptive pill, book an appointment with your GP to discuss your options.

Combined contraceptive pills are well tolerated by many people, but they may not be suitable for some women and people with uteruses for medical reasons, such as those who are over 35 years old and smoke, or people with a higher body mass index (BMI).  Combined contraceptive pills are also not suitable if you have a history of blood clots, or if you are allergic to or do not want to take oestrogen. For those people, a progestogen only pill might be more suitable.

Progestogen is a hormone that, in progestogen-only contraceptive pills, helps prevent pregnancy by affecting the reproductive system in different ways. Depending on the type of progestogen-only pill, it may work by:

Stopping ovulation, the process by which an egg is released from the ovaries each month. This means there is no egg for a sperm to fertilise. This is partly how the newer progestogen-only pills that contain desogestrel work.

Thickening the mucus in the cervix, which is the entrance to the womb. This makes it harder for sperm to pass through and reach an egg. This is partly how the older progestogen-only pills that contain levonorgestrel or norethisterone work.

Everyone is different and the type of contraception that is right for you will depend on factors like your medical history and personal preference. In order to discuss your contraception options, you will usually book an appointment with your GP. As of 2021, some progestogen-only contraceptive pills like Hana® are available to buy over the counter or online.

Progestogen-only contraceptive pills (sometimes referred to as mini pills) contain progestogen and do not contain oestrogen. Because of this, progestogen-only pills may be suitable for more people, including those who cannot or do not want to take oestrogen. Circumstances in which the progestogen-only pill may be suitable for you include:

There are different types of progestogen-only pills available which contain different active ingredients. As of 2021, some progestogen-only pills which contain the active ingredient desogestrel are available to buy over the pharmacy counter or online without a doctor’s appointment or prescription.

Before you are able to purchase a progestogen-only contraceptive pill in this way, you will complete a checklist so the instore or online pharmacist can determine whether this type of contraception is suitable for you. Pharmacists are experts in medicine and are more than qualified to check whether progestogen-only contraceptive pills are suitable for you. Find out more about the training pharmacists go through here.

When taken correctly, progestogen-only contraceptive pills containing desogestrel are over 99% effective at preventing pregnancy. They are usually taken every day at the same time without a break between packs. 

Everyone works differently and there’s no one size fits all when it comes to contraception. Many people may find that they need to try a few methods before they settle on something which works for them. You deserve to feel comfortable and secure in your contraception, so speak up if something doesn’t feel right.

*Dr Hana Patel does not endorse any products or brands

Hana® 75µg film-coated tablets contains desogestrel and is an oral contraception for women of child bearing age to prevent pregnancy. Always read the instructions on the package leaflet carefully.

Contraceptives, hormonal | Treatment summaries | BNF | NICE 

Hormonal methods of contraception – Hormones in human reproduction – Edexcel – GCSE Biology (Single Science) Revision – Edexcel – BBC Bitesize

Combined pill – NHS (www.nhs.uk)

Estrogen and Progestin (Oral Contraceptives): MedlinePlus Drug Information

Progestogen-only Contraceptive Pill (POP) | Patient 

The progestogen-only pill – NHS (www.nhs.uk) 

Estrogen vs. Progesterone: Functions in the Human Body

Hypermobility disorders are a group of conditions that cause joints to be more flexible than normal, which is sometimes called being ‘double-jointed’. This can lead to joint pain, stiffness, injury, dislocation and other problems. 

Whilst joint hypermobility is relatively common and affects around 1 in 30 people, you usually don’t need to worry if you don’t have symptoms. Around 10% of people with hypermobility do experience symptoms, including pain and frequent injuries.  If you suspect you may have hypermobility, you should speak to your GP. Whilst there is no cure or specific treatment, there are ways you can manage your condition and the potential pain associated with it. You can find out more about hypermobility disorders and how to manage them here.

Hormones can have an effect on hypermobility disorders. Hormones such as oestrogen and progesterone can influence the structure and function of collagen, which is a protein that gives strength and elasticity to connective tissue. Oestrogen tends to stabilise collagen, while progesterone tends to loosen it. This means that hormonal changes during the menstrual cycle, pregnancy, menopause or hormonal contraception can affect the symptoms of hypermobility disorders.

If you have a hypermobility disorder, you may be wondering if you can take the contraceptive pill safely and effectively. The answer is not a simple yes or no, as different pills may have different effects on your condition.

There are two main forms of hormonal oral contraception in the U.K. They are combined contraceptive pills, which contain synthetic versions of the naturally occurring hormones oestrogen and progesterone, and progestogen-only pills, which contain the synthetic hormone progestogen and does not contain oestrogen.

Progestogen-only methods of contraception may not be suitable for people with hypermobility disorders, as the natural hormone progesterone can lead to joint laxity and pain, as well as the risk of injury or dislocation. In general, patients with hypermobility disorders may want to avoid the injection and the implant, as these are progestogen-only methods. They might also want to avoid progestogen-only contraceptive pills. Everyone is different and more research needs to be done on the link between hormones and hypermobility, but it’s a good idea to speak to your doctor or pharmacist and let them know about any concerns you may have.

Contraceptive pills that contain oestrogen may have a protective effect on collagen and joint stability, as oestrogen can improve muscle mass and strength, and increase the collagen content of connective tissues. However, oestrogen also carries some risks for people with hypermobility disorders, especially if they have other factors that increase their risk of blood clots or cardiovascular problems. These factors include being overweight, having migraines with aura, smoking or having a family history of thrombosis or stroke. Oestrogen may also worsen some symptoms of EDS, such as bruising or bleeding. 

Speak to your doctor or pharmacist about your contraceptive options and make sure they have all the information available to help you make an informed decision. If you are already on hormonal contraception and you get diagnosed with EDS or another hypermobility disorder, speak to your GP about whether you should change your contraception in light of this new information. Remember that you deserve to feel comfortable and confident in your contraception, and you can change it if it’s not working for you.

There are various contraceptive methods available, including hormonal and non hormonal options. These include barrier methods (such as condoms or diaphragms), natural family planning (such as tracking your fertile days and monitoring your temperature and cervical mucus), copper intrauterine devices (IUDs) or sterilisation (such as tubal ligation or vasectomy). Each method has its own advantages and disadvantages, and some may be more suitable for you than others depending on your condition.

For example, barrier methods are safe and effective if used correctly and consistently, but they may not be very convenient or comfortable for some people. Fertility tracking requires constant monitoring and may still not be effective as the exact point of ovulation varies from person to person and from month to month, so it’s not advisable if becoming pregnant is something that’s really important for you to avoid. 

Copper IUDs are long-lasting and hormone-free devices that are very effective at preventing pregnancy and once it’s inserted they can be effective for 5-10 years, but some people may experience pain when getting them fitted and removed and may feel uncomfortable not having a daily reminder that they are taking contraception. 

Sterilisation is a permanent method that involves blocking or cutting the tubes that carry eggs or sperm to prevent pregnancy, but it requires surgery and it is not reversible. Remember that everyone is different and the right contraceptive method for you may not be the same as it is for someone else. You may also need to try a few different methods before you find something that feels right. 

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Ultimately, the choice of contraception is yours to make based on your personal situation and preferences. Remember that no contraceptive method is 100% effective, and that only barrier methods can protect you from sexually transmitted infections (STIs). Speak to your doctor or pharmacist if you have any questions about which contraceptive method is right for you.

Hana® 75µg film-coated tablets contains desogestrel and is an oral contraception for women of child bearing age to prevent pregnancy. Always read the instructions on the package leaflet carefully.

https://www.nhs.uk/conditions/ehlers-danlos-syndromes/

https://www.hypermobility.org/types-of-hms 

​​https://www.hypermobility.org/hormones-and-hypermobility

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341375/

Cystitis is a common type of urinary tract infection (UTI) that affects the bladder. It can cause symptoms such as pain or burning when urinating, frequent or urgent need to pee, blood in the urine, and lower abdominal pain. Cystitis is fairly common in women (more than half of women will get at least one UTI at some point in their lives) and it’s less common in (although can still affect) men.

You may be wondering if hormonal oral contraceptive pills can cause cystitis. We want to share accurate, medically backed information around sex and contraception so you can understand your body better, so we’ve spoken to some medical experts to let you know what’s up.

“Cystitis is a bladder infection, usually caused by a strain of bacteria (often E. Coli),” says  Dr. Michael Green*, Co-Founder & CMO of Winona. “Some of the symptoms of cystitis are a mild fever, frequent urge to pee, burning or pain during urination, cloudy or strong-smelling urine, or lower abdominal pain or discomfort. If you’re experiencing any of these symptoms, a medical professional can diagnose whether or not you have contracted cystitis.”

Typical symptoms of cystitis/UTIs include:

• Pain or a burning sensation when you pee.
• A frequent need to pee.
• Feeling like you need to pee even when you don’t.
• Bloody or cloudy looking urine.
• Abdominal pain or pressure.
• Fever

UTIs are often caused by bacteria which gets into the bladder. Women and people with vulvas are more likely to get UTIs than men because the urethra is shorter, so it’s easier for bacteria to travel through it, and it’s also closer to both the vagina and anus, both of which may contain bacteria that could cause a UTI.

Some people, particularly those with vulvas, are more likely to get UTIs than others. Whilst some people just seem to be more sensitive to UTIs, there are risk factors which may make cystitis more likely. These are:

• Sexual activity. Having vaginal sex can help move bacteria from the vagina to the urethra and may make the transference of bacteria from your sexual partner more likely.
• Some forms of contraception (more on this in a moment).
• Pregnancy. Pregnancy hormones can change the bacteria in the urinary tract, which makes UTIs more likely.
• Difficulty emptying your bladder.
• Diabetes.
• A weakened immune system.
• Scented feminine hygiene products.
• Wiping back to front after going to the toilet.
• Not peeing after sex. Peeing soon after sex can help flush bacteria out of the urethra.
• Holding your pee for too long, as it can encourage bacteria to grow.
• Menopause. A lower level of oestrogen can cause vaginal tissue to become thin and dry, which may make UTIs more likely.
• Kidney stones.
• Having a catheter placed in your bladder.

The pill contains synthetic versions of the naturally occurring female sex hormones oestrogen and progesterone. Combined contraceptive pills contain the synthetic hormones estrogen and progestogen, whilst progestogen-only pills contain (you guessed it!) only progestogen.  

Current research does not show a link between taking contraceptive pills and getting UTIs. Whilst some people who use hormonal birth control may experience more UTIs than some people who don’t, everyone is different and some people are unfortunately more sensitive to and likely to get UTIs than others. 

Whilst contraceptive pills are unlikely to cause UTIs in themselves, having sex without a condom may make UTIs more likely as it increases the chance of bacteria moving around and getting into the urethra.

According to a 2019 topic briefing by the Agency for Healthcare Research and Quality (AHRQ), oral contraceptive pills are not commonly cited as a risk factor for recurrent UTIs. However, other forms of hormonal birth control that involve devices inserted into the vagina or uterus may have a stronger association with UTIs. These include:

• Diaphragms. These are reusable silicone cups that fit over the cervix and block sperm from entering the uterus. Diaphragms can put pressure on the urethra and make it harder to empty the bladder completely. This may increase the chance of bacteria growth and infection. Diaphragms are often used with spermicide, which can also affect the vaginal flora and pH.
• Cervical caps. These are similar to diaphragms but smaller and tighter. They also cover the cervix and prevent sperm from reaching the uterus. Cervical caps can also cause pressure on the urethra and disrupt the vaginal balance when used with spermicide.
• Spermicide. This is a substance that kills sperm and blocks the cervix. It can be used alone or with other methods such as diaphragms, cervical caps, or condoms. Spermicide can destroy the good bacteria in the vagina and make it easier for harmful bacteria to cause infections.
• Spermicide condoms. These are condoms that are coated with spermicide for extra protection. However, they may also have similar effects as spermicide alone on the vaginal flora and pH.

If you have symptoms of cystitis or a UTI, you should see your doctor as soon as possible. Left untreated, a UTI can spread to the kidneys and cause serious complications. Your doctor can diagnose a UTI by testing your urine sample and then prescribe antibiotics to treat the infection.

You should also see your doctor if you have recurrent UTIs, which means you have more than two UTIs in six months or more than three in a year. Recurrent UTIs may indicate an underlying problem that needs further investigation and treatment. Your doctor may also suggest changing your birth control method if it is contributing to your UTIs.

There are some steps you can take to prevent cystitis and UTIs. “The primary way to reduce cystitis risk is to take good care of yourself,” says Dr Michael Green. “Hydrate, pee often, wipe from front to back, and take care of your vaginal pH. Douches and scented cleaning products tend to disrupt the natural pH balance of the vagina, so avoid them for good measure.”

• Drink plenty of water to flush out bacteria from your urinary tract.
• Urinate frequently and completely, especially after sex.
• Wipe from front to back after using the toilet to avoid spreading bacteria from the anus to the urethra.
• Avoid products that can irritate the urinary tract, such as douches, scented soaps, or feminine sprays.
• Wear cotton underwear and loose-fitting clothes to keep the genital area dry and ventilated.
• Take cranberry supplements or drink cranberry juice, which may have some benefits for preventing UTIs.
• Take probiotics or eat yoghurts with live cultures, which may help restore the vaginal flora and prevent infections.

If you have symptoms of cystitis or a UTI, you should see your doctor for diagnosis and treatment. You should also talk to your doctor about your birth control options and whether you need to switch to a different method that suits your needs and preferences. By taking care of your urinary tract health, you can avoid infections and enjoy a better quality of life.

*Dr. Michael Green does not endorse any products or brands

Hana® 75µg film-coated tablets contains desogestrel and is an oral contraception for women of child bearing age to prevent pregnancy. Always read the instructions on the package leaflet carefully.

https://effectivehealthcare.ahrq.gov/system/files/docs/topic-brief-hormonal-birth-control-utis.pdf  

https://www.avogel.co.uk/health/cystitis/could-the-pill-be-to-blame-for-frequent-utis 

https://www.healthline.com/health/can-birth-control-cause-uti

https://www.nhsinform.scot/illnesses-and-conditions/kidneys-bladder-and-prostate/urinary-tract-infection-uti 

https://www.womenshealth.gov/a-z-topics/urinary-tract-infection

If you’re aged 45 or over, you may be wondering whether you still need to use contraception and what would be a suitable method of birth control for your age group.  Whilst fertility does usually decline in the mid-to-late 30s, people in their 40s and 50s do still sometimes get pregnant. Until you reach menopause – meaning you’re over 50 and you haven’t had a period for a year (12 months in a row) – there is a chance you could get pregnant. If that’s something you want to avoid, you should think about using contraception. 

Which type of birth control is suitable for you depends on several factors, such as your personal and family medical history, your menstrual cycle, your sexual activity and your preferences. In this article, we will explore some of the best birth control options for older women and some of the benefits and risks of using them.

“Women who are over the age of 45 and still ovulating should consider using some form of contraception if they do not wish to become pregnant,” says Rhiannon John, sexologist at Bedbible. “However, if a woman has already reached menopause, she generally does not require contraception to prevent unintended pregnancy. Menopause is typically diagnosed when a person aged 50 or above has not experienced menstruation for a consecutive period of 12 months or if they are under 50 and have not had a period for two years. While there is no definitive test for menopause, these are the commonly used criteria to determine its onset.”

There is no test that can tell for certain whether you’re in the menopause and can stop contraception. There is a blood test to measure levels of follicle stimulating hormone (FSH) that can indicate if a woman is becoming menopausal. But this is not a useful test in women over 45 as FSH levels naturally go up and down at this time.

“It’s important to be aware that if you use the combined pill for contraception, you will likely continue to have monthly bleeding as long as you take the pill,” Rhiannon continues. “Additionally, it’s possible for the pill to mask or conceal the typical symptoms of menopause. If you are specifically interested in determining if you are perimenopausal or menopausal while on the combined pill, it would be advisable to consult with your healthcare provider. They can discuss alternative non-hormonal contraception options, such as condoms or a copper IUD, which may allow for a more accurate evaluation of menopausal symptoms.”

The only reliable way to know if you have reached menopause is to look back at your menstrual history. If you have not had a period for a year, you can stop using contraception. However, if you are using hormonal contraception such as the pill, the patch, the ring or the injection, your periods may be affected by the hormones and not reflect your natural cycle. In that case, you may need to stop using hormonal contraception and use a non-hormonal method, such as condoms or a copper IUD, until you are sure you have reached menopause.

There are many different methods of contraception available in the UK, but some may be more suitable for women in their mid 40s and beyond than others. The type that works best for you will depend on your health and circumstances. Remember that you can always discuss your options with a doctor, sexual health nurse or, in some cases, a pharmacist if you have any queries or concerns. 

Some of the factors that may influence your decision include:

• Your risk of pregnancy: some methods are more effective than others at preventing pregnancy. For example, long-acting reversible contraceptives (LARCs), such as implants, IUDs and IUSs, are more than 99% effective and do not require you to remember to use them every time you have sex or every day.
• Your risk of sexually transmitted infections (STIs): some methods, such as condoms, can also protect you from STIs, while others do not. If you have multiple sexual partners, are sleeping with a new partner or are not sure of your partner’s status, you should use condoms in addition to any other method of contraception to reduce your risk of STIs.
• Your medical history: some methods may not be suitable for you if you have certain medical conditions or risk factors, such as high blood pressure, diabetes, heart disease, stroke, breast cancer or blood clots. You should tell your GP or nurse about any health problems you have or medications you take before choosing a method of contraception.
• Your menstrual symptoms: some methods may affect your periods and cause them to be lighter, heavier, change in frequency or stop altogether. Speak to a doctor or pharmacist about how your chosen contraceptive method may affect your period to make sure you’re informed and comfortable with it.
• Your personal preferences: some methods may suit your lifestyle and preferences better than others. For example, some people with uteruses may prefer a method that they can control and stop at any time, while others may prefer a method that they do not have to think about or see. Some may prefer a method that does not involve hormones, while others may prefer one that does.

Here are some of the most common methods of contraception for you to compare.

The combined pill contains two hormones: oestrogen and progestogen. It works by stopping ovulation (the release of an egg) and making it harder for sperm to reach an egg or for an egg to implant in the womb. The combined pill is more than 99% effective if used correctly, you can start or stop it at any time and it does not interrupt sex. 

“There are no specific limitations on contraceptive methods based solely on age,” says Rhiannon.  “However, certain medical conditions more commonly seen in older women may make some contraceptives less suitable. The combined pill, which contains oestrogen, poses potential health risks such as an increased likelihood of blood clots, cardiovascular issues, and strokes, particularly for women with a history of these conditions. It’s important to note that these risks are specifically associated with oestrogen, not progestogen. To minimise the risks related to oestrogen-containing contraceptives, women can consider non hormonal options and progestogen-only contraceptives as alternative choices.”

The combined pill may also not be suitable for some women and people with uteruses over the age of 35 who smoke or have high blood pressure, and it may increase the risk of certain conditions such as blood clots and breast cancer. Combined hormonal contraceptives are also not recommended for women and people with uteruses who have migraine with aura, and those who who have high blood pressure, cardiovascular disease, a history of stroke, venous thromboembolism (VTE), congenital/valvular heart disease with complications, breast cancer or women and people with uteruses who are aged 50 or older. 

The combined pill also does not protect against sexually transmitted infections (STIs) and you have to remember to take it every day. Speak to your doctor if you’re considering taking the combined contraceptive pill so they can look at your individual situation and help you make an informed decision.

This is a pill that contains only progestogen, a hormone that prevents ovulation and thickens the cervical mucus. It can be used by women and people with uteruses who cannot take oestrogen or have other medical conditions that make the combined pill unsuitable. Progestogen only pills can be suitable for over 35s who smoke, and women and people with uteruses who have a higher BMI, who are breastfeeding, have a history of blood clots and are allergic to or do not want to take oestrogen. It is suitable for and well tolerated by many people, but it can cause side effects and it may not be suitable for everyone. 

Progestogen-only contraceptives may not be suitable for women and people with uteruses who have breast cancer (or a history of breast cancer) and those with a risk of osteoporosis. It also requires daily use and has to be taken at the same time every day, which some people prefer but others may want something that they don’t have to think about taking regularly. You can buy some progestogen-only pills, like Hana®, over the pharmacy counter or online without a doctor’s appointment, and you will need to fill in a consultation beforehand so the pharmacist can make sure a progestogen only pill is suitable for you. 

This is a patch that sticks to your skin and releases oestrogen and progestogen into your bloodstream. It works in the same way as the combined pill, but you only have to change it once a week for three weeks in a row, followed by a patch-free week. It can also make your periods lighter, shorter and more regular, and reduce the risk of ovarian and endometrial cancer. However, it may not be suitable for women over 45 who smoke, have high blood pressure, diabetes, heart disease, migraines with aura or a history of blood clots or breast cancer.

This is a ring that you insert into your vagina and leave in place for three weeks, then remove for one week. It releases oestrogen and progestogen into your bloodstream and works in the same way as the combined pill or patch. It may not be suitable for women over 45 who smoke, have high blood pressure, diabetes, heart disease, migraines with aura or a history of blood clots or breast cancer. It may also cause vaginal irritation, infection, discharge, headaches, breast tenderness or mood changes.

This is an injection that contains progestogen only and lasts for either eight weeks or 12 weeks depending on the type. It prevents ovulation and thickens the cervical mucus. It requires regular visits to your doctor or nurse for injections and some people may experience side effects from the injection, so speak to your doctor or sexual health nurse for more information about whether the injection is the right choice for you.

This is a small rod that is inserted under the skin of your upper arm by a doctor or nurse. It releases progestogen into your bloodstream for up to three years. It prevents ovulation and thickens the cervical mucus. It can cause side effects in some people, so speak to your doctor or sexual health nurse to see if the implant is the right choice for you. It also requires a minor surgical procedure to insert and remove it.

This is a small plastic device that is inserted into your womb by a doctor or nurse. The IUS is a LARC (long acting reversible contraceptive) and some people may prefer choosing this method as once it’s inserted it will be effective for around 3-6 years and you don’t have to think about it. It releases progestogen into your womb and prevents fertilisation and implantation of a fertilised egg. It can cause side effects in some people and some may find the procedure to get it inserted and removed uncomfortable, so speak to a doctor or nurse about your preferences and options.

This is a small plastic or copper device that is inserted into your womb by a doctor or nurse. It lasts for up to five to 10 years depending on the type. It prevents fertilisation and implantation of a fertilised egg by creating an inhospitable environment for sperm and eggs. It requires a minor surgical procedure to insert and remove it.

This is a thin latex or polyurethane sheath that covers the penis during sex and collects the sperm. It prevents pregnancy and sexually transmitted infections (STIs). It is easy to use, cheap and widely available. However, it may break, slip off or cause allergic reactions. It also requires cooperation from your partner and has to be used every time you have sex. If you are experiencing vaginal dryness, water based lubricants can help improve the experience. Avoid oil based lubricants, however, as they can make condoms more likely to break.

This is a thin polyurethane pouch that lines the vagina during sex and collects the sperm. It prevents pregnancy and STIs. It is easy to use, cheap and widely available. However, it may be noisy, uncomfortable or difficult to insert. It also requires cooperation from your partner and has to be used every time you have sex.

This is a method that involves monitoring your body temperature and cervical mucus to identify your fertile days and avoid sex or use another method of contraception on those days. It can help prevent pregnancy without using any hormones or barrier methods. It can also help you understand your body and cycle better. However, it requires daily observation and recording and can be very difficult to be consistent with, and it also requires abstinence or backup contraception on your fertile days. It also may not be reliable if you have irregular cycles, illness, stress or medication that affect your signs.

If you do not want or are done having children, sterilisation is a non-reversible long acting method that can prevent you from getting pregnant. It requires a medical procedure which involves the fallopian tubes being blocked or sealed to prevent the eggs reaching the sperm and becoming fertilised. Speak to a doctor for more information about sterilisation.

“For women in monogamous relationships, another option to consider is a vasectomy for their partner,” says Rhiannon. “A vasectomy is a surgical procedure that involves sealing or cutting the vas deferens, the tubes that carry sperm from the testicles. This procedure is highly effective in preventing pregnancy and is considered a permanent form of contraception for men.”

You can stop using birth control when you have reached menopause and no longer need to prevent pregnancy. However, there is no test that can tell for certain whether you have reached menopause and can stop using birth control. You may have to wait until you have not had a period for 12 months in a row before you can be sure that you are menopausal.

Some methods of birth control can mask the signs of menopause, such as the combined pill, patch or ring, which make your periods regular even if they would naturally stop. Other methods of birth control can cause irregular bleeding or spotting, such as the progestogen-only pill, injection, implant or IUS, which make it hard to tell if your periods have stopped.

If you are using one of these methods and want to know if you are menopausal, you may need to stop using them for a while and see if your periods return or not. You should use another method of contraception during this time if you do not want to get pregnant.

Alternatively, you can ask your doctor for a blood test to measure your levels of follicle stimulating hormone (FSH), which can indicate if you are becoming menopausal. However, this test is not very reliable in women over 45 as FSH levels naturally go up and down at this time.

The best way to decide when to stop using birth control is to talk to your doctor or nurse about your options and preferences. They can help you choose a method that suits you best until you reach menopause.

https://patient.info/doctor/contraception-from-40-to-the-menopause-pro

https://www.womens-health-concern.org/wp-content/uploads/2022/12/04-WHC-FACTSHEET-ContraceptionForTheOlderWoman-NOV22-B.pdf

https://www.nhs.uk/conditions/contraception/menopause-contraceptive-pill/

If you have ever stopped taking the contraceptive pill and wondered when your period would come back – or noticed some changes in your bleeding pattern after stopping the pill – you are not alone. Many people experience some changes in their menstrual cycle after stopping the contraceptive pill.

“The way contraceptive pills affect your period can depend on the type of pill you are taking,” says Deborah Evans*, a pharmacist with over 30 years of experience. “They contain synthetic versions of the hormones oestrogen and progesterone (combined pill), or progestogen only (mini pill), which help to regulate the menstrual cycle.” 

*Deborah Evans does not endorse any products or brands.

The combined contraceptive pill contains synthetic versions of the naturally-occurring hormones oestrogen and progesterone. These hormones help prevent ovulation (the release of an egg from your ovaries) so that no egg is released and there is nothing for the sperm to fuse with.

Some combined contraceptive pill packs come with seven placebo pills, which do not contain hormones. This is known as a ‘rest week’ and during this time you are likely to have a bleed. This bleed is not actually a period, but a withdrawal bleed. You do not need to have a withdrawal bleed once a month, but some people prefer to.

The progestogen only contraceptive pill (also known as the mini-pill) contains only one hormone: progestogen. Progestogen helps prevent ovulation so that no egg is released and there is nothing for the sperm to fertilise, and it also thickens your cervical mucus to make it harder for sperm to reach an egg.

“Generally, combination pills can make bleeding lighter, shorter, and more regular,” says Deborah Evans. “This is because the hormones in the pill prevent the thickening of the uterine lining, which is shed during the pill-free period. Progestogen-only pills, on the other hand, can sometimes cause irregular bleeding or spotting, or no period at all as they are taken continuously.” 

Progestogen only pills like Hana® are taken every day at the same time without a break between packs. Progestogen-only pills can have different effects on your period. Around 20% of people taking Hana experience lighter bleeding or amenorrhea (no periods), between 20-30% may experience more frequent bleeds, and others may not see any difference. If, while on Hana®, you experience more frequent bleeding,  less bleeding or no periods – and these changes do not subside after a few months –  you should speak to a doctor or pharmacist for advice.

We have seen how contraceptive pills can affect your period while you are taking them, but what happens if you stop taking the pill? Can that delay your period?

“Stopping the contraceptive pill can sometimes delay your period,” says Deborah. “This is because the contraceptive pill contains synthetic hormones that affect your menstrual cycle, and when you stop taking the pill your body needs time to adjust to the change in hormone levels.” 

According to the NHS, your periods may be irregular when you come off the contraceptive pill and you should allow up to three months for your natural cycle to resume. This makes sense because your contraceptive pill was preventing ovulation, so it may take some time for your body to start ovulating again.

“When you take a break from your contraceptive pills, your body may experience withdrawal bleeding which can be mistaken for a period,” says Deborah Evans. “This bleeding can occur anytime within the first few days to a week after stopping the pill.

“In some cases, after stopping the pill, it can take several weeks or months for your body to regulate its own hormone production and for your menstrual cycle to return to its natural rhythm and so this can cause your period to be delayed. It is worth noting though that your fertility could return to normal quickly and so you should use an alternative form of contraception if you do not want to get pregnant.” 

Please remember that a delay in your period restarting is not the same as a missed period, but one can easily be mistaken for the other. No contraceptive is 100% effective and your fertility could return very soon after stopping the pill. If you have any concerns about pregnancy, it is best to take a pregnancy test so you know what is going on and can make informed decisions.

“If you are concerned about changes to your menstrual cycle after stopping the contraceptive pill, it is important to talk to your pharmacist or doctor. They can help you understand what is happening in your body and provide advice on how to manage,” Deborah Evans adds.

Hana® 75µg film-coated tablets contains desogestrel and is an oral contraception for women of child bearing age to prevent pregnancy. Always read the instructions on the package leaflet carefully.

https://www.nhs.uk/conditions/contraception/when-periods-after-stopping-pill/

Hana SmPC 2021

How much do you think you know about contraceptive pills? If you’re taking a contraceptive pill to help prevent pregnancy, do you know which one you’re taking? If you’re not sure, you’re not alone. In a 2021 survey we carried out with almost 1,000 respondents, we found that almost 6% of people who take a contraceptive pill as their contraceptive method are not sure which pill they take. 

In another survey conducted in 2021, we found that almost 43% of respondents incorrectly thought that the combined contraceptive pill is also called the ‘mini pill’, which may mean that if they were prescribed the mini pill they wouldn’t be sure which contraceptive pill they were actually using.

At Hana® we think it’s really important to know how contraception works and how it affects your body, so you can feel empowered and in control of your contraceptive choices. That’s why we created our Ask Hana series, to answer common queries and concerns about contraception.

So are all contraceptive pills the same, and if not what types are there? Read on to find out.

Calling contraceptive pills ‘the pill’ can be a bit misleading, because there are actually two main types of contraceptive pills and then within these sub-categories different pills may use different active ingredients to help prevent pregnancy. 

The two types of contraceptive pills available are the combined contraceptive pill and the progestogen-only pill. The combined contraceptive pill contains both progestogen and oestrogen, and it works to consistently prevent ovulation. You generally take the combined pill every day for 21 days of your cycle, and then take a break, or inactive pills, for 7 days.

The progestogen-only pill (sometimes known as the mini pill) contains a synthetic version of the hormone progesterone called progestogen. It does not contain oestrogen (which is why it’s called progestogen-only) and so it can be suitable for people who cannot or do not want to take oestrogen. This type of pill works by thickening your cervical mucus, which makes it difficult for sperm to travel to the egg. When the active ingredient used is a progestogen called desogestrel, it also helps prevent ovulation so no egg is released and the sperm has nothing to fertilise. These pills should be taken every single day at the same time without a break between packs

Hana® is a progestogen-only contraceptive pill available to buy over the pharmacy counter or online with no need for a doctor’s appointment. Find out more about Hana® here.

When taken correctly, both combined contraceptive pills and progestogen-only pills are over 99% effective at preventing pregnancy. 

Different contraceptive pills have different effects on different people, and what works for one person may not work for another. Some people find they may have to try a few different contraceptive methods until they find something which feels right for them.

Both types of contraceptive pills are tolerated by many people, but there are a few things to consider.  The combined contraceptive pill cannot be used by some women and people with uteruses for medical reasons, such as being over 35 years old and a smoker, or with a high body mass index (BMI).  Combined contraceptive pills are also not suitable if you have a history of blood clots, or if you are allergic to or do not want to take oestrogen. For those people, a progestogen only pill might be more suitable as they do not contain oestrogen.

The combined contraceptive pill also cannot be taken by people who are breastfeeding, whilst the progestogen-only pill can be used by those who are breastfeeding.

Combined contraceptive pills are only available with a doctor’s prescription, whilst some progestogen-only contraceptive pills containing desogestrel, like Hana®, are available over the pharmacy counter with no need for a doctor’s appointment. This may be an important factor for people who don’t feel they have the time to – or simply don’t want to – wait for a doctor’s appointment. Click here if you want to see whether Hana® could be suitable for you.

Whilst Hana® is usually well tolerated by many women and people with uteruses, it would not be suitable if: 

• You are allergic to desogestrel or any other ingredients in Hana®, if you have cancer, such as certain types of breast cancer, ovarian cancer or endometrial (uterine) cancer.
• You have, or have had, jaundice (yellowing of the skin or whites of the eyes) or severe liver disorders, and blood tests show your liver has not returned to normal.
• You have an active blood clot in the legs (deep vein thrombosis) or lungs (pulmonary embolism).
• You have unexplained bleeding between periods or after sex (you should check this out with a doctor as it can be a symptom of more serious problems).
• If you are pregnant or think you may be pregnant.

When considering a new contraceptive pill, you should talk to your doctor or pharmacist about any medications and current or previous medical conditions you may have or have had, so they can help you make the right choice for you.

We hope this has answered your question and you now feel more empowered in your knowledge of contraception pills! Check out Ask Hana for other informative articles about contraceptive pills, and let us know if you have a question we haven’t answered on social @hanapilluk. 

No matter how old you are, it’s important that you know which contraceptive options are available to you and how you can access them. The age of consent in the U.K is 16, although some people choose to have sex earlier, but you are legally considered an adult at 18. Some young people may be concerned about trying to access contraception under the age of 18, because it may not be clear what your rights are, what options are available and whether your parents need to be involved.

We know that talking to a pharmacist or doctor about sex and contraception can feel embarrassing and intimidating, and you might be worried about being judged. We want to empower you to take charge of your contraception, ask questions and know your options so you have the knowledge you need to make the right choice for you. We spoke to pharmacist Deborah Evans and Dr. Jessica Langtree to find out more.

There is no lower age limit for contraceptive pills and you don’t need parental permission to go on the pill, but there may be safeguarding concerns around young people taking contraception if they are under the age of consent. Medical professionals want to keep you safe and ensure that you’re not being pressured into anything you don’t want to do.

“The clinician would make a decision based on whether they felt the individual was competently able to make their decision in an informed way,” says Deborah Evans. “There would also be a safeguarding issue if someone was under 13 and if there were any issues around potential abuse. At the end of the day, you want to protect the individual from getting pregnant, but equally, you need to make sure that they’re not being subjected to abuse.” 

It’s important that people can access contraception to avoid unplanned pregnancy and feel in control of their reproductive health, and it’s also important that people have sex on their own terms, when they want to and when they personally feel ready. It’s your body and your choice, and nobody else has the right to decide when or whether you have sex or engage in any form of sexual contact. 

If anyone is pressuring you to do anything you don’t want to do, or if someone is making you uncomfortable in any way, know that there are people you can talk to. It’s always recommended that you speak to a parent or caregiver, but if that doesn’t feel right to you then a doctor, counsellor or organisations like Shout, Childline, Safeline and the NSPCC are there to listen and help you – and your conversation will be confidential.

Contraceptive pills are a popular method of contraception which are over 99% effective at preventing pregnancy if taken correctly. There are two types of contraceptive pills available: combined pills, which contain oestrogen and progestogen, and progestogen-only pills (also known as mini pills) which just contain progestogen. Find out more about contraceptive pills.

For most hormonal contraceptive methods, you will need to speak to a GP or go to your local sexual health clinic, where a medical professional can help you make an informed decision. You can also buy some progestogen-only pills containing desogestrel, like Hana®, over the pharmacy counter with no need for a prescription. You can also buy Hana® online. When purchasing progestogen-only pills from a pharmacist or online, you will complete a checklist for the pharmacist to see if your chosen contraceptive method is right for you. Check if Hana® may be suitable for you.

If you’re starting contraception for the first time, you may want to have a chat with your doctor to find out more about which contraceptive methods are suitable for you. There are lots of contraception options available, so you may find that you need to try a few options before you settle on something that feels right. Your method of contraception may also change throughout your life, depending on your relationship status and personal circumstances. Find out more about contraceptive methods here.

Doctors and pharmacists are trained to help people with all kinds of things. They are there to help you, not judge you.

“Looking after your reproductive and sexual health as a woman is an important aspect of your overall health,” says Deborah Evans. “It’s not anything to be embarrassed about. In fact, being proactive and taking control of your reproductive health is a really positive thing. Your healthcare professional, whether it’s your GP or your pharmacist, will be trained and comfortable to have those conversations with you. They’re not embarrassed about it. 

“If you prefer, you can go into a private consultation area with your pharmacist for privacy. The pharmacist will ask you very straightforward questions just to make sure that this form of contraception is appropriate for you, and to listen to any concerns you might have and address those. It’s a very normal thing.”

If you have any questions about contraception, remember that you can ask your doctor or pharmacist. They are there to help you and provide information to help you feel safe and secure.

*Deborah Evans and Dr Jessica Langtree do not endorse any products or brands

Hana® 75µg film-coated tablets contains desogestrel and is an oral contraception for women of child bearing age to prevent pregnancy. Always read the instructions on the package leaflet carefully.