What does PMS stand for?
Who has PMS?
What are the symptoms of PMS?
What is PMDD?
How can we treat PMS/PMDD?
Does the contraceptive pill affect PMS?
PMS symptoms vs. pregnancy symptoms
Why is there a stigma around PMS?

 

Even if you’re not sure what it is, there’s a pretty good chance you’ve heard of premenstrual syndrome (i.e. PMS). It’s a special part of the menstrual cycle during which you might feel anywhere from just a little off to so sad that you can’t stop crying for days…and then your period starts and it all kind of makes sense. Read on to find out more about premenstrual syndrome and how it may affect you.

What does PMS stand for?

PMS stands for premenstrual syndrome, which is quite literally a syndrome made up of symptoms you might experience before menstruating. PMS occurs specifically during the luteal phase, which starts around two weeks before your period starts. Although we don’t know precisely why it happens the way it does, hormones are involved. 

Approximately two weeks before your period, a peak in oestrogen helps to trigger ovulation, followed by a drop. During the luteal phase oestrogen begins to rise again, while progesterone levels also rise in order to help prepare your uterus to support a potential fertilised egg… or menstruation occurs. But it’s those fluctuations that are thought to cause all the symptoms you might experience. So that’s why it’s called premenstrual syndrome!

Who has PMS?

If you have ovaries, there is a strong chance you will experience PMS as it is linked to the ovarian cycle. It is believed that most women and people with ovaries will experience PMS at some point during their lives. There is also a chance the symptoms will become more severe as you near menopause and your hormonal cycles transition and change. This is thought to quite often begin as you reach your late 30s or 40s

What are the symptoms of PMS?

As previously mentioned, you might not experience anything at all, let alone anything too severe. Everyone’s experience is different, and you may also get different symptoms during different cycles. Some people may experience a wide range of symptoms to varying levels, and these can include:

  • Mood swings
  • Exhaustion or fatigue
  • Bloating
  • Stomach pain
  • Headaches or migraines
  • Hormonal acne (causing spots or even cysts)
  • Changes to your appetite
  • Changes to your libido
  • Breast tenderness


These can vary from month to month, but might also stay the same. Natasha, 31, says: “Every single month without fail I have a cystic acne flare-up on my jawline. My skin has been fine otherwise since my early 20s, but that’s how I know my period is coming.” Acne flare-ups are a reasonably common warning sign that your period is on the way, but there really is a wide range of ways that your body might react to your fluctuating hormones in the preceding weeks. Jen, 24, says: “I get persistent leg cramps before it starts! No idea why but it happens every time.” 

You might not even recognise the signs of PMS as you’re experiencing them. Katie, 34, says “I know I feel rubbish right before it starts but it’s been unpredictable all my life.”

What is PMDD?

Premenstrual dysphoric disorder, or PMDD for short, is often thought of as a more severe version of PMS. Like PMS, it occurs during the luteal phase. It can present with the same symptoms as PMS (though potentially significantly heightened), along with additional and more concerning symptoms such as paranoia, insomnia, vomiting, hot flushes, and more. It is a condition that can be disruptive and damaging to your daily life, personally and professionally. If you think that you might be suffering from PMDD, particularly if it is hindering your ability to carry out your routine, it’s a good idea to speak to your GP about treatment options.

How can we treat PMS/PMDD?

For most people, the physical symptoms of PMS can usually be managed with home remedies including hot water bottles, over the counter painkillers and appropriate rest or exercise depending on what feels right for you. To address the emotional and mental symptoms, it may be helpful to engage in exercise, reduce sugar, caffeine, and alcohol intake, and explore other self-care methods. However, if your symptoms are severe and significantly impair your ability to work, study, or socialise as usual, it might be worth considering discussing stronger treatment options with your GP, which could include hormonal contraception. In severe cases, surgery could be an option.

Does the contraceptive pill affect PMS?

Hormonal contraception can help some people manage PMS symptoms, but it doesn’t work the same for everybody. Contraceptive pills in particular help prevent pregnancy by stopping your ovaries from releasing an egg, thereby preventing ovulation, but people using hormonal contraception can still experience a bleed along with the hormonal fluctuations that cause PMS. 

The monthly hormonal fluctuations associated with the menstrual and ovarian cycles can be unpredictable, complex and vary from person to person. So if you are hoping to use hormonal contraception to treat PMS, you should start by working with your GP to come up with a treatment plan, which may involve the combined contraceptive pill – along with a little trial and error.

PMS symptoms vs. pregnancy symptoms

There is some overlap between PMS and pregnancy symptoms. Pregnancy-related bloating can be mistaken for bloating before a period. The two also share in common things like mood swings, cramping, and headaches. There is less chance (although it’s not impossible) of feeling nauseous before your period, so that could indicate that it’s worth taking a pregnancy test.

The biggest sign that you might be experiencing pregnancy symptoms rather than PMS? A missing period. If your period is absent, it’s time to take a test. Your period might also be absent due to other factors including stress, but it’s a good place to start. If you have any further concerns or questions, please contact your GP.

Why is there a stigma around PMS?

Period shaming is real. Have you ever reacted in anger and heard someone rudely chortle “Sounds like it’s your time of the month!” or been brushed off as “hysterical”? It’s frustrating, right? Or when you hear about how women can’t be politicians or run businesses because they get too emotional during their periods, or men accusing each other of having a period when they show any emotion at all. It’s a sad fact of life that PMS is used to put down anyone who might have a period, or even just feelings! 

Unfortunately, this stigma also stops people who need treatment from feeling able to seek out the help that they need. Experiencing PMS does not make your feelings any less valid or give anyone the right to treat you badly, and one way that we can combat this is through proper education. If you think you might have PMS or PMDD and are nervous about approaching your GP to discuss what you’re going through, there are loads of resources online that can help to give you the tools you need.

You can also read more about what might happen to your period while you’re on Hana or whether your menstrual cycle really can “sync up” with your friends on our blog.

 

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.

ellaOne® 30mg film-coated tablet contains ulipristal acetate and is indicated for emergency contraception within 120 hours (5 days) of unprotected sexual intercourse or contraceptive failure. Always read the label.

References

How does the Hana® contraceptive pill work?

Have you heard of Hana®, a progestogen-only contraceptive pill? When taken correctly, at the same time every day without a break between packs, Hana® is over 99% effective. But what really happens to your body when you take a contraceptive pill like Hana®?

In 2021 we surveyed over 1,000 people, and 53% of them said they didn’t know how progestogen-only contraceptive pills work. We get it – with so many contraceptive options out there and them all working in varying ways, it’s bound to get confusing for someone looking for specific information.

We think you deserve to know the facts. When it comes to your body and your contraception, you should feel empowered to know what works for you and why. When you’re making important decisions around how to prevent unplanned pregnancies, you should have all of the answers.

Medical products, in particular, can be a little bewildering to try and educate yourself on – there’s so much information to absorb and, as we know, our bodies are complicated things, so learning about them and how certain medications can work or affect them can feel tricky and inaccessible.

Don’t you just wish that sometimes the facts could be presented to you in a way that’s understandable and easy to digest? We’re here to help with that…

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.

All About Contraceptive Pills
What is the mini pill?
What is the combined pill?
Can you switch from the combined pill to progestogen-only pill?
Meet Hana – an over the counter progestogen-only pill.

You’ve definitely heard of it, you may have even taken it, but how much do you really know about the pill? While birth control pills are often simply referred to as ‘the pill’, there are actually two types of contraceptive pill which contain different ingredients.

It’s really important to learn about the contraception you’re taking so you feel empowered to take charge of what happens to your body. Join us as we do a deep dive into the differences between the progestogen-only pill and the combined pill.

What is the mini pill?

The mini pill (also known as the progestogen-only pill or PoP) is a hormonal method of contraception which contains a synthetic version of the naturally-occurring hormone progesterone. Traditional PoPs work mainly by thickening cervical mucus, and may also work to prevent ovulation. Other PoPs containing desogestrel, like Hana, work mainly by preventing ovulation and have a secondary action of thickening cervical mucus.

The PoP does not contain oestrogen and can therefore be taken by women and people with uteruses for whom oestrogen may be unsuitable, such as those with high blood pressure and smokers over the age of 35. You can also use the PoP while breastfeeding.

The progestogen-only pill is taken every day, at the same time, with no break in between packs. If you miss your pill, there is either a 12 hour or 3 hour window in which you can remember to take it, and it will still be effective. Traditional progestogen-only pills have a 3-hour window, whereas progestogen-only pills which contain desogestrel (like Hana) have a 12 hour window. Find out more about the progestogen-only pill here.

What is the combined pill?

The combined pill is a hormonal method of birth control which contains synthetic versions of the hormones oestrogen and progesterone. It works by preventing ovulation and is usually taken for 21 days with a seven day break during which you may have a withdrawal bleed. You can also get everyday (ED) pills which have no break.

As the combined pill contains oestrogen, it may not be suitable for some women and people with uteruses if they experience adverse side effects from taking this hormone. This includes people with high blood pressure and smokers over the age of 35.

It’s really important to remember that neither contraceptive pill can protect you from STDs, only condoms can do that.

Let’s look at some of the key details you should know about each pilL. This guide is for reference only and should not be used in place of a consultation with a healthcare professional, but it may help to inform your choice.

Effectiveness Who can take it? How to get it? How to take it?
Progestogen-only pill/ Mini Pill 99% effective with perfect use, 91% effective with typical use. Can be used at any fertile age (so, from your first period until the menopause).

Suitable for women (and people with uteruses) who can’t take oestrogen.

Can be used immediately after giving birth.  [Evidence]

Over the counter in pharmacy or online without a prescription.

From a GP.

From a sexual health clinic.

One pill taken  at the same time every day with no breaks between packs.
Combined Pill 99% effective with perfect use, 91% effective with typical use. Can be used at any fertile age (so, from your first period until the menopause).

Suitable for women (and people with uteruses) who can take oestrogen, your doctor will ask you questions to make sure there is no indication that this pill may not be suitable for you.

From a doctor.

From a sexual health clinic.

One pill taken every day, at the same time, sometimes with a seven day break.

Can you switch from the combined pill to progestogen-only pill?

Yes you can. If you’re taking the combined pill but think you’d like to try the progestogen only pill instead, the transition is pretty straightforward.

It’s important to remember that everyone is different and some types of birth control may just not suit you for whatever reason.

It’s important not to leave a gap in between your old pill and your new pill as this could impact its effectiveness. You can switch to your new pill the day after finishing your last pack. If you leave any time between finishing one pill and starting another, you should use a barrier method, such as condoms, for the first seven days of switching to the progestogen-only pill.

You can also switch from the progestogen-only pill to the combined pill if you wish, and the same rules apply about using condoms for the first week if there’s a gap between your old pill and your new pill, as your new pill will not be effective yet. You should speak to your doctor about this to ensure you are making an informed decision. [Evidence: https://www.nhs.uk/conditions/contraception/the-pill-progestogen-only/]

Meet Hana – an over the counter progestogen-only pill.

Hana is a progestogen-only pill which is available to buy over the counter without prescription, so you won’t have to wait for a doctor’s appointment. The pharmacist will ask you some questions to see whether Hana is right for you. Hana contains desogestrel which helps prevent pregnancy by preventing ovulation and thicken the cervical mucus. When used correctly, Hana is 99% effective at preventing unplanned pregnancy. No other contraceptive pill is more effective without prescription.*

Hopefully, this article has helped you understand the difference between contraceptive pills so you feel more empowered to make an informed decision about your contraception choices. Want to find out more about the Hana pill? Read What Is Hana for more information.

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

*Verify at Hana.co.uk/verify

My decade with the pill
What does a ‘day in your life’ look like?
What life lessons have you learned over the last 10 years?
When do you take your pill?
Do you think you know a lot about the contraceptive pill?

What do the Game of Thrones premiere, Rihanna’s song ‘We Found Love (In a Hopeless Place)’ and the ten-year anniversary of Wikipedia have in common? They all began ten years ago in 2011!

A lot can change in a decade. Your life can transform, the world around you might have changed dramatically, and you’re mortified by Facebook’s ‘on this day’ reminder of the outfit you wanted to forget.

Some things, however, stay the same. Our recent survey on people’s relationships with the contraceptive pill showed us that many people have long-term relationships with their pill. Sixty-eight per cent of our respondents said they started taking the contraceptive pill before the age of 20, whilst more than 40% have taken their pill for more than five years. 

Why did they choose to take the pill over other types of contraception? Eighteen per cent like feeling in control of their contraception every day, and eighteen per cent wanted to be able to stop their contraception at any time.

There is no one ‘type’ of person who takes the pill. People from all walks of life, of all reproductive ages and all relationship statuses, may choose to take it. We spoke to four people who have taken the pill for a decade to find out more about them and their relationship with their pill.

What does a ‘day in your life’ look like?

“I wake up naturally (I hate having to set an alarm!), have a shower, have a cup of warm apple cider vinegar and ginger and go to my work kitchen in the basement to start work,” says Gemma, a 29-year-old vegan chef. Gemma has been on the contraceptive pill for 11 years and started taking it during her first serious relationship.

“I’ll usually make 5 or 6 cakes or food for a function I’m catering for or prep for a retreat,” Gemma adds. “I usually get hungry around one and make myself some lunch, watch a bit of telly and continue with work if there’s any left to do. Then I’ll go for a walk, do some yoga, see a friend or my mum and get back to make dinner. Sometimes my boyfriend works till the early hours so I usually eat alone, read, watch more telly and go to bed at about midnight.”. 

“If it’s a weekday, I wake up at 7am, shower and make a smoothie, before getting on the tube to work. After checking emails on my commute, I get to the office for 9am and will spend my day liaising with artists, creating social media content and having meetings with collectors.” Iso is 24 and has been taking the pill for over ten years.

“I get home at 7 and go for a run along the Thames, before cooking dinner – carbonara is my go-to,” says Iso. “I’ll spend the rest of the evening with my housemates watching tv or chatting, and then get into bed at 10 pm. I’ll read (but mostly scroll through TikTok) and try to wind down to sleep by 11 pm.”

Don’t do something because someone wants you to, do it because you want to. Most people aren’t bothered about what you’re doing, so don’t worry too much

What life lessons have you learned over the last 10 years?

“Don’t do something because someone wants you to, do it because you want to. Most people aren’t bothered about what you’re doing, so don’t worry too much,” says Alice, a 32-year-old manager at a software company. She has been taking the pill for 11 years.

“Don’t let others take you off course. When I was 17 I swam and sailed for the UK teams. However, I let being a teenager and peer pressure lead me away from that – something I’ve regretted ever since,” says Becky, a 39-year-old lifestyle blogger. Becky has been taking the pill for over 20 years.

When do you take your pill?

It’s really important to take your contraceptive pill at the same time every day, because if you miss your pill you may not be protected against unplanned pregnancy. Hana®, a progestogen-only pill available to buy over the pharmacy counter without prescription, should be taken at the same time every day without a break between packs. 

If you do miss your pill, you have a 12-hour window in which you can take it and still be covered. If it’s been longer than 12 hours, it counts as a missed pill and you should use another contraceptive method (like condoms) for the next 7 days to help prevent unplanned pregnancy. Find out more about what you should do if you miss your Hana® pill here.

So how do you remember to take your pill? “I take my pill at 10pm – I have a reminder on my phone that keeps me accountable,” says Iso, “I keep it by my bed or in my purse if I’m away from home.”

Many people choose to keep their pill by their bed and take it before bed, so it becomes part of their natural nighttime routine. It’s also important to remember to take it with you if you’re going away, as it can be easy to get swept up in the moment and forget. “I have a pack in my makeup bag so I can’t forget to take them with me if I’m going away,” says Gemma. 

Remember to follow your pills storage instructions (found on the leaflet) to make sure it’s being stored correctly. Find out more about when you should take your pill here.

Do you think you know a lot about the contraceptive pill?

In a recent study, we found that 47% of our respondents don’t think they know how the progestogen-only pill works. “I know bits and pieces. Probably not enough though,” says Becky. “I don’t really know how it works, I’m not a doctor,” says Gemma.

We think that knowing how the contraceptive pill works – and how the menstrual cycle and ovulation work – can be really empowering and help you feel more confident in your body and with your contraception.

Whilst 58% respondents in our recent survey said they understood their menstrual cycle ‘fairly well’,  47% of those surveyed thought the egg lived in the body for a few days after ovulation and 17% thought the egg lasted a week. 

So let’s clear some things up. Ovulation is where an egg is released from the ovary and moves down into the fallopian tube. The egg survives for 12-24 hours. If sperm manages to reach the egg, it may become fertilised. If the fertilised egg successfully travels down the fallopian tube and implants in the uterus, it can grow into an embryo. 

The contraceptive pill works by preventing ovulation so the egg isn’t released, and it also works by thickening cervical mucus to make it harder for sperm to get through. When taken correctly, the progestogen-only contraceptive pills are >99% effective at preventing pregnancy.

Whether you want to commit to Hana® for a decade or just find out more, you can purchase this progestogen-only pill over the counter or via our subscription service.

Life After Birth: Talking Contraception with New Parents

Mums on the pill
Taking the contraceptive pill
Through the ages
How to take the pill
The journey to parenthood
Going back on the pill
Growing your family
Going forward

Mums on the pill

Did you know that 29% of British women rely on a daily contraceptive pill as their main source of contraception? That means that the pill is statistically the most popular contraceptive choice in the UK – and at Hana, we are all about making your choice of contraception easily accessible.

Contraceptive pills can be used by many different people through different stages of their life. People take the pill to help protect them against unplanned pregnancies, to control the size of their family or because children aren’t on the cards for them. 

Have you thought about starting a family? It’s not necessarily for everyone, but the great thing about contraception in our country is that it gives you control and choice – it is up to you whether or not you want children and, if you do, when, how and how many. 

Today, we are chatting to four mums about their experience of having children and returning to contraception. From all different walks of life and parts of the UK, these women have one thing in common – they all started taking the contraceptive pill again after birth.

Taking the contraceptive pill

We recently ran a poll with over 1,000 people, asking women, trans men and non-binary people about their contraception. Unsurprisingly, 51% said that they took their daily contraceptive pill to avoid unplanned pregnancy.

Abbie, who is a first-time mum to 10-month-old Eliza, says: “I have been on the pill since I was 14 or 15. I had been taking it for seven years when I did some research and made the switch to the progestogen-only pill (PoP). I wanted something that better suited my lifestyle, and this option made it so I wouldn’t need to have a break between packs, which was ideal. I didn’t really experience any lasting side effects, and I ended up sticking with it.”

Through the ages

The public’s reaction to the pill has been steadily changing over the past few decades. We’ve gone from only married women having access to the pill in the 60s, the uproar around all women being granted access in the 70s, the introduction of the morning after pill in the 80s and sexuality becoming more discussed and less taboo in the 90s. Now, you can purchase some progestogen-only pills online and over the counter with no need for a GP appointment – instead you have a consultation with a pharmacist to make sure it’s the right option for you.

As accessibility of daily contraception gets better, so does the acceptance of women being in charge of their own reproductive life. It seems like the world is steadily becoming more and more sex positive – and we’re here for it!

Lil, a mum of three children under eight says: “The pill grew in popularity in the 90s, so I hopped straight on that bandwagon with the combined pill, which I took for a couple of years. When I met my partner, I wanted to be protected against pregnancy. I can’t stand needles so couldn’t have the (contraceptive) injection, and didn’t fancy any invasive procedure like getting the coil, so going back on the pill seemed like my best option. I decided to try the progestogen-only pill this time and I never looked back. I have always been so careful about taking it properly, but I actually fell pregnant because I was unwell and the pill hadn’t had a chance to absorb into my system!”

How to take the pill

You should take your pill at the same time every day. The efficiency of the pill can be compromised if you are unwell, so if you experience sickness or diarrhoea within 3-4 hours of taking your pill, it probably won’t have had a chance to absorb into your system. You should take another pill as soon as possible (even if that means taking two in one day), and continue as normal from then on. If you are repeatedly unwell or unwell for a number of days, you should take your pill as normal, but consider using a barrier contraception – like condoms – during this time, and for seven days afterwards. Always check the PIL (patient information leaflet) for advice.

The journey to parenthood

The average age for a new mum in the UK was 29 years old in 2019 and seems to be rising. Whereas 20+ years ago, people were looking to settle down and start having kids much younger, that simply isn’t the case for many people today. 

Lil, who just turned 41, tells us: “When I first got pregnant, it was a huge shock. Even though I was in my thirties and loads of my friends were having kids, it wasn’t planned. When I realised that 40 was on the horizon, we decided to try again. It’s not exactly traditional, but I wouldn’t have it any other way.” 

We are all unique, and so is each person’s reaction to coming off the contraceptive pill. Your fertility should return soon after you stop taking the contraceptive pill; some people come off the pill and fall pregnant straight away, while some people may try for a few months or longer. Everyone’s ovulation patterns and fertility are different, so not falling pregnant straight away doesn’t necessarily mean there is an issue. If you have been trying to conceive for more than a year (or six months if you are over 35 years old), then you should see a doctor to check why pregnancy may be harder for you.

Sophie’s pregnancy with her daughter, Gigi, wasn’t planned at all. “I came off the pill with the aim of trying cycle-tracking as a contraceptive method, didn’t realise that I was supposed to use a barrier for the first few months and got pregnant! It was an emotional rollercoaster, but a pretty brilliant one!” 

Everyone’s story of parenthood begins differently. Some people choose to get married and wait a few years, but others want to start their journey as a parent straight away.

Abbie, 29, says, “I waited until we were back from our honeymoon to come off the pill and start trying. Five months later, I was pregnant. I feel so lucky to be Eliza’s mum, but at the same time sometimes I wonder how something so small can test your patience so much!”

Going back on the pill

There are loads of reasons why a new parent might choose to go on the pill after having a baby and, while there is so much to think about at this exciting time, the contraceptive pill is an option that can easily slot into your new life and routine. 

Abbie decided to stay on the PoP (progestogen-only pill) because she was breastfeeding. “I knew I wanted to make sure that I didn’t get pregnant again, so I went back on the pill about 16 weeks after having Eliza.”

“I took the pill for 8 weeks, six weeks after giving birth,” says Carly, who is mum to baby Romell. “I knew I didn’t want to get pregnant again straight away, and wanted to be protected while I worked out what kind of contraception was going to be my best option going forward.” 

The great thing about the contraceptive pill is that it fits easily into your lifestyle and gives you control over your body. Progestogen-only contraceptive pills like Hana are suitable for people who are breast-feeding and you can start using Hana in the first 21 days after childbirth. If you start later you should use a condom for 7 days as an extra precaution in addition to taking the pill.

Growing your family

In 2018, the average completed family size for women in England and Wales was 1.89 children per woman. There are a lot of things to consider when thinking about having more children. In Hana’s recent survey, 18% of people said that they take the pill because they want to be able to stop taking their contraceptive at any time.

“I love taking the pill because it gives me control of when and how we grow our family,” says Abbie. “I know that no contraception is 100% effective, but the odds around taking the pill* are so good and it makes me feel much more comfortable knowing that when I next want to have a baby, I can just come off the pill again and start trying.”

Some people like Sophie, 30, might want to entirely avoid experiencing pregnancy again:  “I really didn’t like being pregnant or giving birth, so there is more to consider now I’ve done it once, which is why I’m back on the pill.

Going forward

Parenthood can be tough and completely different for everyone who experiences it – but it’s important to remember that all parents started out new to parenthood! It’s all well and good having your Gran tell you to ‘sleep when the baby sleeps’, but we know that’s not always going to be the reality…

You are your own person, and so is your baby,” says Abbie. “Only you will have your mothers intuition and know what is best. Oh, and make time for your other half! Our relationship changed immeasurably when we became parents and we quickly lost sight of how we used to be. Now we schedule regular time to spend together, just the two of us.”

They say it takes a village to raise a child. Community is always important, and trying to have a support system in place to help you as you get to grips with this new chapter of your life will definitely help! Loads of mums meet others through baby groups, some have their family close by to lend a helping hand and some rely on online support networks – you’ve just got to work out what feels best for you. Parenthood can be lonely, but it’s important to remember that you’re never alone.

Surround yourself with the strongest support network possible,” says Sophie. “Try going to baby groups to meet new mums and don’t be afraid to ask for their phone number or give yours out… I think us Brits are super shy. I felt like I was dating again!” 

For all the sleep deprived and distracted parents out there, overwhelmed with both love and washing, we are here for you. When you don’t have time to make or attend a doctor’s appointment, Hana® can be purchased over the pharmacy counter and online (with a pharmacist-reviewed checklist to help ensure it is an appropriate product for you).

Regardless of your situation, we want you to feel in control and empowered when it comes to your contraception, and finding out what’s best for you.

*When used correctly, taken at the same time every single day without breaks, Hana® can be more than 99% effective at helping to prevent pregnancy.

Hana® film-coated tablets. Oral Contraception. Contains desogestrel. Read label.

Hana responds to YOUR comments about the progestogen-only pill

Hana responds to YOUR comments about the progestogen-only pill
How can it be safe to buy a contraceptive pill from a pharmacist?
Does tracking your menstrual cycle work as a contraceptive method?
Is making the progestogen-only pill available to buy over the pharmacy counter going to make it unavailable for free on the NHS?
What’s with ‘women and people with uteruses’?
What about the male contraceptive pill?

Since Hana® and another progestogen-only pill became available to buy over the pharmacy counter without prescription, people have had a lot of things to say about it. 

Some people are concerned that the pharmacist’s consultation won’t be as robust as a doctor’s, others question our use of the words ‘women and people with uteruses’, and many want more contraceptive options for men and people with penises.

In this article, we’re going to directly address and discuss some of the questions and concerns that people have been raising on our social media channels.

How can it be safe to buy a contraceptive pill from a pharmacist?

Instagram status 1

As you may know, there are different types of contraceptive pills. The combined contraceptive pill contains synthetic versions of the naturally occurring hormones oestrogen and progesterone, whereas the progestogen-only pill contains  – you guessed it! – a synthetic version of the naturally occurring hormone progesterone.

The progestogen-only pill does not contain oestrogen, which means it is suitable for some people who cannot take oestrogen, such as women and people with uteruses over the age of 35 who smoke and people who are on certain medications or who have specific health conditions. 

As Hana® and other progestogen-only pills only contain progestogen, blood pressure checks are not required to use them.

The progestogen-only pill is available over the pharmacy counter, but that doesn’t mean you just ask for it and buy it. You will need to have a consultation with a pharmacist – either in person or by completing an online questionnaire – which is then checked by a qualified pharmacist before proceeding. 

Pharmacists complete a five year degree and undergo regular training, so are fully qualified to dispense contraception. Your pharmacist will ask all the questions a doctor would ask you, and are available to answer any questions you may have about your contraception.

Does tracking your menstrual cycle work as a contraceptive method?

Instagram post 2

There are a lot of different ways people choose to help them prevent pregnancy. Some people use fertility tracking – tracking their menstrual cycle and ovulation, often with the help of an app – and using contraception around their most fertile days, whilst having unprotected sex on ‘safe’ days. 

This method requires really accurate calculations. Ovulation typically occurs in the middle of your cycle, but it varies from person to person – and sometimes from month to month. 

Ovulation typically lasts from 12-24 hours, after which the egg dissolves and can no longer be fertilised, but sperm can live inside the body for up to 5 days after unprotected sex. Some people have irregular cycles, and your cycle can be affected by things like stress, sleep and weight loss or gain.

It can be hard to be accurate enough to reliably prevent pregnancy using this method. If you’re interested in trying this method, make sure you’re comfortable with and able to regularly take your body temperature and track your cervical mucus as well as keep a close eye on your menstrual cycle. 

Is making the progestogen-only pill available to buy over the pharmacy counter going to make it unavailable for free on the NHS?

progestogen-only-pill-instagram-post

When Hana® and some other progestogen-only pills was made available to buy over the pharmacy counter without prescription, it was never designed to replace the contraceptive services you can get from your doctor. If you want to see your doctor about your contraception, that’s entirely up to you and that option will and should always be there for you.

This move was designed to make the contraceptive pill easier to access for people who, for whatever reason, can’t or don’t want to wait for a doctor’s appointment. Maybe they find it hard to schedule appointments around work or other commitments, perhaps they have to wait for ages before they can schedule an appointment, or maybe they’d just rather get the pill in a pharmacy. Accessibility is important, so that people can choose the right option for them. 

What’s with ‘women and people with uteruses’?

women and people with uteruses

We use the words ‘women and people with uteruses’ because women are not the only people who may want to use the progestogen-only pill. Some trans men and non-binary people who have not had a hysterectomy and do not identify as female will still have the ability to become pregnant and may wish to use the contraceptive pill (or another form of contraception) to prevent pregnancy. You can find out more about inclusive language at Hana® here.

Contrary to what some people think, taking testosterone does not prevent pregnancy. The combined pill is not usually recommended for people taking testosterone, because oestrogen can counteract its effects, so the progestogen-only pill can be a good choice for some trans men and non-binary folk.

It’s also important to remember that being trans or non-binary does not mean someone is necessarily taking hormones or has had or wants to have surgery. The way people express their gender identity is unique to them and is their choice. We want to ensure that everyone knows what their contraceptive options are. 

What about the male contraceptive pill?

male contraception

We recently conducted a survey with over 1,000 women, trans men and non binary people. We found that nearly 90% (88% to be exact) would like their male partner to use a contraceptive pill or a form of long term contraception if such a thing existed, and 50% said this was because it would be good to feel like the responsibility of contraception was equally shared.

It would be good for there to be more contraceptive options for men. Men and people with penises are fertile for longer in their lives (there is no male equivalent of menopause), they are fertile every day of the month and the fact they don’t get pregnant means that statistically, they can have a lot more children than women. Unfortunately, trials on the male pill are still ongoing. Read more about the male pill on ellaOne.co.uk, our sister site.

In the meantime, there are a lot of contraceptive options to choose from – including condoms – which do rely on the partner with a penis. There are also reasons that women and people with uteruses may want to continue to take the pill even if these options existed. 

Our survey also showed that 39% of the people who wouldn’t want their partner to use a contraceptive pill or other option said it was because they – the person with the uterus – was the one who could get pregnant and so wanted to feel in control of their contraception. 

We hope that in the future there will be more contraceptive options for everyone, so you can find something that works for you.

The Progestogen-only pill: your contraception guide

What is the Progestogen-Only Pill?
What Are the Benefits of Using the Progestogen-Only Pill?
What is the Desogestrel Pill?
How to Take the Desogestrel Pill
The Progestogen-Only Pill And Periods
Pregnancy on the Desogestrel Pill
Does Anything Impact the Effectiveness of the Progestogen-Only Pill?
What are the Potential Side Effects and Risks of Using the Mini Pill?
Where Can I Get the Progestogen-Only Pill?
Coming Off the Progestogen-only Pill

You’re probably familiar with ‘the pill’. In fact, you may already use or have used it at some point in your life. 

But did you know that when it comes to birth control pills you have more options than you might realise? Since the 1960s, people have been using the combined pill and the progestogen-only pill (PoP) to prevent unplanned pregnancy.

Although they share the same goal, these pills have quite different effects on your body. Choosing the right pill for you and your body is extremely important.

Have you ever heard of the mini pill, progestogen-only pill or PoPs? No? Well, you’re in the right place then! These are all names we use for a type of pill that doesn’t contain any oestrogen.

What is the Progestogen-Only Pill?

The progestogen-only pill (PoP) is a type of contraceptive pill. Some progestogen-only pills, like Hana, work by inhibiting ovulation (egg release) and, when taken correctly, are over 99% effective at preventing pregnancy. Progestogen-only pills also alter your cervical mucus, making it hard for sperm to travel into your uterus during or after sex. 

For the pill to be most effective, you need to take it at the same time every day, without taking a break between packs. 

What Are the Benefits of Using the Progestogen-Only Pill?

The purpose of any contraception is to help prevent pregnancy. There are plenty of benefits to choosing the progestogen-only pill.

In contrast to the combined pill, progestogen-only pills like Hana can be used by women who cannot take oestrogens, or do not want to, and by women who are breast-feeding – as long as they are medically suitable. 

From 2021 you can buy Hana over the counter in your local pharmacy or online, following a consultation with a pharmacist. So you can say goodbye to doctor’s appointments and waiting around for your prescriptions. Say ‘Hello’ to Hana, and quicker, more convenient, access to a contraceptive pill.

Pharmacist and sexual-health expert Deborah Evans* says, “It’s important to remember that neither pill protects you against sexually transmitted infections (STIs). So if you’re having sex with a new partner or partners, make sure you use extra protection such as condoms or dental dams. You should consider getting checked regularly for STIs.”

What is the Desogestrel Pill?

There are two types of progestogen-only pill available at the moment: traditional mini pills and those that contain desogestrel, like Hana.

So what is desogestrel and how can it affect your body?  Desogestrel is a synthetic type of female sex hormone known as a progestogen.

The desogestrel progestogen-only pill works in two ways to prevent unplanned pregnancies by:

  1. Helping to stop ovulation (egg release – so sperm have nothing to fertilise) and
  2. Thickening your cervical mucus

You can think of this as having two lines of defence against unplanned pregnancy.

How to Take the Desogestrel Pill

When it comes to taking desogestrel, sticking to your routine is key to effectiveness. You should take your pill at the same time every day, 365 days a year.

There are a few things you can do to remind yourself to take your pill, such as:

  • Keeping it somewhere you will see it everyday, such as by your bathroom sink. (Wherever you store Hana, make sure it is out of the reach of children and that it is stored below 30℃.)
  • Setting a daily reminder on your phone.

It’s very important to take your pill at the same time every day. 

If you are less than 12 hours late, take the delayed pill straight away and take your further pills as usual. Hana can still protect you from pregnancy.

However if you are more than 12 hours late taking it, you will no longer be protected against unplanned pregnancies. 

If you are more than 12 hours late, take the most recently missed pill straight away and leave any earlier missed pills in the strip. Take your further pills as usual. Use extra contraception (e.g. condoms) for the next 7 days. 

Missing tablets at any time in the cycle can reduce the efficacy of Hana and risk pregnancy but if you have missed one or more tablets in the first week of taking Hana and had sex in the week before missing the tablets, the risk you may get pregnant is higher than any other time in your cycle. Ask your pharmacist for advice.

If you miss more than one tablet in your pack, across consecutive days, you only need to take one of your missed tablets. Then you can continue taking your pill as normal but you will need to use a barrier method of contraception (such as condoms) for 7 days.

You can find even more information about Hana and how to take it in your package leaflet, which you can view online here.

The Progestogen-Only Pill And Periods

Unlike some combined pills, where you have a week each month without taking pills and normally have a period, with the progestogen only pill you take it continuously without a break. When you finish one pack, you begin another straight away.

Your periods may continue as usual. However, up to 50% of people who take the progestogen-only pill containing desogestrel experience irregular bleeding. This often happens in the first few months while your menstrual cycle adjusts.

Between 20 and 30% of those using the progestogen-only pill report more frequent periods, while 20% experience less bleeding or amenorrhoea. Amenorrhea is a technical term meaning that your periods stop altogether. 

Heavier or more frequent bleeding usually settles down after a few months of taking the pill. If you experience this and it doesn’t subside within a few months, then it is worth discussing this with your doctor to ensure there are no other reasons for the bleeding.

Pregnancy on the Desogestrel Pill

Do not use Hana if you are pregnant, or think you may be pregnant. Take a pregnancy test or talk to your pharmacist, doctor or family planning nurse if your period is late after missing any pills in the last month, or if you think you may be pregnant. If you become pregnant, stop taking Hana and see your doctor.

“No method of contraception is 100% effective” Deborah tells us “But if you discover you’re pregnant whilst taking the pill then you’re understandably likely to be anxious. The most important thing is to speak to your doctor to understand your options.”

The only way to know for certain that you’re pregnant is to take a pregnancy test, especially if you don’t have regular periods.

If you are pregnant, there is no evidence that the desogestrel pill negatively affects foetal development. 

If you find out you’re pregnant on the pill, it’s important to speak to your doctor as soon as possible. You should stop taking your pill straight away. Your doctor will check you over, talk you through your options, and refer you for further help or support.

Does Anything Impact the Effectiveness of the Progestogen-Only Pill?

Taking your pill at the same time every day is the best way to maximise efficacy. The progestogen-only pill may be less effective if you:

  • Leave breaks between packs of pills
  • Take it at different times every day
  • Have been vomiting or had diarrhoea (in this case, you should use alternative contraception during your illness and at least 7 days after your illness has passed)

What are the Potential Side Effects and Risks of Using the Mini Pill?

We’ve all heard stories about side effects of using the mini pill and some of us have experienced them first hand. Everyone is different and can experience different side effects – or none at all. 

The good news is that progestogen-only desogestrel pills, like Hana, are generally well tolerated. Changes to your menstrual cycle also tend to calm down within a few months of using the pill.

Common (affecting up to 1 in 10 people)

  • Irregular menstruation or amenorrhoea (no periods)
  • Altered mood
  • Depressed mood
  • Decreased libido (sex drive)
  • Headache
  • Nausea
  • Acne
  • Breast tenderness
  • Weight gain

Uncommon (affecting up to 1 in 100)

  • Vaginal infection
  • Difficulty wearing contact lenses
  • Vomiting
  • Dysmenorrhoea (painful periods)
  • Ovarian cysts
  • Tiredness
  • Hair loss

Rare (These may affect up to 1 in 1,000 women)

  • Rash
  • Hives
  • Painful blue-red skin lumps (erythema nodosum)

If you are finding it difficult to manage any of these side effects, it may be worth speaking to your pharmacist or doctor or looking for an alternative form of contraception. You can also report side effects via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or the MHRA Yellow Card app in Google Play or Apple App Store.

Where Can I Get the Progestogen-Only Pill?

You can get progestogen-only pills from the pharmacy, from the GP or at a sexual health clinic. 

Until recently, you needed to make an appointment with your doctor, or a sexual health clinic, and get a prescription to get the pill. 

While this might not be a major inconvenience, this does require a bit of planning. If you can’t get a doctor’s appointment or there are delays with your prescription, this could disrupt taking your pill every day at the same time.

With Hana, no prescription is no problem. Hana is available to buy over the counter in your local pharmacy or online, following a consultation with a pharmacist. 

A pharmacist, like Deborah, will make sure the pill is suitable for you and that you know how to take your pill properly. “Our job is to make sure you have plenty of information and support when getting your pill,” says Deborah, “So feel free to ask us anything and be reassured that we will respect your privacy and confidentiality.”

This means that, as long as the PoP is suitable for you, you can drop in and pick up Hana after answering some questions for the pharmacist. 

Coming Off the Progestogen-only Pill

If you do decide that PoPs aren’t for you anymore, stopping the pill is really simple and easy – just stop taking it. 

The progestogen-only pill doesn’t have any long lasting effects on your fertility. So if you do have sex and don’t want to get pregnant, you should use an alternative method of contraception as soon as you stop taking the pill.

***

The most important thing is to choose a pill that you feel confident and comfortable using. 

And remember, it’s OK if one pill doesn’t suit you! There are plenty of alternative methods of contraception. You can find out more about them here.

To find out more about Hana, head over to this article What is Hana or check your package leaflet, which can also be viewed online here.

*Deborah Evans does not endorse any pharmaceutical brands or products.

From the other side of the counter: Interview with pharmacist Deborah Evans

How does someone go about becoming a pharmacist? Could you talk us through the process?
Would pharmacists have any specific training on contraceptives?
Why is a progestogen-only pill available over the pharmacy counter without prescription?
What is the difference between the consultation you’d do with a pharmacist to buy the progestogen-only pill and the one you’d do with a doctor?
Some people are concerned that medical checks and a doctor’s appointment are necessary before they can take the contraceptive pill.
What are the benefits of having the progestogen-only pill available over the counter?
What would you like people to know about the progestogen-only pill consultation?
There are some concerns that people have around paying for contraception when it is currently free on the NHS. What would you say about that?

How much do you know about pharmacists? Would you trust a pharmacist with your contraception?

This year, Hana, a progestogen-only daily contraceptive pill, became available to buy over the pharmacy counter without prescription.

The fact that you can buy Hana and other progestogen-only pills (also known as PoPs or mini-pills) over the pharmacy counter has created another access route to this type of contraception so that people who cannot or don’t want to have a doctors appointment can still access it.

Hana is also available to buy online, if you’d prefer to access it that way. Whether you choose to buy Hana in a pharmacy or via Hana Direct, there is always a pharmacy consultation involved, in order to ensure that Hana is right for you. 

We know that some people are concerned about the progestogen-only pill being available without prescription.

Screenshot of a tweet. The tweet says 'Contraception pill can be bought over the counter in UK pharmacies for the first time.
Screenshot of a tweet. the tweet says 'I'm on the contraceptive pill for health issues. My doctor runs checks on me every 3 months before he issues anymore. If my doctor feels these health checks are eddential then how can it be healthy to be able to just walk into a pharmcy and buy these medications over the counter?'
Screenshot of a tweet. The tweet says 'Over the counter contraceptive pill? No prescription, no medical check, no ongoing checks on blood pressure etc. I don't like the sound of that!'
Screenshot of a tweet. The tweet says 'How is a contraceptive pill now available over the counter - at a cost [obviously] - and without any prescription? This is surely something to be hugely concerned about?'

How does someone go about becoming a pharmacist? Could you talk us through the process?

To become a pharmacist, you have to complete a four-year degree course followed by one pre-registration year. During the four years of the master’s degree, we study a range of scientific topics including pharmacology, pharmaceutics, chemistry. anatomy and physiology, microbiology and many more. In a number of schools of pharmacy they share some of their training with medical students.

Then, we have to do a pre-registration year in practice, which takes place somewhere like a community pharmacy or a hospital environment. At the end of the pre-registration year you have to do an exam. So, in total it takes five years to qualify as a pharmacist.

Pharmacists train as scientists and clinicians and have a unique set of skills and knowledge. Using this scientific knowledge, we advise patients on how to take medicines and recommend the best medicine for particular conditions and diseases.  We have a deep understanding of how medicines work at a molecular level as well as how they affect the human body. 

As experts in medicines, we know what medicines do and how they interact with each other. Our learning in practice continues when we finish their training to ensure our knowledge is current.

*Would pharmacists have any specific training on contraceptives?

Pharmacists will have done reproductive health as part of their training. We also come across many situations where we’re supporting women around their reproductive health, including supplying the morning after pill. 

As some progestogen-only pills are available to buy over the pharmacy counter, we will make sure that we’re fully trained and able to answer people’s questions. Pharmacists are trained in safeguarding and are aware of important issues such as non-consensual intercourse, child protection, vulnerable adults, consent and confidentiality.

 It is important that pharmacists have this training for many aspects of their role and for contraception, this could in some circumstances, be linked to abuse of children or vulnerable adults. Their training includes as a minimum a professional course and assessment in Safeguarding Children and Vulnerable Adults.

*Rigorous training on how to conduct the desogestrel consultation is available to all pharmacists.

Why is a progestogen-only pill available over the pharmacy counter without prescription?

The progestogen-only pill containing desogestrel (the active ingredient in Hana) has been available since 2002. Over that time, millions of women have safely used the progestogen-only pill. 

The MHRA, who are the regulators that scrutinise all the data around a medicine before regulating it, are comfortable that some progestogen-only pills containing desogestrel can be sold under the supervision of a pharmacist. 

The Royal College of Obstetricians and Gynaecologists called in their Better for Women report for the progestogen-only pill to be reclassified from a Prescription Only Medicine (only available with a prescription) to a Pharmacy Medicine (can be bought over the counter in a pharmacy or online with a consultation)​​ in 2019. It’s all about increasing access to contraception.

I would say the availability of desogestrel over the counter has simply increased access to some daily contraceptive pills for more people.

What is the difference between the consultation you’d do with a pharmacist to buy the progestogen-only pill and the one you’d do with a doctor?

There shouldn’t be any difference in the consultation. The pharmacist will be asking women similar questions and talking to them about their contraceptive options. The difference is that a woman can walk into a pharmacy without an appointment and have a conversation with a qualified healthcare professional without having to potentially wait weeks for that appointment.

Some people are concerned that medical checks and a doctor’s appointment are necessary before they can take the contraceptive pill.

I welcome the availability of desogestrel, a progestogen-only pill (POP) that has been used in millions of women, without the need to see a doctor. A pharmacist will ensure that the appropriate questions are asked before supplying desogestrel to ensure that it is appropriate for the woman.

Unlike with the combined contraceptive pill, there is no requirement to take blood pressure before issuing the progestogen-only pill – this is the same whether you see a pharmacist or a doctor. If you would like to check your blood pressure, your pharmacist can provide this service.

Pharmacy-led provision of desogestrel has been authorised by the MHRA and is widely supported by doctors and the medical community to increase access to some daily contraceptive pills.

They have no need for concern. Pharmacists are highly trained healthcare professionals and the consultation that someone who can get pregnant receives in a pharmacy before they buy the daily contraceptive pill will be every bit as rigorous as the one they would get from a GP.

“This is good news for women and families. Pharmacists have the expertise to advise women on whether desogestrel is an appropriate and safe oral contraceptive pill for them to use and to give women the information they need, to make informed choices,” said Dr June Raine CBE, Chief Executive, Medicines and Healthcare products Regulatory Agency (MHRA).

What are the benefits of having the progestogen-only pill available over the counter?

The main benefits are access and choice; access in that you can buy it without a doctor’s appointment, choice in that there are now more options available to you directly from the pharmacy.

For example, if you visit your pharmacy to buy the morning after pill, your pharmacist will be able to talk to you about desogestrel and your other contraceptive options.

What would you like people to know about the progestogen-only pill consultation?

Looking after your reproductive and sexual health as a woman is an important aspect of your overall health. 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. 

The pharmacist will ask you very straightforward questions just to make sure that this form of contraception is appropriate for you, as well as listen to and address any concerns you might have. The consultation can also be done in a private room if you would prefer.

There are some concerns that people have around paying for contraception when it is currently free on the NHS. What would you say about that?

I would say the availability of desogestrel over the counter has simply increased access to some daily contraceptive pills for more people. It has made no difference to the accessibility of free contraception. We’re very fortunate in this country to have access to free contraception and that hasn’t been taken away.

If you want to keep seeing your doctor, that is absolutely fine, and if you’d rather see a pharmacist, that’s fine too. Access to contraception should include as many options as possible, so different people can find something that works for them.

If you have any questions about how Hana works, you can find out more here. Have a question we haven’t answered yet? Get in touch using #AskHana.

*Deborah Evans does not endorse any products or brands.

The history of the progesterone-only contraceptive pill

Where Do Babies Come From?
Weasel Testicles, Anyone?
The Search For A Birth Control Pill
The legacy of the pill
How Hana Made History

In 2021, history was made as progestogen-only contraceptive pills containing desogestrel became available to buy over the counter without a prescription. Hana is one of these pills!

The pill has been available in the UK for almost 60 years and compared to 1961 when you had to prove you were married to access the pill, we’ve come a very long way.

It’s about time that women and people who can get pregnant are free to choose their contraception and to get it on their terms, without having to wait for a doctor’s appointment. You will be asked some questions for your pharmacist to check if your chosen progestogen-only pill is right for you.

To celebrate, we’re taking a deep dive into other significant events in the history of contraception to show just how far we’ve come. From discovering how babies are made to the invention of the pill and the birth of Hana, read on to discover how Hana made history.

Where Do Babies Come From?

For as long as there have been babies, people have been trying to not have babies. The problem was: our ancestors didn’t know how babies were made.

People realised pretty quickly that penetrative intercourse (aka P in V sex) could lead to the person with the V getting pregnant, but it wasn’t until 1875 that they figured out how pregnancy worked.

To get pregnant, someone with a vagina has to be ovulating. Ovulation (aka release of an egg from the ovaries) usually occurs once a month roughly in the middle of the menstrual cycle, although that varies from person to person.

If someone with a penis ejaculates into your vagina around the time that you’re ovulating, the sperm can fuse with the egg to create an embryo which then moves to the uterine wall and can develop into a foetus.

This is all common knowledge now, but how babies are made was the unanswered question that baffled the scientific world for centuries.

Ever been with a guy who lept up straight after sex to stare at his sperm under a microscope? That was the situation Antonie van Leeuwenhoek’s wife found herself in when Leeuwenhoek studied his seed and concluded it was made up of ‘tiny little creatures’ which ‘moved like eels’1.

This sparked a ‘spermist’ vs ‘ovarist’ debate, where spermists argued the eel-like creatures in sperm were the babies – little, miniature humans swimming to their new home. Ovarists, on the other hand, thought babies came from the eggs in female ovaries1.

Spermists thought babies came from sperm and ovarists thought they were made in eggs, but for centuries no one put two and two together. It wasn’t until 1875 when German scientist Oscar Hertwig put a sea urchin – a good choice as they are transparent and have a similar reproduction set up to humans- under a microscope, dropped a sperm onto it and watched as the cells merged into a single nucleus. Finally, the origins of life had been discovered.

Weasel Testicles, Anyone?

From the dawn of civilisation people have been trying to enjoy sex without getting pregnant. Some early methods of contraception are familiar. Coitus Interruptus (the withdrawal method) was a popular choice, although people put way too much importance on sperm and to ‘waste your seed’ was seen as a sin in many cultures2.

While it would be many centuries until the birth control pill was created, early societies used natural ingredients to prevent pregnancy. An ancient Greek legend involves the goddess of spring Persephone eating nothing but pomegranate seeds to avoid getting pregnant when she was kidnapped by the God of the underworld. We now know that pomegranate seeds have naturally occuring contraceptive components, so the ancients were onto something2!

Less effective forms of ancient contraception involved wearing weasel testicles around your neck or wearing animal organs as condoms. The famous lover Casanova even encouraged women to use half a lemon as a cervical cap!

The Search For A Birth Control Pill

Condoms, diaphragms, douches and pessaries (a prosthetic device inserted into the vagina which used to be used as a contraceptive containing spermicide) all predate the pill, but they were often unsafe, messy or relied heavily on the man. Women needed something that they could use on their own terms to prevent unplanned pregnancy – and in the 1950s, they finally got it.

Long standing contraceptive advocate and originator of the term ‘birth control’ Margaret Sanger met Goodwin Pincus at a dinner party and together they decided to start searching for a hormonal contraceptive which women and people with uteruses could take to prevent pregnancy.

Pincus was trying to rebuild his image after the scientific community rejected him for being a Frankenstein style scientist – and bragging about it to the press. Sanger had spent years working as a nurse and had met women desperate to stop having children for the sake of their health and their existing family. She wanted women to be able to enjoy sex without fear of pregnancy – and to put them back in control of their fertility.

It is important to note that Sanger was a eugenicist.* Her motives may have been in empowering women to be able to enjoy sex without the fear of pregnancy leering over them, it may have been in stopping people she deemed unfit from having children, or it was likely a combination of the two.

*Eugenics is the study of how to arrange reproduction within a human population to increase the occurrence of heritable characteristics regarded as desirable.

Together with catholic doctor John Rock and heiress and scientist Katherine McCormick, who funded most of the research, work began on creating a contraceptive pill.

As it was illegal to conduct large birth control trials in the US, the first pill was tested on women in Puerto Rico where there weren’t such laws. The women were not informed this was an experimental trial or of possible side effects, making this an incredibly unethical study.

The early pill contained a much larger dose of hormones than it does today and almost 20% of the women in the Puetro Rican trials complained of headaches, nausea, dizziness and weight gain. Despite how unethical this study was, only one woman became pregnant and the trial was deemed a success5.

In 1957 the first birth control pill containing oestrogen and progestogen was made available in the U.S.A. Named Enovid, the pill was initially marketed for ‘gynecological disorders’ until 1960 when it was approved for contraceptive use.

Enovid came with a big label saying “warning: prevents pregnancy” so people still got the message. A year after it’s launch, 400,000 women in the United States were taking it — which increased to 1.2 million by 19627.

A year later, Enovid was available in the U.K for married women. Non married women were only allowed to obtain the pill legally in 1967 in the U.K – but there are stories of women getting around this by using a fake wedding ring.

The legacy of the pill

The birth control pill isn’t called one of the seven wonders of the modern world for nothing.6 Giving women the option to control their fertility meant that they could choose when, and if, they had children. This revolutionised women’s possibilities. It gave them the option to work for longer, pursue different careers, and to marry for love – not necessity.

“The pill gave women more autonomy. It gave them control over their reproductive health. If they were married and their husband didn’t want to use condoms, for example, or refused to use condoms, this gave them a level of control over their fertility that they wouldn’t have otherwise had,” says Dr Anne Hanley*, a historian specialising in sexual and medical health.

How Hana Made History

Things have changed for the better since the days of weasel testicles and lemon diaphragms. Better access to contraception and more (if still not perfect) acceptance of female agency and sexuality means that women and people with uteruses are by and large no longer defined or controlled by their reproduction. We can choose if we have kids at all, how many we have and when we have them. A lot of that is thanks to the pill.

In 2021, Hana – a progestogen only pill available to buy over the counter without prescription – launched in the U.K. Suitable for many women and people with uteruses, Hana can help prevent pregnancy by consistently inhibiting ovulation and thickening the cervical mucus.

It’s been sixty years since the pill was first invented and now women and people with uteruses can finally access it without a doctors appointment. Whether you’re too busy or cannot get a doctors appointment, or if you simply want to decide which pill you take, you just need to answer some questions so your pharmacist can help you decide if Hana is right for you. We trust that you know what you want. It’s 2021 and it’s about time! Want to find out more about Hana? Read this next.

The health care providers quoted in this article do not endorse any products or brands.

 

Does the pill make you gain weight?

Can the progestogen-only pill make you gain weight?
Why do people put on weight?
How to avoid weight gain on the pill
Diet
Exercise
Calorie restriction
Drink plenty of water

“Does the pill make you fat?”

You may have heard that the pill can cause weight gain. We understand that this is a concern for some people and may even put you off taking the pill altogether. So we’ve done our best to explain why in some cases the pill can cause weight gain, but don’t forget that everyone is different and can respond differently to contraceptive pills.

Some women and people with uteruses may experience slight weight gain when they start a new contraceptive pill, while many won’t see any difference.

‘The pill’ can refer to either the combined pill (which contains synthetic versions of the hormones oestrogen and progesterone) or the progestogen-only pill (PoP). Hana is a progestogen-only pill, so let’s find out more about whether the PoP can cause weight gain.

Can the progestogen-only pill make you gain weight?

Whilst weight gain is listed as a common side effect for the progestogen-only pill and may affect up to 1 in 10 people, it’s important to remember that pills like Hana can affect people in different ways. Evidence also suggests that when people do put on weight associated with the pill, it doesn’t mean they are piling on the pounds. There may be a slight increase in weight, but it is not often a significant amount.

A review of 22 studies into both the mini pill and the combined pill found that participants gained less than 4.4 pounds (2 kilograms) after 6 or 12 months of starting the mini pill. There wasn’t much difference in weight gain between those who took the combined pill or the progestogen-only pill. [Ref:https://www.cochrane.org/CD008815/FERTILREG_effects-progestin-only-birth-control-weight]

Deborah Evans*, an experienced pharmacist, says: “if you are experiencing any unwanted side effects from your contraceptive pill, you should speak to a pharmacist or your doctor about your options.”

“You should feel comfortable with your choice of contraception, and there are plenty of other options if the pill isn’t right for you,” she continues.

Why do people put on weight?

When people gain weight, it’s usually due to one of three factors: fluid retention, increase in muscle mass or an increase in body fat.

It’s hard to tell whether weight gain has anything to do with the pill as there are many other reasons someone may gain weight. Your weight also naturally fluctuates and it’s common to see a slightly different number on the scales even within the same day. While slight weight gain could be a result of the pill, you should also consider whether anything else in your routine has changed.

If you are concerned that your contraceptive pill is making you gain weight, you should speak to your doctor or pharmacist for advice.

How to avoid weight gain on the pill

Fluctuations in weight are perfectly normal. While some people do notice a slight increase in their weight after starting a new pill, it’s important to remember that it could also be down to other factors.

Say if you started taking the pill because you’re in a relationship, and that means you’re going on more dates to restaurants or enjoying more takeaways while you curl up on the sofa with your partner – can you be sure that it’s the pill making you gain weight, or enjoying some indulgence with your new partner?

If you want to maintain your weight or lose weight, you should stick to a healthy, balanced diet and exercise regularly. Please note that some people may be unable to lose weight due to a pre-existing condition, so you should contact your doctor if you believe that to be the case.

Diet

The best way to avoid weight gain is a healthy diet combined with regular exercise.

As with most things in life, there is no one-size-fits-all diet. Eating plenty of vegetables, fruits and whole grains as well as being careful not to eat too many high calorie/sugar snacks can all help maintain a healthy weight. Remember that alcohol is also high in calories, so limiting your alcohol intake is a good idea if you’re worried about weight gain.

It’s important not to treat any foods as ‘bad’ or ‘off-limits’ because you might actually end up craving them more! Moderation is key with any good diet, so as long as the majority of your meals are balanced and make you feel satisfied and energised you’re doing okay.

Exercise

Exercise is important for weight loss because it burns excess calories which may otherwise be turned into fat, but there are tons of other benefits. Regular exercise is great for your mental health, it helps keep you fit and healthy, it can help you avoid loads of health issues and it makes you feel good!

Exercise doesn’t have to be about spending 40 minutes on the treadmill or lifting 100kg weights. Swimming, yoga, jogging, cycling, dance and martial arts are all great ways to strengthen your muscles and trim some calories, so just find something that you enjoy and want to stick at.

The NHS recommends 150 minutes of moderate intensity activity per week (like walking fast, cycling and or hiking) or 75 minutes of vigorous intensity activity a week (like swimming, running or anything that builds up a good sweat!). It’s also important to move around during the day, even if it’s just for a ten minute walk in your lunch break.

Calorie restriction

Calories get a bad name, but they’re actually really important because they’re what gives you energy! Weight gain problems are related to consuming more calories than you burn, which then results in weight gain. If that’s something you want to avoid, you should look at your diet and exercise routine to ensure you’re not eating more calories than you need.

It’s recommended that women eat around 1,500-2,000 calories a day depending on lifestyle, age and other factors. It’s really important that you don’t eat too few calories because you won’t feel good and you won’t have the energy to go about your day.

Rather than avoiding the meals you enjoy, consider using a smaller plate to reduce your portion sizes instead and filling up your plate with vegetables. Adding seeds and nuts to a meal is a great way to fill up on some extra healthy fats – plus it tastes good too!

Drink plenty of water

Last, but certainly not least, make sure you’re drinking plenty of water. Drinking enough water can help you feel fuller for longer, plus you’ll feel well hydrated and it’s great for your skin!

The bottom line is that the pill may or may not make you gain weight. While we don’t know for sure that it’s connected to the pill, you are an expert in your own body and so if your current pill is causing any adverse side effects you have every right to try something else. A pharmacist or another healthcare professional will be able to advise you on a suitable contraceptive method for you.

If you’re finding it hard to lose weight despite following diet and exercise advice, you may want to speak to a healthcare professional as weight gain can sometimes be linked to health conditions which require medical attention.

If you can’t or don’t want to book a doctor’s appointment, Hana is a progestogen-only contraceptive pill which is available to buy over the counter without a prescription. You will need to answer some questions for the pharmacist to check it is suitable for you. You can buy a one month or three month pack to start with, so you can see whether it works for you. Find out more about Hana here.

*Deborah Evans does not endorse any products or brands.