What is Desogestrel?

Cerazette is a progestogen-only contraceptive pill (also known as a mini-pill) used to prevent pregnancy. It contains desogestrel 75 micrograms, a synthetic version of the hormone progesterone. Unlike combined oral contraceptives, Cerazette does not contain oestrogen, making it more suitable for women who are unable to take oestrogen-based contraception.

Cerazette is often recommended for women who are:

Over the age of 35 and smoke
Breastfeeding
At risk of blood clots
Sensitive to oestrogen
Prone to migraines

How does Desogestrel work?

Desogestrel prevents pregnancy in three ways:

Stops ovulation – prevents the release of an egg from the ovary
Thickens cervical mucus – makes it harder for sperm to reach the egg
Thins the womb lining (endometrium) – makes implantation of a fertilised egg less likely

These combined actions make the progesterone only pill a highly effective method of contraception when taken correctly.

What is desogestrel Used For?

Desogestrel is widely used in the UK as an effective contraceptive method. It is a key ingredient in progestogen-only pills (POP), commonly known as the mini-pill. Desogestrel works by preventing ovulation, meaning no egg is released from the ovaries for fertilisation. It also thickens cervical mucus, making it harder for sperm to reach the egg. Unlike combined oral contraceptives, Desogestrel does not contain estrogen, making it suitable for women who are sensitive to estrogen or have specific health conditions. When taken correctly, Desogestrel offers over 99% effectiveness in preventing pregnancy and is a reliable option for many women.

How does desogestrel work?

Desogestrel 75 is an effective contraceptive that prevents pregnancy through two main mechanisms:

Inhibition of Ovulation: The primary function of Desogestrel 75 is to stop ovulation, which means the ovaries do not release an egg. Without an egg, there is nothing for sperm to fertilise, significantly lowering the chance of conception.
Thickening of Cervical Mucus: The medicinel also thickens the mucus in the cervix, creating a barrier that makes it challenging for sperm to pass through. Even if ovulation does occur in rare cases, this mechanism provides an additional layer of protection by preventing sperm from reaching the egg.

These combined actions ensure a high level of contraceptive efficacy when the medicine is taken consistently at the same time every day.

How Effective is the progesterone only pill?

When used correctly, Cerazette is more than 99% effective at preventing pregnancy. However, missed pills, vomiting, diarrhoea, or interactions with certain medications can reduce its effectiveness.

Always follow the guidance in the Patient Information Leaflet and speak to your pharmacist or GP if you're unsure.

How long does the progesterone only pill take to work?

If you start Cerazette on day 1 or 2 of your period, you are protected immediately.
If you start on any other day, use additional barrier protection (e.g. condoms) for 7 days.
What to Do If You Miss a Pill
If you're less than 12 hours late, take the missed pill as soon as possible and continue as normal – you will remain protected.
If you're more than 12 hours late, take the missed pill immediately and continue with the next at your usual time (this may mean taking two pills in one day). Use additional contraception for 2 days, as protection may be reduced.
If you've had unprotected sex in the 48 hours before or after missing a pill by more than 12 hours, you may need emergency contraception – contact your GP or pharmacist for advice.

When to consider the progesterone only pill for Contraception

When choosing a contraceptive method, it’s important to consider your health, lifestyle, and individual needs. Always consult a healthcare provider to determine whether it is the right choice for you.

Who should use the progesterone only pill?

Women Sensitive to Estrogen: Those who experience side effects from estrogen-containing contraceptives or have health conditions that contraindicate estrogen use.
Breastfeeding Mothers: As it does not affect milk production, it's suitable for women who are breastfeeding.
Women Over 35 Who Smoke: Estrogen-containing medicines are not recommended for smokers over 35; the progesterone only pill offers a safer alternative.
Women with Migraine: Especially those who experience migraines with aura, as estrogen can exacerbate this condition.

Who should avoid the progesterone only pill?

Women with Severe Liver Disease: As the medication is processed through the liver, it may not be suitable for those with significant liver issues.
History of Breast Cancer: Women who have had breast cancer should consult their healthcare provider, as hormonal contraceptives may not be recommended.
Unexplained Vaginal Bleeding: Before starting Desogestrel 75, any unusual bleeding should be investigated to rule out underlying conditions.
Allergic Reactions: Those with known allergies to desogestrel or any other component of the tablet should avoid its use.

Can you buy the progesterone only pill over the counter?

In the UK, certain brands of Desogestrel 75 microgram tablets, such as Hana, are available over the counter without a prescription. This allows women to access contraception more conveniently. However, it's advisable to consult with a pharmacist or healthcare provider to ensure it's the appropriate method for you, especially if you have underlying health conditions or are taking other medications.

Alternative Medications

While the progesterone only pill is a popular choice, other contraceptive options may suit different needs. These include:

Combined Oral Contraceptives (COCs)

Composition: These tablets contain both estrogen and progestogen.
Who can use them: Suitable for women without risk factors such as smoking, high blood pressure, or a history of blood clots.
Benefits: Offers additional advantages like regulated menstrual cycles, reduced menstrual pain, and improved acne.
Limitations: Not recommended for women who are breastfeeding or those over 35 who smoke.

Intrauterine Devices (IUDs)

Composition: Long-acting reversible contraceptives (LARCs) that are inserted into the uterus.
Types: Copper IUDs (non-hormonal) and hormonal IUDs (release progestogen).
Advantages: Effective for 3-10 years, depending on the type, and requires no daily action.
Drawbacks: Requires a medical procedure for insertion and removal and may cause irregular bleeding initially.

Contraceptive Implants

How They Work: A small rod is placed under the skin, releasing hormones over time to prevent pregnancy.
Duration: Offers protection for up to 3 years.
Advantages: Highly effective and maintenance-free after insertion.
Disadvantages: It may cause side effects like irregular bleeding or skin reactions at the insertion site.

Other alternatives include contraceptive injections, vaginal rings, and barrier methods like condoms and diaphragms.

Discussing your lifestyle and health with a healthcare provider can help you choose the best method.

How to Take it

Using Desogestrel 75 correctly is vital for ensuring its effectiveness:

Daily Dosing: 

• Take one tablet every day, preferably at the same time. This maintains consistent hormone levels in your body and ensures optimal protection.
• The pack is designed to remind you of the days of the week, helping you stay on track.
  
  

Swallowing Instructions:

• Swallow the tablet whole with water. Do not chew or crush the tablet, as this can affect how the medication is absorbed.
  
  

Missed Dosage:

• If you miss a dose by less than 12 hours, take it as soon as you remember and continue your schedule as usual.
• If the delay exceeds 12 hours, take the missed dose immediately, but use a backup contraceptive method for the next 48 hours.
  
  

No Breaks Between Packs:

• Unlike combined medicines, Desogestrel 75 requires no tablet-free interval. Start the next pack immediately after finishing the current one.

Active Ingredient:

• Desogestrel 75 micrograms: A synthetic form of the hormone progestogen.
  
  

Inactive Ingredients:

• These may vary by manufacturer but generally include lactose monohydrate, maize starch, povidone, and magnesium stearate.
  
  

Always read the patient information leaflet (PIL) in your pack for the complete list of ingredients, and to check for any you might be allergic to.

As with all medications, Cerazette may cause side effects in some women.

Common side effects include:

Changes to your period (irregular bleeding or no bleeding)
Headaches
Breast tenderness
Mood changes
Reduced sex drive
Nausea
Weight gain
Acne

These are usually mild and settle over time. If bleeding is heavy or prolonged, or if you experience any troubling symptoms, speak to your GP or pharmacist.

For a complete list of side effects, consult the Patient Information Leaflet.