Microgynon (Ethinylestradiol, Levonorgestrel)

Microgynon, a combined oral contraceptive, is used to prevent pregnancy by modulating the hormonal regulation of the menstrual cycle.

• Contraception (prevention of pregnancy): suppresses ovulation and creates an environment that reduces fertilisation.
• Cycle regulation: provides predictable withdrawal bleeding each month.
• Acne management: reduces androgen‑driven skin lesions in women when prescribed for this purpose.

• Microgynon contains ethinylestradiol, a synthetic estrogen, and levonorgestrel, a progestogen. The estrogen component stabilises the endometrial lining while the progestogen suppresses the mid‑cycle luteinising hormone surge, preventing follicular rupture. Together they thicken cervical mucus and alter the endometrium, making implantation unlikely.

Microgynon may cause a range of adverse reactions, most of which are mild and transient.

Common Side Effects

• Nausea: mild stomach upset, often resolves with continued use.
• Headache: tension‑type or migraine‑like pain.
• Breast tenderness: temporary swelling or soreness.
• Spotting: irregular light bleeding between periods.
• Mood changes: irritability or mild depression.
• Weight fluctuation: modest fluid retention.

Serious or Rare Side Effects

• Deep vein thrombosis: painful swelling in a leg, requires urgent care.
• Pulmonary embolism: sudden shortness of breath, chest pain.
• Stroke: neurological deficits, facial droop, speech difficulty.
• Myocardial infarction: chest discomfort, radiating pain.
• Severe allergic reaction: rash, swelling, difficulty breathing.
• Liver tumor: abnormal liver function tests, abdominal pain.

Before prescribing Microgynon, clinicians should evaluate individual risk factors and counsel patients on safe use.

• Smoking: avoid use in women over 35 who smoke, due to increased thrombotic risk.
• History of thromboembolism: contraindicated in patients with prior deep vein thrombosis or pulmonary embolism.
• Pregnancy: discontinue immediately if pregnancy is confirmed; the product is not indicated during pregnancy.
• Breastfeeding: consult a healthcare professional before use, as hormones may affect milk production.
• Blood pressure monitoring: check regularly, especially in patients with hypertension.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, protect from moisture and direct sunlight.

Microgynon can interact with several medicines, altering its effectiveness or increasing adverse event risk.

Major Interactions (Avoid)

• Rifampicin and other enzyme‑inducing antibiotics: reduce contraceptive efficacy.
• Anticonvulsants such as phenytoin or carbamazepine: may diminish hormone levels.
• HIV protease inhibitors (e.g., ritonavir): can increase hormone concentrations, raising side‑effect risk.

Moderate Interactions (Monitor Closely)

• Antifungal agents like ketoconazole: may increase plasma levels of ethinylestradiol.
• Selective serotonin reuptake inhibitors (SSRIs): can slightly elevate risk of bleeding.
• Diuretics: may affect electrolyte balance, requiring periodic monitoring.