Milligest (Ethinylestradiol, Gestodene)

Milligest is a combined oral contraceptive that acts on the hormonal regulation of the menstrual cycle to prevent pregnancy.

• Prevention of pregnancy: provides reliable contraception for women of child‑bearing potential.
• Menstrual cycle regulation: helps achieve more predictable and lighter periods.
• Acne management: may improve mild acne associated with androgen excess.
• Endometriosis symptom control: reduces menstrual pain and lesion progression.

• Ethinylestradiol and gestodene work together to suppress the mid‑cycle surge of luteinising hormone (LH) and follicle‑stimulating hormone (FSH), thereby inhibiting ovulation. The estrogen component stabilises the endometrial lining, while the progestogen thickens cervical mucus and alters the endometrium, creating an environment less favorable for fertilisation and implantation.

Common side effects are usually mild and transient, reflecting the hormonal activity of the preparation.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Headache: tension‑type or migraine‑like pain.
• Breast tenderness: swelling or discomfort.
• Spotting or breakthrough bleeding: irregular light bleeding.
• Weight gain: modest fluid retention.
• Mood changes: irritability or mild depression.

Serious or Rare Side Effects

• Venous thromboembolism: deep‑vein thrombosis or pulmonary embolism.
• Stroke or myocardial infarction: especially in smokers over 35.
• Severe hypertension: sudden increase in blood pressure.
• Liver dysfunction: jaundice or abnormal liver enzymes.
• Allergic reaction: rash, itching, swelling of face or throat.

Before prescribing Milligest, clinicians should assess individual risk factors and counsel patients on safe use.

• Smoking status: avoid in women over 35 who smoke due to increased thrombotic risk.
• Cardiovascular disease: contraindicated in patients with history of stroke, myocardial infarction, or uncontrolled hypertension.
• Liver disease: use with caution in active liver disease or severe hepatic impairment.
• Pregnancy and lactation: not indicated; discuss alternative contraception if pregnancy is suspected.
• Drug interactions: review concomitant medications that may affect hormonal efficacy.
• Store at ambient temperature: keep below 25 °C, in the original packaging, protected from moisture and direct sunlight.

Milligest may interact with other medicines that influence hormone metabolism or increase clotting risk.

Major Interactions (Avoid)

• Strong CYP3A4 inducers (e.g., rifampicin, carbamazepine): may markedly reduce contraceptive effectiveness.
• Anticoagulants (e.g., warfarin): may increase bleeding risk.
• Certain antiretrovirals (e.g., protease inhibitors): can alter hormone levels.

Moderate Interactions (Monitor Closely)

• Antifungals (e.g., ketoconazole): may increase hormone concentrations.
• St. John’s wort: may modestly reduce efficacy.
• Seizure medications (e.g., phenytoin): may require additional contraceptive measures.