Levest

What is Levest?

Levest is a brand of the combined contraceptive pill, used to prevent unwanted pregnancies. It contains synthetic versions of the hormones oestrogen and progesterone.

How does Levest work?

Levest works by overriding your natural menstrual cycle to prevent ovulation. This means that the ovaries won't release an egg each month. In addition to this, the pill thickens the mucus surrounding the cervix so that it is difficult for sperm to enter. It also thins the womb lining so that a fertilised egg cannot embed itself. 

How effective is Levest?

Levest is 99% effective if it is taken perfectly. In real life, if 100 women take the combined contraceptive pill over the course of one year, on average 9 would be expected to fall pregnant. This difference is mostly due to women not being able to take the pill perfectly. 

When does Levest start to work?

Levest will start to work right away if you begin taking it on the first day of your period. If you start it at any other time during your cycle you won't be protected against pregnancy right away so you will have to use additional contraception, such as condoms or a diaphragm, for the first 7 days.

Levest for non-contraceptive purposes

Levest can also help to minimise the symptoms of PMS and cause your periods to become lighter, less painful and more regular. The combined pill is sometimes given to women to treat acne as it can help to reduce the appearance of spots. It is also useful for managing the symptoms of endometriosis. Speak with your doctor if you have symptoms of endometriosis and would like to consider the combined pill.

Can you use Levest for period delay?

Levest can be used for period delay by skipping the pill-free week and running two packs back to back. This will delay your period for a further 21 days. Norethisterone is specifically designed to delay your period and is available to order from Dr Felix. This may be a good option if the combined pill is not suitable for you.

Levest for endometriosis

The combined pill is often prescribed for women with endometriosis to keep the symptoms under control. In this case, you may be advised to take Levest for 3–4 months at a time without the 7-day breaks between pill packs in order to suppress menstruation. While it is not a cure for endometriosis, the pill can successfully manage the condition and prevent painful periods and the discomfort associated with it.

Switching contraceptive pill

For some women, they need to try several different types of the pill in order to find the one that is right for them. If you are taking another type of the combined pill and wish to switch to Levest, wait until you finish your current pack and begin Levest the next day instead of taking the 7-day break. The mini pill can be stopped at any time and you can start taking Levest right away. You will not be protected from pregnancy right away, however, so you will need to use condoms, or another barrier method of contraception, for the first 7 days.

What should I do if I miss a pill?

If you miss a pill, i.e. it’s been more than 24 hours since you should have taken it,  take it as soon as you remember, even if this causes you to take two at the same time. You will need to use additional contraception, such as condoms, for the next 7 days as your protection may be affected. Keep taking the rest of your pills on time. If you have less than 7 pills left, skip the pill-free week and begin the next pack after you finish your current one. If you miss more than one pill then you may be at risk of pregnancy. See your doctor or pharmacist for advice as it may be necessary to take the morning after pill.

What should I do if I took a pill too late?

If you take your pill later than usual, but within 24 hours of the time it was due, this is not something to worry about and your contraception won't be affected. Continue to take the rest of your pills on time.

If I have vomited, will Levest still work?

Levest may not work if you vomit within 3–4 hours of taking it. This is because the hormones have not had a chance to be fully absorbed into the bloodstream. In this case, you should take another pill right away. Keep taking the rest as usual, your cycle will be one day shorter than normal. If the vomiting continues, your contraception may be affected and you will need to use additional contraception until you have felt better for 7 days.

When can I get pregnant after taking Levest?

After stopping Levest, you can get pregnant at any time as your fertility will usually return right away. For some women, their natural period may not return for 1–2 months so the timescale is different for everyone. It depends on your body and how long it takes to adjust. If you are planning to get pregnant, seek advice from a family planning clinic.

When will my period start again after I stop taking Levest?

Your period can take anything up to a couple of weeks to 2 months to return after stopping the pill. Everybody is different so it will depend on how long your body takes to adjust.

Active ingredients

The active ingredients contained in Levest are levonorgestrel and ethinylestradiol.

Inactive ingredients

The other ingredients included in Levest are: lactose monohydrate, maize starch, povidone k-25, sucrose, talc, calcium carbonate, povidone k-90, glycerin, macrogol 6000, titanium dioxide, magnesium stearate and carnauba wax.

Is it safe to take Levest for a long time?

Levest is usually safe to take long term provided you don't have any health conditions that put you at risk of a blood clot or which can be made worse by taking the pill. Your doctor will assess your suitability for Levest before prescribing it to you. You will also need to have yearly blood pressure checks to ensure that taking the pill has not caused your blood pressure to rise.

How to start Levest

You should ideally start taking Levest on the first day of your period. This means you will be protected against pregnancy right away. You will also be protected immediately if you start it up to day 5 of a natural cycle, provided your cycle isn’t unusually short. You can also start it at any other time in your cycle, if you are sure you’re not pregnant, however, you will need to use an additional contraceptive method for the first 7 days.

How to take Levest

Levest needs to be taken at the same time each day so it's best to choose a time that will be convenient for you to take it where you can access the pill easily. For example, first thing in the morning or last thing at night. Each packet will either have the days of the week printed above each pill or arrows to signify which order to take them in. Levest is taken every day for 21 days before having a 7-day break. You then start the next pack at the end of these 7 days.

How to use Levest for period delay

To use Levest for period delay, skip the pill-free week and start taking the next pack of pills the next day. In most cases, you won't have a bleed until the end of the second pack. 

Common side effects include: 

• Headaches 

• Abdominal pain 

• Nausea 

• Breast pain or tenderness 

• Weight gain 

• Mood changes 

Uncommon side effects include: 

• Vomiting 

• Diarrhoea 

• Fluid retention 

• Breast enlargement 

• Migraines 

• Lack of sex drive 

• Itchy red rash 

Rare side effects: 

• Allergic reaction 

• Weight loss 

• Poor tolerance of contact lenses 

• Vaginal discharge 

• Breast discharge 

• Inflammation of large intestine 

• Pancreatitis 

• Blood clots 

• Increased risk of breast cancer

Contraindications

Levest should not be taken by women who: 

• May be pregnant 
• Are over the age of 35 and smoke ≥15 cigarettes per day
• Have given birth within the past 6 weeks and are breastfeeding
• Have heart problems including angina, pulmonary hypertension, atrial fibrillation, or bacterial endocarditis
• Have ever experienced a blood clot including venous thromboembolism, deep vein thrombosis (DVT), stroke, heart attack or transient ischaemic attack (TIA)
• Have certain conditions which can affect your blood clotting 
• Have very high blood pressure 
• Are allergic to any of the ingredients 
• Have ever had a migraine with aura
• Have breast cancer
• Have certain liver problems including severe cirrhosis, or a liver tumour
• Have recently undergone, or plan to undergo, major surgery where you will be immobilised

 
Extra precaution should be taken if: 

• You have a family history of breast cancer 
• You smoke or have recently stopped smoking
• You are overweight or obese
• You have a family history of blood clots 
• You have gallbladder disease 
• You have unexplained vaginal bleeding 
• You have high cholesterol or triglycerides 
• You have diabetes 
• You have depression 
• You have inflammatory bowel disease 
• You have epilepsy 
• You have systemic lupus erythematosus 
• You have a condition which first appeared during pregnancy or previous hormonal contraceptive use 
• You have hepatitis
• You have ever had chloasma 
• You have angioedema 
• You have sickle cell anaemia 

Talk to your doctor before using Levest if you have any underlying health conditions to make sure it is safe for you to take.

Drug Interactions

There are certain medications which can interfere with the way Levest works. These include: 

• Epilepsy medications 
• Hepatitis C medications 
• HIV medications 
• Griseofulvin 
• Rifabutin 
• Rifampicin 
• St John's wort

Tell your doctor if you are taking any of these medications as Levest may not be suitable for you.

Levest vs the mini pill

The mini pill differs from the combined pill, such as Levest, as it only contains a progestogen rather than the oestrogen and progestogen combination. The mini pill is safe to take for most women, including those with health conditions. It does not pose the same risk of blood clots but it can still affect your mood and cause nausea, headaches and acne. The mini pill is taken continuously throughout the month and cannot be used to delay your period.

Alternatives to Levest

There are other types of the combined pill which contain the same hormonal components. These are Microgynon 30, Ovranette and Rigevidon which are also available from Dr Felix, alongside all types of the pill available in the UK. The vaginal ring or patch also work in the same way as the combined pill. Long term methods of contraception include the implant, injection, IUD and IUS.

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