From the Guidelines
Some birth control pills that contain levonorgestrel include Alesse, Aviane, Lessina, Levlen, Levora, Lutera, Nordette, Portia, Seasonale, and Seasonique. These medications are combination oral contraceptives that typically contain both levonorgestrel (a progestin) and ethinyl estradiol (an estrogen) 1. They work by preventing ovulation, thickening cervical mucus to block sperm, and thinning the uterine lining to prevent implantation. The standard dosing regimen involves taking one pill daily for 21 days followed by 7 days of placebo pills or no pills (during which withdrawal bleeding occurs), though extended-cycle formulations like Seasonale allow for fewer periods per year.
Key Points to Consider
- Effectiveness depends on consistent use, with perfect use resulting in over 99% effectiveness 1.
- Common side effects may include nausea, breast tenderness, headaches, and spotting between periods.
- These pills require a prescription from a healthcare provider who can help determine the most appropriate option based on individual health factors and needs.
- It is recommended to start adolescents on a monophasic pill with monthly bleeding and then change regimens and/or extend cycles, as indicated, to address patient adverse effects or preference 1.
- Many experts recommend starting adolescents on a COC containing 30 to 35 μg of ethinyl estradiol and a progestin, such as levonorgestrel or norgestimate 1.
Important Considerations for Use
- Patients should be counseled that a backup method (ie, condoms or abstinence) should be used for at least the first 7 days for contraceptive efficacy and that a condom should be used at all times for protection against STIs 1.
- A routine follow-up visit 1 to 3 months after initiating COCs is useful for addressing adverse effects or adherence issues 1.
- COCs have few contraindications in healthy female adolescents, but they should not be prescribed for patients with severe and uncontrolled hypertension, ongoing hepatic dysfunction, complicated valvular heart disease, migraines with aura or focal neurologic symptoms, thromboembolism or thrombophilia, complications of diabetes, and complicated solid organ transplantation 1.
From the FDA Drug Label
Enpresse® (levonorgestrel and ethinyl estradiol tablets USP – triphasic regimen), are available in packages of six cyclic dispensers. The names of some BCP that contains levonorgestrel include:
- Enpresse 2
From the Research
Birth Control Pills Containing Levonorgestrel
- Alesse is a low-dose monophasic combination oral contraceptive that contains 100 microg levonorgestrel and 20 microg ethinyl estradiol 3, 4
- Low-dose ethinylestradiol/levonorgestrel 20 microg/100 microg is another combined oral contraceptive that prevents pregnancy primarily by inhibiting ovulation 5
Key Characteristics of These Pills
- The Pearl index (pregnancies per 100 woman-years of use) with ethinylestradiol/levonorgestrel 20 microg/100 microg was 0.88 3, 5
- The cumulative pregnancy rate was 1.9% at the end of a 3-year open-label trial 3, 5
- These pills are well tolerated, with adverse events commonly associated with combined oral contraceptives, such as headache and metrorrhagia 3, 4, 5