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Desogestrel (Progestogen Only Pill) 💊
💊 Desogestrel is a progestogen-only pill used for contraception. It mainly thickens cervical mucus and thins the endometrium, but unlike older POPs, desogestrel also reliably inhibits ovulation ✅. Always check the BNF for the latest guidance.
⚙️ Mode of Action
- 🧬 Progestogen → thickens cervical mucus → blocks sperm entry.
- 📉 Alters endometrium → less suitable for implantation.
- 🚫 Suppresses ovulation (in most cycles, unlike older POPs).
📋 Indications / Dose
- 👩 Contraception in women of childbearing potential.
- 💊 Dose: 75 micrograms once daily, at the same time each day.
- ➡️ Start on day 1 of cycle; taken continuously (no pill-free break).
- ⏰ >12-hour delay = “missed pill” → reduced contraceptive cover.
🔗 Interactions
- See BNF for full list (notably enzyme-inducing drugs ⚠️).
⚠️ Cautions
- History of thromboembolism 🩸
- Hypertension, diabetes mellitus, migraine
🚫 Contraindications
- Acute porphyria
- Breast cancer 🎗️
- Severe arterial disease
- Undiagnosed vaginal bleeding 🚨
💊 Side Effects
- Irregular bleeding / amenorrhoea
- Breast tenderness, headaches 🤕
- Mood changes, acne
- Rare: thromboembolic events ⚠️
💡 Clinical Pearl:
POP “missed pill” window = 12 hours ⏰.
If >12 h late, advise immediate pill + barrier contraception for 48 h.
(COC window = 24 h).
📚 Case Example
👩 A 25-year-old woman on desogestrel 75 mcg presents after missing her pill by 15 hours. ➡️ Advice: Take pill immediately, continue regular dosing, and use condoms for 48 h. She is reassured that if she had been <12 h late, no extra precautions would be needed. ✅
🔗 References
- BNF: Desogestrel
- Faculty of Sexual & Reproductive Healthcare (FSRH) Guidelines
- Patient.info – Progestogen-Only Contraceptive Pill
📅 Revisions
- Last updated: Check BNF for latest dosing and safety guidance.
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