Description
How it Works (Mechanism of Action)
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Suppresses ovulation partly.
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Lowers estrogen levels locally in endometrial tissue.
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Causes endometrial thinning, reducing bleeding and pain.
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Has anti-inflammatory effects in endometriotic lesions.
Dosage
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Endometriosis: 2 mg once daily, continuous (no pill-free break).
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Take at the same time daily, with or without food.
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Missed dose: Take within 12 hours; if >12 hrs, skip and continue next dose (don’t double).
Common Side Effects (mild to moderate)
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Menstrual changes: irregular bleeding, spotting, lighter or missed periods.
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Headache or migraine.
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Breast discomfort or tenderness.
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Mood changes (irritability, low mood, depression in some).
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Weight changes (slight gain or loss).
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Acne / oily skin in some cases.
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Nausea, abdominal bloating, or stomach upset.
Serious (Less Common) Side Effects ⚠️
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Severe mood depression or anxiety.
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Increased risk of blood clots (DVT, pulmonary embolism) (rare, less than estrogen pills).
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Vision disturbances or severe headache (possible migraine with aura).
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Liver problems: yellowing of skin/eyes (jaundice), dark urine.
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Allergic reactions (rash, itching, swelling).
Precautions & Contraindications
🚫 Avoid or use with caution if:
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Pregnant or planning pregnancy (not for use in pregnancy).
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Breastfeeding (limited data, avoid unless prescribed).
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History of thrombosis (blood clots), stroke, or heart disease.
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Severe liver disease or liver tumors.
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Unexplained vaginal bleeding.
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Hormone-sensitive cancers (like breast cancer).
👉 Always check blood pressure, liver function, and clotting history before starting.
Drug Interactions
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Rifampicin, phenytoin, carbamazepine, and other enzyme-inducing drugs may reduce effectiveness.
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Herbal supplements like St. John’s Wort can reduce hormone levels.
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Alcohol has no direct interaction but may affect liver metabolism.
Pregnancy & Fertility
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Not used in pregnancy.
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Fertility returns quickly after stopping (unlike some long-acting hormonal options).
Lifestyle Advice
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Take daily at the same time.
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Maintain healthy diet & exercise to manage weight changes.
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Track mood changes and discuss with doctor if persistent.
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Avoid smoking, especially if over 35 years (clot risk).
Reviews
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