Evaluna

Evaluna is a combined low-dose pill containing the progestin levonorgestrel and the estrogen ethinylestradiol. The pill belongs to the so-called 2nd-generation pills and contains a very low estrogen dose of 0.02 mg as Evaluna 20 and a low estrogen dose of 0.03 mg as Evaluna 30.

Levonorgestrel is one of the longest-used progestins. It is considered particularly safe and has a lower risk of thrombosis compared with newer progestins.

When taken correctly, Evaluna offers a Pearl Index of 0.1 to 0.9.

Evaluna works through the combined action of levonorgestrel and ethinylestradiol:

Suppression of ovulation: The hormones inhibit the release of the gonadotropins FSH and LH from the pituitary gland, so that no ovulation takes place.

Thickening of the cervical mucus: The progestin levonorgestrel makes the mucus at the cervix thicker and less permeable to sperm.

Changes to the endometrium: The lining of the uterus builds up less, which would make implantation of an egg more difficult.

The effect is only guaranteed if the pill is taken daily.

Evaluna is particularly suitable for:

• Women looking for well-tolerated contraception with a low risk of thrombosis
• First-time pill users
• Women who are sensitive to higher estrogen doses
• Women without an increased risk of thrombosis

Pills containing levonorgestrel have the lowest risk of thrombosis among combined pills.

Evaluna 20:

• 0.02 mg ethinylestradiol
• 0.1 mg levonorgestrel
• Monophasic preparation (all tablets contain the same dose)
• 21 tablets per blister pack

Evaluna 30:

• 0.03 mg ethinylestradiol
• 0.15 mg levonorgestrel
• 21 tablets per blister pack

The number indicates the amount of estrogen in micrograms.

Daily use:

• One tablet daily, ideally at the same time each day
• Swallow with a little water
• Take for 21 days, then a 7-day break

Starting the pill:

• Ideally start on the 1st day of your period
• Protection then begins immediately

Missed tablet:

• Take it within 12 hours – no problem
• After more than 12 hours, protection may be reduced. What to do next depends on the week of use:
• Week 1: take the last missed tablet immediately, even if this means taking two tablets at the same time, and take the remaining tablets at the usual time. Use a condom as additional contraception for the next 7 days. If sexual intercourse took place in the previous 7 days, the possibility of pregnancy should be considered.
• Week 2: take the missed tablet as in week 1. If the tablets were taken correctly on the 7 days before the first missed tablet, no additional protection is needed. Otherwise, or if more than 1 tablet was missed, use a condom as additional contraception for 7 days.
• Week 3: if the tablets were taken correctly on the 7 days before the first missed tablet, no additional protection is needed as long as one of two options is followed. Either take the missed tablet as in week 1 and start the next blister pack straight away without a tablet-free break. Or stop taking the tablets from the started blister pack, take a 7-day break, counting the days on which tablets were missed, and then start a new blister pack. Otherwise, take the missed tablet as in week 1, start the next blister pack without a break and use a condom as additional contraception for 7 days.
• If several tablets were missed and no bleeding occurs in the following tablet-free break, the possibility of pregnancy must be considered.

Evaluna is contraindicated in:

• Thrombosis or thromboembolism (current or in the past)
• Known thrombophilia
• Heart attack or stroke
• Breast cancer or hormone-dependent tumors
• Severe liver disease or liver tumors
• Unexplained vaginal bleeding
• Pregnancy
• Smokers over 35 years of age
• Migraine with aura
• Severe or poorly controlled high blood pressure

Common:

• Headache
• Breast tenderness
• Nausea
• Mood changes
• Breakthrough bleeding (especially at the beginning)
• Weight gain

Uncommon:

• Changes in libido
• Skin changes

Rare but serious:

• Venous thrombosis
• Arterial thrombosis

The risk of thrombosis is lower with levonorgestrel pills than with pills containing newer progestins.