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Alesse 21/28 Review

Alesse is a monophasic hormonal birth control preparation. It contains ethinyl estradiol and levonorgestrel. This birth control drug is applied for an unwanted pregnancy prevention. It should be taken considering doctor’s recommendations.



  • Contraception;
  • Hormone-dependent functional disorders of the menstrual cycle (including dysmenorrhea, menorrhagia without an organic cause, premenstrual syndrome).

Mechanism of action

Alesse is a contraceptive combined estrogen-gestagen drug. When taken, it inhibits the pituitary secretion of gonadotropic hormones. The contraceptive effect is implied due to several mechanisms. As a progestin component, Alesse contains a 19-nortestosterone derivative – levonorgestrel. It excels progesterone in the activity of the corpus luteum hormone and acts at the receptor level without preliminary metabolic transformations. Ethinyl estradiol is estrogen component. Under the influence of levonorgestrel, there is a blockade of the release of releasing factors (LH and FSH) of the hypothalamus. It also provides the suppression of pituitary secretion of gonadotropic hormones. It contributes to the inhibition of maturation and the release of an egg ready for fertilization (ovulation). The contraceptive effect is enhanced by ethinyl estradiol. It maintains a high viscosity of cervical mucus. When taken these nirth control pills regularly, it normalizes the menstrual cycle and helps to prevent the development of a number of gynecological diseases, including tumor nature.

Mode of application and dosage

Oral administration. 1 tablet of Alesse 1 time per day, starting from 1 or 5 days of the menstrual cycle (depending on the type of drug used: monophasic, 2- or 3-phase) for 21 days. Then a 7-day break is followed.

Alesse 28 is taken without any breaks. The latest seven pills contain placebo having no effect on female health. These 7 pills are colored in white.


  • Hypersensitivity;
  • Liver failure, liver tumors;
  • Congenital hyperbilirubinemia;
  • Malignant tumors (primarily breast cancer or endometrium);
  • The presence in the history of severe cardiovascular and cerebrovascular diseases, thromboembolism and predisposition to them (ischemic or hemorrhagic stroke, widespread atherosclerosis, myocarditis, decompensated heart failure, heart defects, severe forms of arterial hypertension);
  • Severe diabetes mellitus;
  • Sickle cell anemia, chronic hemolytic anemia, vaginal bleeding of unknown etiology, migraine;
  • Otosclerosis;
  • Cystic mole;
  • Otosclerosis with hearing impairment, idiopathic jaundice or itching during a previous pregnancy;
  • Congenital hyperlipidemia;
  • Age over 40 years.

Take Alesse birth control carefully in the following cases:

  • diseases of the liver and gall bladder;
  • epilepsy;
  • depression;
  • ulcerative colitis;
  • uterine fibroids;
  • mastopathy;
  • tuberculosis;
  • kidney disease;
  • adolescence (without regular ovulatory cycles).

Side effects

Alesse may cause the following side effects:

  • nausea;
  • vomiting;
  • headache;
  • tenderness of the mammary glands;
  • weight gain;
  • decreased libido and mood;
  • voice hoarseness;
  • intermenstrual bleeding;
  • eyelid edema;
  • conjunctivitis;
  • visual impairment;
  • discomfort when wearing contact lenses.

With prolonged use, the following side effects may be found:

  • chloasma;
  • hearing loss;
  • itching;
  • jaundice;
  • calf muscle cramps;
  • hypertriglyceridemia;
  • hyperglycemia;
  • decreased glucose tolerance;
  • increased blood pressure;
  • thrombosis and venous thromboembolism;
  • skin rashes;
  • changes in the nature of vaginal secretion;
  • vaginal candidiasis;
  • increased fatigue;
  • diarrhea.


Barbiturates, some antiepileptic drugs (carbamazepine, phenytoin), sulfonamides, pyrazolone derivatives can enhance the metabolism of the steroid hormones that are a part of this birth control drug.

A decrease in contraceptive effectiveness can also be found with the simultaneous administration with certain antimicrobial drugs (ampicillin, rifampicin, chloramphenicol, neomycin, polymyxin B, sulfanilamides, tetracyclines), which is associated with a change in intestinal microflora.

When taking gestagen-estrogenic drugs, it may be necessary to adjust the dosage regimen of hypoglycemic drugs and indirect anticoagulants.

What if I miss a dose?

The missed pill should be taken within the next 12 hours. If 36 hours have passed since the last pill was taken, then contraception is unreliable. In order to avoid intermenstrual bleeding, the drug should be continued with the exception of the missed tablet. In cases of missing tablets, it is recommended to additionally use another non-hormonal method of contraception (for example, barrier).

Alesse and pregnancy

Alesse is contraindicated in pregnancy and lactation (breastfeeding).

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