Hana

What are Hana Pills?

Hana is one of the first contraceptive pills to be available over the counter without a prescription from a clinician. However, a clinician or pharmacist will still need to assess if it is safe and suitable for you by asking you some questions about your health. Hana contains one active ingredient, desogestrel, a synthetic progestogen, making it a progestogen-only or mini pill.  Each pill contains 75 micrograms (mcg) of desogestrel, and when it is taken correctly, it is more than 99% effective at preventing pregnancy.

Because Hana does not contain oestrogen, it may be a good option for women who may not be able to use the combined pill, perhaps because they have high blood pressure or are over 35 and smoke or would prefer not to take a synthetic oestrogen.

The Importance of Easy Access to Contraception

Making effective contraception easier to access can help more people find a method that works for them and use it consistently. The introduction of over-the-counter progestogen-only pills, such as Hana, gives women in the UK another way to access reliable contraception without needing a prescription.

To illustrate this point, a 2020 study found that women who received an over-the-counter mini pill, like Hana, alongside emergency contraception and rapid access to a sexual health clinic were 20% more likely to be using effective contraception 4 months later than those given emergency contraception only. This suggests that it could prevent unintended pregnancy following the use of emergency contraception, like the morning-after pill.

By allowing women to obtain a progestogen-only pill over the counter, Hana can help make contraception more convenient and accessible. The fact that you can buy the medication online from reputable pharmacies such as Prescription Doctor and have it delivered directly to your door adds to the convenience. All of this may support continued contraceptive use and contribute to reducing the number of unintended pregnancies.

How Does the Hana Contraceptive Pill Work?

Hana birth control pills contain the active ingredient desogestrel, a synthetic progestogen that works to prevent pregnancy in 3 ways:

• Stopping your ovaries from releasing an egg (ovulation)
• Thickening the cervical mucus to make it difficult for sperm to reach an egg
• Thinning the womb lining so that a fertilised egg cannot attach itself to it

The Hana pill will not protect you against sexually transmitted infections (STIs), it is only designed to stop you from getting pregnant. The most effective way to protect you and your partner from STIs such as chlamydia and gonorrhoea is to use a condom every time you engage in sexual activity.

How Long Does the Hana Pill Take to Work?

Hana starts to work immediately if you start taking it on day 1 of your period. If you start taking it at any other time during your menstrual cycle, you will need to use condoms for 7 days until Hana becomes effective.

How Effective is the Hana Pill?

When taken perfectly, Hana is more than 99% effective at preventing pregnancy. However, when typical use is considered, which includes factors such as forgetting to take your pill or being sick or having severe diarrhoea, it is closer to being 91% effective. In reality, this means that every year 9 in 100 Hana users will get pregnant.

One study comparing the effectiveness of a 75 mcg desogestrel mini pill with a 30 mcg levonorgestrel equivalent found that, over a year, one in 727 women became pregnant in the desogestrel group, compared with three in 257 in the levonorgestrel group. This demonstrates that, when taken correctly, Hana is over 99% effective.

How to Take Hana Pills

Hana pills should be taken once daily at the same time every day. This ensures that each pill is taken 24 hours apart. Each strip contains 28 pills, and you should swallow each pill whole with a glass of water if needed.

To take Hana, you should:

1. Start the Hana strip by taking a pill from the top row. Choose a pill that corresponds to the correct day of the week. So, if today is Monday, take the pill from the top row marked ‘MON’.
2. Take one pill every day, at the same time each day, following the direction of the arrows, until you have finished the strip.
3. When you have taken all the pills in the current strip, start a new strip of Hana pills the next day without having a break or waiting for a bleed.

You may experience some vaginal bleeding while taking Hana, especially when you first start taking it. If you do, you should keep taking Hana as normal without stopping. If you are concerned about vaginal bleeding, speak to your clinician for advice.

When to Start Taking Hana Contraception

If you have not used any hormonal contraception in the previous month, then you should start taking Hana on day 1 of your period. If you follow these instructions, you will be protected from pregnancy straight away and will not need to use any additional contraception.

If you start taking Hana on days 2 to 5 or any other time during your menstrual cycle, you will need to use an additional barrier contraception, like condoms, for the first 7 days of taking Hana.

How to Change From a Combined Pill

If you are switching to Hana from a combined pill and you have had a pill-free break, take your first Hana pill on the day after your break. If you have inactive pills in your current pack, take Hana the day after you have finished the inactive pills. In either case, you must use condoms for the first 7 days of taking Hana.

If you have not had a break or you have not yet started your inactive pills, start Hana the day after taking your last pill in the strip or the last active pill. If you are not sure which pills are active or inactive, a pharmacist can help. If you start Hana following these instructions, you do not need to use extra contraception and will be protected against pregnancy straight away.

How to Change From Another Mini Pill

You can switch from another mini pill to Hana on any day. Start taking Hana on the day after you stop your other pill. You will not need to use extra contraception.

How to Change From a Contraceptive Ring or Patch

If you are switching to Hana from a contraceptive ring or skin patch, you should use the following instructions:

• If you have had a break between removing the ring or patch, start Hana on the day after your break ends. You will need to use extra contraception, like condoms, for the 7 days of taking Hana.
• If you start Hana on the day your patch or ring is removed, so you do not have a patch or ring-free break, you do not need to use extra contraception and will be protected against pregnancy straight away.

Hana Missed Pill Guidance

If you forget to take the Hana contraceptive pill, what you should do will depend on when you should have taken the missed pill.

• Less than 12 hours ago: Take the delayed pill straight away and take the next pill as usual, even if that means taking two Hana pills on the same day. Your protection from pregnancy should not be affected.
• More than 12 hours ago: Take the most recently missed pill right away; do not try to make up for any more delayed tablets. You should then take your next pills as usual, even if that means taking two pills in one day. Condoms should be used for the next 7 days.

If you have missed one or more pills in the very first week of taking Hana and had sex in the week before missing the tablets, the risk of pregnancy is increased. You should speak to a clinician for advice, as you may need to use emergency contraception.

If your period is late after missing any pills or you think you might be pregnant, take a pregnancy test. If you are pregnant, you must stop taking Hana and see a doctor.

What If I Take Too Many Hana Tablets?

If you take more Hana pills than you should have, it is unlikely to cause you serious harm. However, you may experience side effects, such as feeling or being sick, and vaginal bleeding, especially in young girls. If you are concerned or you have any of these symptoms, contact a doctor or pharmacist for advice.

If You Vomit or Have Severe Diarrhoea

If you vomit within 3 to 4 hours of taking Hana, or you have severe diarrhoea, the active ingredient may not have been properly absorbed, and you may not be protected against pregnancy. If this happens, you should follow the missed pill guidance in the Patient Information Leaflet.

You should use an additional contraception method, such as condoms, for the duration of the illness and for the first 7 days of normal pill taking. If you are unsure about what to do, a doctor or pharmacist can help.

Hana Side Effects and Cautions

Before taking Hana, it is important that you understand the potential side effects and cautions associated with taking it, so you know what to expect.

Hana Contraceptive Pill Side Effects

Hana, like all medications, can cause side effects, although there is no guarantee you will get them. Most people find that side effects are temporary and mild, and usually improve within 3 months of starting Hana once their body has got used to desogestrel.
 

This is not an exhaustive list of Hana side effects. For this, you must read the patient information leaflet that comes with your medication, or view it online.

It is important to report any side effects you get while taking Hana, including any that aren’t listed, to your doctor, pharmacist or the Yellow Card Scheme, as this will help provide information about the safety of Hana.

Changes to Your Periods

When taking Hana, you are likely to experience changes to your period. These changes are usually normal, and you should continue taking Hana exactly as it is prescribed. Some of the changes you might notice are:

• Your periods may be less or more frequent, shorter or longer, lighter or heavier than before you started Hana.
• You may have spotting or bleeding between periods, which can range from a slight stain to a heavier bleed like a period that may require the use of a tampon or sanitary towel.
• Your periods stop completely.

If you experience any of the following changes, you should contact your doctor or family planning nurse, but continue to take Hana as usual, unless you are advised to stop taking it:

• Your period is different from what you would expect while taking Hana
• Your period is happening more frequently than you find acceptable
• Your period is unusually heavy
• You repeatedly have bleeding that is brought on by sex

Risk of Blood Clots

While taking Hana, there is a small increase in the risk of developing a blood clot (thrombosis). However, this risk is lower than it is with combined contraceptive pills. It's also important to remember that blood clots can occur in people who do not use hormonal contraception and during pregnancy.

If you have previously had a blood clot or have a family history of blood clots, you should tell your clinician during your consultation. This will help them assess whether Hana is a suitable contraceptive option for you.

Because progestogen-only pills carry a lower risk of blood clots than combined pills, they may be a more appropriate choice for people over the age of 35 who smoke. That said, smoking is associated with a range of serious health risks, so stopping smoking is strongly recommended. Our quit smoking service can help you find the most suitable treatment and support.

Breast Cancer Risk

Breast cancer is uncommon in women under the age of 40, but the likelihood of developing it increases with age. You should contact your doctor promptly if you notice any new breast lumps, changes in breast shape or size, skin changes, or unusual nipple discharge.

Women using any type of contraceptive pill have a slightly higher chance of being diagnosed with breast cancer compared with women of the same age who do not use hormonal contraception. For progestogen-only pills such as Hana, the risk is thought to be similar to that associated with combined contraceptive pills, although further research is needed to confirm this. However, when you stop taking the pill, within 10 years, your risk of getting breast cancer is the same as that of someone who has never taken the pill before.

The increase in risk appears to be linked more closely to a woman's age than to the length of time she has been taking the pill.

Hana Pills Warnings and Interactions

Despite Hana being an effective birth control method, it may not be suitable for everyone. It’s important to tell your clinician during your consultation about any health conditions you have or medications you are taking, so they can assess whether Hana is safe and suitable for you.

You should not take Hana if you:

• Have cancer that is affected by sex-steroid hormones, such as some types of breast cancer, ovarian cancer, or endometrial cancer
• Have a blood clot in the legs, lungs, or any other organs
• Have or have ever had jaundice (yellowing of the skin or whites of the eyes) or severe liver disease, and blood tests show your liver function has not yet returned to normal
• Have any unexplained vaginal bleeding between periods, or if you have bleeding repeatedly after sex
• Are allergic to desogestrel or any of the other ingredients listed in Hana
• Are pregnant or think you might be pregnant

If any of these apply to you, our clinicians may suggest an alternative contraception method. For example, a different mini pill or a combined contraceptive might be more suitable depending on your medical history. 

Precautions with Hana Contraceptives

Before taking Hana, tell the clinician if you have:

• Ever had cancer that is affected by progestogen hormones, such as certain types of breast, ovarian, or endometrial cancer
• Ever had a blood clot in your legs or lungs
• High blood pressure
• Diabetes
• Tuberculosis 
• Liver problems, including liver cancer
• Ever had chloasma

If any of these apply to you, you may still be able to take Hana, but your doctor may want to see you more often.

Hana Interactions

Some medications can make Hana less effective or potentially unsafe. You should tell the clinician about any medications you are taking, including prescription, over-the-counter, and herbal medications, before starting Hana.

Tell the clinician if you are taking any medications to treat:

• epilepsy (e.g. primidone, phenytoin, barbiturates, carbamazepine, oxcarbazepine, felbamate, topiramate, phenobarbital)
• tuberculosis (e.g. rifampicin, rifabutin)
• HIV infections (e.g. efavirenz)
• pulmonary arterial hypertension: high blood pressure in the blood vessels of the lungs (bosentan)
• depression (the herbal remedy St. John’s Wort)
• fungal infections (e.g. griseofulvin)

If you are taking any of these medicines for a short period, you can continue taking Hana, but you must use extra contraception, such as condoms, every time you have sex and until 28 days after stopping the last dose of the other medicine or herbal remedy.

If you are taking any of these medicines for long-term treatment of a condition, you must speak to your doctor for further advice.

You should also tell the clinician if you are taking medications to treat: 

• fungal infections (e.g. ketoconazole, itraconazole, fluconazole)
• certain bacterial infections (e.g. clarithromycin, erythromycin)
• high blood pressure, angina or certain abnormal heart rhythm (e.g. diltiazem)

Some medicines can affect the amount of Hana in your blood. Tell your clinician and use condoms if you are receiving treatments for:

• HIV infections (e.g. ritonavir, nelfinavir, nevirapine)
• hepatitis C virus infection (e.g. boceprevir, telaprevir)

Taking Hana With Emergency Contraceptives Containing Ulipristal Acetate

Speak to a clinician or pharmacist about restarting Hana after taking emergency contraception. This is because how you proceed will depend on the type of morning-after pill you have used.

If you have taken a morning-after pill containing ulipristal acetate, such as ellaOne, the combination of this with Hana can affect both medicines, which can increase the risk of pregnancy. If you have used an emergency contraceptive containing ulipristal acetate during your cycle, you must wait 5 days after taking it before taking Hana. 

You will also need to use condoms every time you have sex during the 5 days while you wait to start Hana and for the first 7 days of taking Hana. That means you must use condoms each time you have sex for 12 days after taking the morning-after pill.

If you have taken emergency contraception containing levonorgestrel, such as Levonelle, during your cycle, you can start or continue taking Hana the same day, but you must use additional contraception, such as condoms, every time you have sex for the next 7 days.

Pregnancy and Breastfeeding

You must not take Hana if you are pregnant or think you may be pregnant. Take a pregnancy test or speak to a doctor, pharmacist, or family planning nurse if your period is late after missing any pills or if you think you may be pregnant. If you become pregnant, stop taking Hana and see a doctor. 

Hana may be taken while you are breastfeeding, but you must speak to a doctor, nurse, or pharmacist first. The active ingredient in Hana, desogestrel, does not appear to affect breast milk production or quality. However, some people have reported a reduction in breast milk production while taking desogestrel. A small amount of the active ingredient may pass into your breast milk. If you are concerned, speak to a doctor or pharmacist for more advice.
 

Frequently Asked Questions About Hana Contraceptive Pills