By Dr. Jeannie Hilton, DO, OB-GYN
Medically Reviewed by Alexandra Dubinskaya, MD, FACOG, NCMP, IF
Last Update: January 29, 2025
What is Levlen?
Levlen is a combination birth control pill that contains ethinylestradiol and levonorgestrel, two hormones that work together to prevent pregnancy. It stops ovulation, thickens cervical mucus to block sperm, and alters the uterine lining to make implantation less likely. Taken once daily, this pill is a popular choice for those looking for a reliable contraceptive that also helps regulate menstrual cycles and may reduce period discomfort.
For best results, it’s important to take the pill at the same time every day without missing a dose. Consistency ensures maximum effectiveness in preventing pregnancy. If you’re considering this contraceptive, a healthcare provider can help determine if it’s the right option based on your individual health needs and lifestyle.
FAQ
What type of pill is Levlen?
Levlen is a combination birth control pill that contains ethinylestradiol and levonorgestrel, two hormones that work together to prevent pregnancy. It is classified as a monophasic pill, meaning each active tablet delivers the same hormone dose throughout the cycle. This consistency helps maintain steady hormone levels, making it a reliable contraceptive option. As an oral contraceptive, the tablet is taken once daily to effectively prevent ovulation, thicken cervical mucus, and alter the uterine lining. Following a regular schedule is key to maintaining its effectiveness.
How does it work?
Levlen works by preventing ovulation, meaning your ovaries don’t release an egg each month. Without an egg, pregnancy cannot happen. It also thickens cervical mucus, making it harder for sperm to reach an egg, and changes the uterine lining so a fertilized egg cannot attach.
To be effective, the pill must be taken at the same time every day. Missing pills or taking them late can lower protection. When used correctly, it is a highly reliable birth control method.
Can the pill help with anxiety?
Yes! Some research suggests that birth control pills containing ethinylestradiol and levonorgestrel may help stabilize mood and reduce anxiety symptoms in some users. A study found that 60% of women using oral contraceptives reported improved mood stability, while only 7.4% experienced increased anxiety. The pill helps regulate hormonal fluctuations, which can contribute to mood swings and anxiety. However, individual responses vary, and some may be more sensitive to hormonal changes.
How effective is Levlen?
This birth control is over 99% effective with perfect use, meaning it is taken at the same time every day without missing a dose. With typical use, which includes occasional missed pills, its effectiveness drops to around 91%. Studies confirm that combination birth control pills like this one are among the most reliable contraceptive options, significantly reducing the risk of unintended pregnancy.
According to birth control reviews, Levlen has an average rating of 3.8 out of 10 on Drugs.com, based on 105 user reviews, with 24% reporting a positive experience. When rated specifically for birth control effectiveness, it holds an average score of 3.5 out of 10 from 75 reviews, with 21% of users giving positive feedback. While experiences vary, many users find this low-dose contraceptive to be a dependable option when taken consistently. For the best results, following a strict daily schedule is essential.
Does it cause weight gain?
Levlen does not cause significant weight gain in most users. Studies show that the average weight change is less than 2 kg (4.4 lbs) over 6 to 12 months, with no clear link between the pill and long-term weight gain. Research suggests that any slight changes are usually due to water retention, lifestyle, or natural body fluctuations, rather than fat gain.
If weight gain occurs, it is typically temporary and varies by individual. Maintaining a balanced diet and regular exercise can help manage any changes. If you have concerns about weight while using this pregnancy prevention pill, consult a healthcare provider for personalized guidance.
What are the side effects?
Levlen (ethinylestradiol and levonorgestrel), like other combination birth control pills, may cause side effects in some users. Commonly reported side effects include:
- Nausea and vomiting – Experienced by up to 11% of users.
- Headaches – Reported by approximately 33% of users.
- Irregular or heavy uterine bleeding – Occurs in up to 17% of users.
- Breast pain – Reported by up to 11.2% of users.
- Painful periods (dysmenorrhea) – Experienced by up to 11% of users.
- Weight changes – Some users may experience weight gain.
- Mood changes, including depression – Reported by some users.
These side effects are generally mild and often diminish as the body adjusts to the medication. If any symptoms persist or become bothersome, consulting a healthcare provider is recommended.
How do I use Levlen 28?
To use this estrogen-progestin pill correctly, follow these simple steps to ensure maximum effectiveness:
- Start your pack – Take the first active pill on the first day of your period or on the first Sunday after your period starts.
- Take one pill daily – Swallow one pill at the same time every day without skipping. Follow the arrows on the pack.
- Complete the pack – Take all 21 active pills (white or beige), then take the 7 inactive pills (sugar pills) to maintain your routine. Your period should start during the inactive pill days.
- Start a new pack immediately – Once you finish the 7 inactive pills, begin a new pack the next day, even if your period hasn’t ended.
- If you miss a pill – Take it as soon as you remember. If you miss two or more active pills, follow the instructions in the leaflet and use backup contraception (e.g., condoms) for 7 days.
- Use backup protection if needed – If you vomit or have diarrhea within 3 hours of taking a pill, take another one and use extra contraception if necessary.
For best results, take the pill at the same time every day and don’t skip doses.
How much estrogen is in this medication?
Levlen contains 30 micrograms (mcg) of ethinylestradiol, a synthetic estrogen that helps regulate the menstrual cycle and prevent ovulation. This low-dose estrogen level is commonly used in birth control pills to balance effectiveness with a lower risk of hormone-related side effects. Compared to higher-dose pills, this pill may have a lower chance of estrogen-related symptoms like nausea and fluid retention while still providing reliable contraception.
Does this pill increase breast size?
Levlen, like other combination birth control pills, contains hormones that may cause a temporary increase in breast size due to fluid retention and hormonal changes. Studies show that up to 20% of users report mild breast swelling, especially in the first few months of use, but this effect typically subsides over time as the body adjusts.
This change is not due to actual tissue growth and is usually not permanent. Maintaining a consistent pill schedule can help minimize hormone fluctuations, reducing temporary breast swelling. If breast tenderness or swelling persists beyond a few months, adjusting lifestyle factors like hydration and diet may help manage symptoms.
What are the pros and cons of Levlen?
This combination oral contraceptive has several benefits, but like any medication, it also has potential drawbacks. Here’s a quick comparison:
Pros | Cons |
---|---|
Over 99% effective with perfect use | 91% effective with typical use (missed pills reduce effectiveness) |
Regulates menstrual cycles and may make periods more predictable | May cause breakthrough bleeding in the first few months |
Can help reduce period pain and cramps | Some users report headaches or nausea |
May improve acne for some users | Can cause breast tenderness or mild swelling |
Convenient once-daily pill | Must be taken at the same time every day for best results |
Lower estrogen dose may reduce hormone-related side effects | Not suitable for smokers over 35 years due to blood clot risk |
May help reduce risk of ovarian and endometrial cancer | Does not protect against sexually transmitted infections (STIs) |
Most users find this combined pill to be a reliable and well-tolerated birth control option. Side effects are usually mild and temporary, improving as the body adjusts.
Is this pill good for acne?
What to avoid while on these pills?
To ensure this estrogen-progestin pill works effectively and to minimize side effects, avoid the following:
- Skipping pills – Missing doses lowers effectiveness and increases the risk of pregnancy. Take your pill at the same time every day.
- Smoking – Increases the risk of blood clots, stroke, and heart issues, especially for those over 35.
- Certain medications – Antibiotics like rifampin, anticonvulsants, and some antifungals may reduce effectiveness. Always check with your doctor before starting new medications.
- Grapefruit and grapefruit juice – May increase hormone levels in your blood, leading to a higher chance of side effects.
- St. John’s Wort – This herbal supplement can lower the contraceptive’s effectiveness, increasing the risk of pregnancy.
- Vomiting or severe diarrhea – Can reduce absorption of the pill. Use backup contraception if you experience these symptoms within 3 hours of taking a pill.
Following these precautions helps ensure this oral birth control remains effective while reducing potential risks.
Can this pill cause infertility?
Levlen, like other combination birth control pills, does not cause infertility. Research indicates that fertility typically returns to normal shortly after discontinuing the pill. A study involving 3,727 women found no evidence that long-term oral contraceptive use adversely affects pregnancy rates.
While some individuals may experience a temporary delay in conception after stopping this daily contraceptive, this is usually short-term and does not impact long-term fertility. Factors such as age and overall health play more significant roles in fertility than prior use of birth control pills.
What happens when you stop taking the pills?
When you stop taking Levlen, your body will return to its natural hormone cycle, and ovulation can resume within 1 to 3 months. Most users regain normal fertility quickly, with studies showing that 80% of women conceive within a year after stopping the pill.
Your menstrual cycle may take time to regulate, and some may experience temporary irregular periods. Any side effects caused by the pill, like breast tenderness or mild water retention, should subside. If your period doesn’t return within 3 months, consult a healthcare provider to rule out underlying conditions.
Can you skip your period twice in a row on Levlen?
Yes, you can skip your period twice in a row on this contraceptive tablet by continuing to take the active pills from a new pack instead of the inactive pills. This method is safe for most users and is commonly used to delay or stop periods temporarily.
Studies show that extended-cycle pill use is effective and does not harm fertility. Some users may experience breakthrough bleeding or spotting, but this usually decreases over time. If you plan to skip your period regularly, consult a healthcare provider to ensure it’s the right option for you.
About the Author
Dr. Jeannie Hilton, DO, is a highly experienced OB-GYN committed to providing comprehensive, patient-centered care tailored to women’s unique health needs. She has practiced at esteemed institutions like Complete Women’s Care of Naples and Virginia Beach Obstetrics and Gynecology, where she emphasizes a supportive environment that empowers women to make informed health decisions. Dr. Hilton earned her Doctor of Osteopathic Medicine from the Philadelphia College of Osteopathic Medicine, where she was recognized for her leadership and academic excellence. She completed her Obstetrics and Gynecology residency through Coastal AHEC/UNC, gaining expertise in all aspects of women’s health. With additional training in osteopathic techniques and a strong foundation from Pennsylvania State University, she integrates holistic, evidence-based approaches to ensure optimal outcomes. Throughout her career, Dr. Hilton has remained a dedicated advocate for women’s health, blending compassion with clinical excellence.
Disclaimer: This information is provided for general knowledge and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Always seek guidance from a qualified healthcare provider regarding any medical concerns or conditions. In case of an emergency, contact local emergency services immediately. Your use of this content is voluntary, and any decisions made based on it are solely your responsibility.