Gederal (ethinylestradiol, desogestrel) is a combined hormonal contraceptive, predominantly used to prevent pregnancy. This product and similar products are often referred to as the pill, and the vast majority are taken similarly.

Though not as common, Gederal is sometimes taken to prevent other issues; it can alleviate menopause symptoms and can help treat acne, premenstrual symptoms, ovarian cysts, and numerous other conditions. Women taking Gederal for any reason should be aware that this product will interfere with conception of a child. Gederal should not be taken for any reason while pregnant.

Why Combined Contraceptives?

Combined hormonal contraceptives all contain two female hormones: an estrogen (ethinylestradiol in Gederal) and a progestogen (desogestrel in Gederal). While there are many choices regarding which estrogen and progestogen are used, that one of each is taken is important in reducing the patient's risk of developing uterine cancer, assuming the patient has an intact uterus. This is true even when estrogen supplements are taken to alleviate menopausal symptoms.

Women who have had their uterus removed, or men who are taking estrogen supplements, do not need to worry about taking a progestogen along with estrogen. These patients may utilize estrogen-only treatments.

Taking Gederal for Birth Control

Gederal comes in strips of tablets. Each strip contains 21 pills, and if taking as a contraceptive one tablet should be taken per day until gone. After taking 21 tablets, the following 7 days no tablets are consumed. Menstruation should occur during these 7 days. After 7 days of no tablets a new strip of 21 tablets should be started, even if still menstruating.

Tablets can be taken regardless of food or fluid, though many patients do prefer a drink when swallowing a pill. Gastrointestinal side effects, if experienced, may be alleviated if tablets are taken with food.

Consistency is critical with all oral contraceptives. In the interest of preventing pregnancy no more than a single tablet can be missed from a 21-tablet strip of Gederal, and even then the missed tablet must be taken no later than when the next scheduled tablet is due. Tablets are also best taken at the same time each day, both to help the patient remember and also to keep levels of the hormone consistent in the body. Women who live chaotic lifestyles that make consistent pill-taking difficult may prefer other contraceptive methods, such as IUDs or vaginal rings.

If Gederal is the first contraceptive taken:

• Take the first Gederal tablet on the first day of menstruation.
• Continue taking a single tablet for 21 days, until the strip is empty.
• After 21 days, do not take any tablets for 7 days. Menstruation should occur during this week.
• After 7 days of no tablets, begin a new strip of 21 Gederal tablets. Do so even if still menstruating.

When to start taking tablets can vary to some degree if switching from another birth control method, including other combined hormonal tablets, patches, IUDs, and so forth. Starting Gederal is also a little more complicated following a miscarriage or birth of a child. Speak with a doctor as to the best time to start the medication in these scenarios.

Some women will experience some menstrual irregularities for the first month or two when starting or switching birth control methods, including lighter or heavier periods, absent periods, spotting, and so forth. These are not concerning unless severe or persistant beyond the first couple of months.

Menopause & Other Uses

Gederal can be effective at mitigating disruptive symptoms of menopause, such as hot flashes, difficulty sleeping, vaginal atrophy, and so forth. These symptoms are caused by a sharp reduction in estrogen in the body; the estrogen in Gederal helps supplement it when natural production declines. The progestogen in Gederal helps prevent uterine cancer.

For menopause symptoms treatment is typically (though not always) similar to when the medication is used as a contraceptive.

For other conditions treatment can be much more varied, ranging from every day to a few days per month. While Gederal can be tremendously beneficial in treatment, patients are advised to find a doctor or organization familiar with using it for a given circumstance before starting treatment.

Potential Side Effects

Most women experience only mild side effects from Gederal. However, some individuals are at significantly greater risk of experiencing complications from using this medication. Do not take Gederal without explicit doctor instruction if there is a history of:

• Blood clots
• Liver impairment
• Hypertension (high blood pressure)
• Diabetes
• Migraines, especially with aura
• Epilepsy
• High cholesterol
• Family history of breast cancer
• Family history of heart problems
• Family history of circulation problems

Additional risk factors that can contribute to serious side effects include being older than age 35, being overweight or obese, and being a smoker. Some of the more serious side effects associated with this medication can be fatal if ignored. All patients are encouraged to read the insert that comes with each package of Gederal, which contains more detailed side effect descriptions.

Otherwise healthy patients typically experience occasional side effects that are usually mild and transient, meaning they fade away as the body adjusts to treatment. Most commonly reported are:

• Lightheadedness
• Headache
• Increased blood pressure
• Breast tenderness
• Mood swings
• Libido changes
• Fluid retention (edema)
• Abdominal upset

The above are not cause for concern unless severe or persistent. Speak with a doctor if concerned; a dosage adjustment may help. Alternatively there are many very similar medications with different active ingredients that can be tried.

Always double-check with a doctor or pharmacist before mixing other medications with Gederal. Over-the-counter treatments, like St. John's wort, as well as prescription medications, like antibiotics, can reduce Gederal's effectiveness while taken. Gederal can also reduce the effectiveness of other medications, and it may be in the patient's best interest to stop taking Gederal for a while.

Be sure that dentists or doctors are informed that Gederal is being taken prior to undergoing any kind of surgery.