What is the Hana pill?
Hana is a progestogen-only oral contraceptive, commonly known as the mini pill. It is distinct from the more widely known combined oral contraceptive pill because it contains only one type of synthetic female sex hormone, a progestogen called desogestrel. Unlike combined pills that contain both estrogen and progestogen, Hana is a single-hormone formulation. The tablets are taken daily, without any break between packs, to provide continuous contraceptive protection. The availability of Hana over the counter, without a doctor's prescription (in the UK), marked a significant shift in access to contraception. A consultation with a pharmacist is still required before purchase to ensure it is a safe and suitable option for the user.
How does the Hana pill work?
The active ingredient, desogestrel, works in two primary ways to prevent pregnancy, making it a highly effective contraceptive.
Inhibiting ovulation
The main mechanism of action for Hana is preventing the release of an egg from the ovaries each month. Desogestrel suppresses the surge of follicle-stimulating hormone (FSH) and luteinising hormone (LH) that is necessary to trigger ovulation. This makes it more effective at preventing ovulation than older, traditional mini pills.
Altering cervical mucus
Secondly, Hana works by thickening the cervical mucus. This makes it more difficult for sperm to pass through the cervix and enter the womb, creating an additional barrier to fertilisation.
Thinner womb lining
An additional mechanism is the thinning of the womb's lining (endometrium), making it less receptive to a fertilised egg should one manage to be released and fertilised.
How to take Hana
Hana is a daily pill taken at the same time each day without a break between packs. The pack contains 28 tablets, with the days of the week marked for guidance.
- For maximum effectiveness, take one tablet at the same time every day. Many people find it helpful to link it to a daily routine, like brushing their teeth or setting a daily alarm.
- If you miss a pill by less than 12 hours, take it as soon as you remember. Your contraceptive protection should not be reduced.
- If you are more than 12 hours late, take the most recently missed pill as soon as you remember and leave any earlier missed pills. You must use extra contraception (e.g., condoms) for the next 7 days. The risk of pregnancy is higher if you miss a pill in the first week and had sex in the week before.
- After vomiting or severe diarrhoea, if it occurs within 3-4 hours of taking Hana, the pill may not have been fully absorbed. You should treat it as a missed pill and follow the guidance above.
Hana vs. the combined pill: A comparison
| Feature | Hana (Progestogen-Only Pill) | Combined Pill (Estrogen & Progestogen) |
|---|---|---|
| Hormones | Contains only the progestogen desogestrel. | Contains both a synthetic progestogen and estrogen. |
| Mechanism | Inhibits ovulation and thickens cervical mucus. | Inhibits ovulation, thickens cervical mucus, and thins the uterine lining. |
| Missed Pill Window | A larger 12-hour window for missed pills, offering more flexibility. | A smaller 3-hour window for most traditional POPs. |
| Suitability | An option for those unable to take estrogen, such as women with high blood pressure, smokers over 35, or breastfeeding women. | Not suitable for individuals with certain medical conditions, older smokers, or those breastfeeding. |
| Bleeding Pattern | Can cause irregular periods, spotting, or no periods at all (amenorrhoea). | Typically leads to a more regular bleeding pattern (withdrawal bleed) during the placebo week. |
Potential side effects
Like all medications, Hana can cause side effects, though not everyone will experience them. For many, side effects are mild and may subside after the first few months as the body adjusts.
Common side effects (affecting up to 1 in 10 people):
- Mood changes or depressed mood
- Decreased sex drive (libido)
- Headaches
- Nausea
- Acne
- Breast pain or tenderness
- Weight changes
- Irregular periods, spotting, or no periods at all
Uncommon side effects (affecting up to 1 in 100 people):
- Vaginal infections
- Difficulty wearing contact lenses
- Hair loss
- Vomiting
- Ovarian cysts
- Tiredness
Serious side effects are rare but require immediate medical attention. These include signs of a severe allergic reaction (swelling of face, lips, tongue) or symptoms of a blood clot (severe leg pain, shortness of breath). If you experience persistent or severe side effects, it's essential to consult a healthcare professional.
Safety and contraindications
The UK's Medicines and Healthcare products Regulatory Agency (MHRA) reclassified Hana for over-the-counter sale after confirming its safety for most women following a pharmacist consultation. However, some individuals should not take Hana:
- Those with a history of breast cancer or other sex-steroid sensitive malignancies.
- Individuals with an active or a history of blood clots (venous thromboembolism).
- People with severe liver disease or tumours.
- Those with unexplained vaginal bleeding.
- If you are pregnant or think you might be pregnant.
Pharmacists are trained to assess suitability and advise accordingly. It is also crucial to inform the pharmacist of any other medications, including herbal remedies like St. John's Wort, as they can interact with Hana and reduce its effectiveness. For more detailed safety information, refer to the official public assessment report for Hana on the GOV.UK website: Hana public assessment report - GOV.UK.
Conclusion
Hana offers a convenient, over-the-counter option for contraception, particularly for women who cannot take combined pills containing estrogen. Its dual mechanism of action, primarily suppressing ovulation and thickening cervical mucus, provides high efficacy when taken correctly. While side effects like irregular bleeding are common, they often subside, and Hana presents a safe and accessible alternative for many. Consulting with a pharmacist is an important step to ensure it is the right and safest choice for your individual health circumstances.
