Medical Disclaimer: The information presented here is for educational purposes only and should not replace consultation with a healthcare professional. Cilest is a prescription medication, and only a licensed provider can determine if it is appropriate for your health needs, prescribe it, and advise on its proper use.
Cilest is a combined oral contraceptive pill, often called “the Pill,” used primarily to prevent pregnancy. As a combined hormonal contraceptive, it contains two types of synthetic hormones. Cilest works by introducing these hormones into the body to alter the natural reproductive cycle. It is a highly effective method of reversible contraception when taken consistently and correctly.
Composition and Primary Mechanism
Cilest contains two active ingredients: the progestin norgestimate and the estrogen ethinyl estradiol. Each active tablet delivers 250 micrograms of norgestimate and 35 micrograms of ethinyl estradiol. This combination works through three primary biological mechanisms to prevent conception.
The primary action is the suppression of ovulation. The synthetic estrogen and progestin hormones prevent the surge of pituitary hormones necessary to trigger ovulation.
The hormones also cause the cervical mucus to become thicker and less permeable. This makes it difficult for sperm to travel through the cervix and reach the uterus and fallopian tubes. Finally, the hormones modify the lining of the uterus, or endometrium, making it less receptive to the implantation of a fertilized egg. These mechanisms ensure high contraceptive reliability when the pill is taken correctly.
Approved Uses
The primary indication for Cilest is the prevention of unintended pregnancy. When taken perfectly, combined oral contraceptives offer one of the most reliable forms of reversible birth control available. Cilest is also prescribed for various non-contraceptive health benefits.
One common secondary use is the management of menstrual disorders, such as heavy periods (menorrhagia) and painful periods (dysmenorrhea). By regulating the hormonal cycle, the pill can lead to lighter, shorter, and more predictable withdrawal bleeding, which reduces discomfort and disruption.
Cilest is also approved for the treatment of moderate acne in women who desire oral contraception. The estrogen component helps reduce androgen levels, which are a contributing factor to acne development. Lowering androgen levels leads to decreased oil production in the skin. The pill may also be used to mitigate pre-menstrual symptoms and has been associated with a long-term reduction in the risk of ovarian and endometrial cancers.
Detailed Instructions for Taking Cilest
Cilest is a 21-day pill regimen. Each pack contains 21 active tablets, followed by a seven-day pill-free interval. The medication must be taken orally once daily, at the same time each day, to maintain consistent hormone levels and maximum effectiveness. Establishing a routine, such as taking the pill immediately after waking or right before bed, helps ensure adherence.
Starting the Pill
There are two common ways to start the medication: on the first day of the menstrual period, which provides immediate contraceptive protection, or on the first Sunday following the start of the period. If starting on Sunday or any day other than the first day of bleeding, a backup barrier method, such as condoms, must be used for the first seven consecutive days. After the 21 active pills are finished, the user takes no pills for seven days, during which a withdrawal bleed typically occurs.
Handling Missed Doses
Handling a missed dose depends on which week of the cycle the miss occurs. If a single active pill is missed and the user remembers within 12 hours of the scheduled time, the pill should be taken immediately, and the next pill taken at the usual time; this does not reduce contraceptive protection. If the pill is missed by more than 12 hours, or if two or more pills are missed, contraceptive protection may be compromised.
If a pill is missed in Week 1, take the last missed pill immediately, and use backup contraception for seven days, especially if intercourse occurred in the week before the missed dose. If a pill is missed in Week 2, take the last missed pill immediately, but backup contraception is generally not needed if Week 1 pills were taken correctly. Missing a pill in Week 3 requires taking the missed pill immediately and starting a new pack the next day, skipping the seven-day break to maintain protection.
Potential Side Effects and Safety Warnings
Like all hormonal medications, Cilest can cause side effects, many of which are mild as the body adjusts. Common side effects include nausea, headache, breast tenderness or enlargement, and mild mood changes. Breakthrough bleeding or spotting is also frequent, especially in the first three months, and usually resolves on its own.
The combined pill carries a risk of serious cardiovascular events, necessitating careful medical screening before prescription. The primary concern is the increased risk of venous thromboembolism (VTE), which involves the formation of blood clots, primarily in the deep veins of the legs. These clots can travel to the lungs, causing a pulmonary embolism.
Symptoms that require immediate medical attention include sudden severe chest pain, shortness of breath, sudden loss of vision, or severe pain and swelling in one leg. The risk of VTE is highest in the first year of use or upon restarting the medication after a break of four weeks or more.
The risk of stroke and heart attack is also elevated, particularly in women who have pre-existing risk factors. Smoking dramatically increases the risk of serious cardiovascular side effects, especially in women over age 35; combined oral contraceptives are generally not prescribed to heavy smokers in this age group. Other conditions that contraindicate the use of Cilest include a personal or family history of blood clots, inherited clotting disorders, uncontrolled high blood pressure, and certain types of migraines with aura.
The medication should also not be used by individuals with a history of certain cancers, such as breast or liver cancer, or those with severe liver disease. Before prescribing Cilest, a healthcare provider conducts a thorough medical history and physical examination to assess all risk factors. Ongoing medical monitoring is important during use to identify developing conditions, such as high blood pressure.