Yes, Lessina is a combination birth control pill. It contains two hormones: a progestin (levonorgestrel, 0.1 mg) and an estrogen (ethinyl estradiol, 0.02 mg). The presence of both a progestin and an estrogen is what makes any oral contraceptive a “combination” pill, as opposed to the progestin-only mini-pill.
What’s in a Lessina Pack
Each 28-day pack of Lessina contains 21 pink active tablets and 7 white inactive (placebo) tablets. The pink pills deliver the two hormones daily, while the white pills contain no medication at all. You take the white pills during the fourth week to maintain your daily habit and trigger a withdrawal bleed that resembles a period.
The estrogen dose in Lessina (0.02 mg of ethinyl estradiol) sits at the lower end of what combination pills typically contain. This makes it a “low-dose” formulation, which some people tolerate better than pills with higher estrogen levels.
How It Prevents Pregnancy
Lessina works through three overlapping mechanisms. The hormones stop ovulation, so no egg is released for sperm to fertilize. They also thicken cervical mucus, making it harder for sperm to reach the uterus, and thin the uterine lining to make implantation less likely.
With typical, real-world use, about 7 out of 100 people using combination pills become pregnant in the first year. That gap between typical use and near-perfect protection mostly comes down to missed pills, late starts on new packs, and medications that interfere with hormone absorption.
Other Names for the Same Formulation
Lessina is one of many generics that share the exact same hormone combination and dose, originally marketed under the brand name Alesse. If your pharmacy substitutes a different name, it’s likely the same pill. Equivalent versions include Aviane, Aubra, Falmina, Larissia, Lutera, Orsythia, Sronyx, Vienva, Afirmelle, and Delyla. All contain 0.1 mg levonorgestrel and 0.02 mg ethinyl estradiol per active tablet.
Common Side Effects
Most side effects of Lessina are mild. The most frequently reported include nausea, vomiting, spotting or bleeding between periods, weight changes, breast tenderness, and difficulty wearing contact lenses. Nausea and vomiting in particular tend to improve within the first three months as your body adjusts to the hormones.
Other reported effects include bloating, abdominal cramps, changes in menstrual flow, headaches, mood changes, and shifts in libido. Some people also notice skin darkening (melasma) that can persist even after stopping the pill. Temporary infertility after discontinuation is possible, though fertility typically returns within a few cycles.
Cardiovascular Risks and Who Should Avoid It
The most serious risk tied to combination pills like Lessina involves blood clots, heart attack, and stroke. Smoking dramatically increases this risk, especially if you’re over 35 and smoke 15 or more cigarettes a day. The combination of estrogen, age, and smoking is particularly dangerous.
Other factors that compound cardiovascular risk include high blood pressure, high cholesterol, obesity, and diabetes. Lessina is not appropriate for people with a current or past history of blood clots, stroke, coronary artery disease, or certain liver conditions. It’s also contraindicated if you have a history of hormone-sensitive breast cancer, unexplained vaginal bleeding, or are taking certain hepatitis C medications.
Medications That Can Reduce Effectiveness
Certain drugs speed up how your liver breaks down the hormones in Lessina, which can make the pill less effective. The most well-established culprit among antibiotics is rifampin, used for tuberculosis. A 2023 study found that people taking rifampin processed levonorgestrel faster than normal, potentially lowering the hormone’s contraceptive effect. Common antibiotics like amoxicillin do not have this interaction.
Some seizure and mood-stabilizing medications, including lamotrigine and valproic acid, can also accelerate hormone metabolism. Certain herbal supplements have documented interactions with birth control pills as well. If you start any new medication while on Lessina, it’s worth confirming whether it could interfere.
What to Do If You Miss a Pill
If you miss one active pill (meaning it’s been 24 to 48 hours since you should have taken it), take it as soon as you remember, then continue your pack on schedule. You don’t need backup contraception. You may end up taking two pills in one day, which is fine.
Missing two or more pills in a row requires extra precautions. Take the most recently missed pill right away and discard any other missed ones. Continue the rest of the pack as usual, but use condoms or abstain for the next 7 days. If those missed pills fell in the last week of active tablets (roughly days 15 through 21), skip the placebo week entirely and start a new pack immediately after finishing the remaining active pills. If you missed pills during the first week and had unprotected sex in the previous five days, emergency contraception is worth considering.