Katya

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Katya on Prescriptsy

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Katya is a combined oral contraceptive pill containing gestodene 75 micrograms and ethinylestradiol 30 micrograms.

It is a monophasic preparation, meaning every active tablet contains the same dose of hormones.

Katya is a generic equivalent of Femodene and is manufactured to the same pharmaceutical standards.

It is taken for 21 consecutive days followed by a 7-day tablet-free interval, during which a withdrawal bleed usually occurs.

Katya is a prescription-only medicine (POM) in the United Kingdom and is available free of charge on the NHS as part of the UK's provision of free contraception.

Reliable contraception is fundamental to reproductive health and family planning.

In the United Kingdom, approximately 3.1 million women use a combined oral contraceptive pill, making it one of the most popular reversible contraceptive methods.

Combined pills offer high efficacy (more than 99% with perfect use), good cycle control, and additional benefits including reduced menstrual pain, lighter periods, and a degree of protection against ovarian and endometrial cancer.

However, they also carry important risks that must be understood, including a small increase in the risk of venous thromboembolism (VTE) and rare cardiovascular events.

This page provides a comprehensive clinical overview of Katya, covering its mechanism of action, effectiveness, dosage guidance, side effects, important safety information, and how to obtain a prescription in the United Kingdom.

Important safety information about Katya

Before reading further, note these essential safety points about Katya and combined oral contraceptives.

• Katya is a prescription-only medicine and requires a clinical assessment before use.
• Combined pills increase the risk of blood clots (VTE). The risk is small but higher than in non-users.
• Migraine with aura is an absolute contraindication. Stop Katya immediately if you develop migraine with aura.
• Smoking while taking a combined pill significantly increases cardiovascular risk. Women over 35 who smoke must not use combined oral contraceptives.
• Katya does not protect against sexually transmitted infections.
• Certain medicines reduce the effectiveness of the pill. Always tell your prescriber about all medicines and supplements you take.

Understanding combined hormonal contraception

Combined oral contraceptives contain a synthetic oestrogen (usually ethinylestradiol) and a progestogen. Together, these hormones prevent pregnancy through three principal mechanisms.

First, they suppress ovulation by inhibiting the hypothalamic-pituitary-ovarian axis.

The exogenous oestrogen and progestogen provide negative feedback to the hypothalamus and pituitary gland, preventing the mid-cycle surge of luteinising hormone (LH) and follicle-stimulating hormone (FSH) that triggers the release of an egg from the ovary.

Second, the progestogen thickens the cervical mucus, creating a physical barrier that impedes sperm transport.

Third, the progestogen alters the endometrium, making it less receptive to a fertilised egg.

Combined pills are classified by the type of progestogen they contain. Second-generation progestogens include levonorgestrel and norethisterone. Third-generation progestogens include gestodene (contained in Katya) and desogestrel.

The generation of progestogen affects certain risk profiles, particularly VTE risk, as discussed below.

The choice of pill is individualised based on efficacy, side effect profile, VTE risk, and patient preference.

The standard regimen for most combined pills involves 21 days of active tablets followed by a 7-day hormone-free interval, during which a withdrawal bleed occurs.

The 7-day break was originally included in pill design to mimic a natural menstrual cycle, but it is not medically necessary.

The FSRH now advises that flexible regimens, including continuous use (omitting the break) or extended cycles (taking pills for 9 or 12 weeks before a break), are safe and may reduce withdrawal-associated symptoms such as headaches, mood changes, and pelvic pain.

How Katya works: mechanism of action

Each Katya tablet contains ethinylestradiol 30 micrograms and gestodene 75 micrograms.

Ethinylestradiol is a potent synthetic oestrogen that, in combination with a progestogen, suppresses the hypothalamic-pituitary-ovarian axis, preventing the LH surge needed for ovulation.

It also stabilises the endometrium, reducing irregular bleeding and providing good cycle control.

Gestodene is a third-generation progestogen with high progestational activity and strong binding affinity for progesterone receptors.

It contributes to ovulation suppression, thickens cervical mucus, and produces endometrial changes unfavourable to implantation.

Gestodene has relatively low androgenic activity compared with levonorgestrel, which may be beneficial for women who experience androgenic side effects such as acne or hirsutism with second-generation pills.

However, third-generation progestogens are associated with a slightly higher risk of VTE compared with second-generation progestogens, a factor that must be considered in prescribing decisions.

Katya is a monophasic pill, meaning every tablet contains the same dose of hormones.

This simplifies the regimen because there is no need to take pills in a specific order (unlike biphasic or triphasic preparations) and facilitates flexible or continuous use.

Effectiveness and reliability

With perfect use (defined as taking the pill every day at approximately the same time, without missing any tablets), the combined pill has a failure rate of less than 1 per 100 women per year.

With typical use, which includes missed pills, late starts, drug interactions, and absorption issues from vomiting or diarrhoea, the failure rate is approximately 7 to 9 per 100 women per year.

Consistent, correct use is the single most important factor in maximising the effectiveness of the pill.

The effectiveness of Katya may be reduced by enzyme-inducing medicines, vomiting within 3 to 4 hours of taking a tablet, and severe diarrhoea.

Women should be aware of these factors and follow the missed pill rules outlined in the dosage section when applicable.

Katya compared with other combined pills

Femodene is the branded equivalent of Katya, containing the same active ingredients in the same doses. Millinette 30/75 is another generic equivalent. All are bioequivalent and interchangeable. The choice between brands typically depends on availability and NHS formulary preferences.

Compared with COCs containing levonorgestrel (such as Microgynon 30, Rigevidon, and Levest), Katya has a slightly higher VTE risk due to its third-generation progestogen but may be better tolerated by women who experience androgenic side effects with levonorgestrel-containing pills.

The FSRH advises that a levonorgestrel-containing COC should generally be the first choice where possible, given its lower VTE risk, but acknowledges that patient preference and tolerability are important considerations.

COCs containing newer progestogens such as drospirenone (Yasmin, Lucette) or dienogest (Qlaira) are also available and may be preferred for specific indications, though they carry VTE risks similar to or higher than third-generation progestogens.

Alternative contraceptive methods include progestogen-only pills (suitable for women with contraindications to oestrogen), the contraceptive implant (Nexplanon), intrauterine systems (Mirena, Levosert), intrauterine devices (copper coil), contraceptive injections (Depo-Provera), and barrier methods.

Long-acting reversible contraceptives (LARCs) such as the implant and IUS are more effective than oral pills because they do not depend on daily adherence.

Dosage and administration

Take one Katya tablet at the same time each day for 21 days.

After the 21st tablet, take a 7-day break during which you will usually experience a withdrawal bleed.

On day 8, start the next strip regardless of whether the bleed has finished. Starting the first pack on day 1 of your period provides immediate contraceptive protection.

Starting on any other day up to day 5 requires additional contraception (condoms) for the first 7 days.

Missed pills should be managed according to the FSRH guidelines as described in the dosage information section above. Consistency in timing, even if exact precision to the minute is not required, helps maintain reliable hormone levels and contraceptive efficacy.

Flexible and continuous use is increasingly recommended by the FSRH.

Taking packs back to back without a 7-day break is safe and can reduce symptoms associated with hormone withdrawal, including headaches, mood swings, and period pain.

Some women prefer a tricycling approach, taking three packs (63 days) followed by a 4 to 7 day break. Discuss these options with your prescriber.

Side effects of Katya

Common side effects

Headache, nausea, breast tenderness, mood changes, fluid retention, and breakthrough bleeding or spotting are the most commonly reported side effects, particularly in the first 2 to 3 cycles of use.

These effects usually settle as the body adjusts to the hormones. Changes in libido may occur.

Some women notice weight fluctuations, though large-scale evidence does not support a significant causal link between combined pills and weight gain.

Blood clot risk (venous thromboembolism)

All combined oral contraceptives increase the risk of VTE (DVT and PE).

In women not using hormonal contraception and not pregnant, the background rate of VTE is approximately 2 per 10,000 women per year.

For women taking a COC containing levonorgestrel (second-generation), the rate is approximately 5 to 7 per 10,000.

For COCs containing gestodene (third-generation, including Katya), the rate is approximately 9 to 12 per 10,000.

The risk is highest during the first year of use, in women with additional risk factors (obesity, immobility, thrombophilia, family history), and during the first use or restart after a break of 4 weeks or more.

For context, the risk of VTE during pregnancy is approximately 29 per 10,000 women per year.

Other serious risks

Arterial thromboembolism (stroke and heart attack) is very rare in young women but is increased by COC use, particularly in those who smoke, have hypertension, or have migraine with aura.

A small increase in breast cancer risk is associated with current and recent COC use; the risk returns to baseline approximately 10 years after stopping.

Cervical cancer risk may be marginally increased with long-term use, though the relationship is confounded by other factors.

Combined pill use is associated with a reduced risk of ovarian cancer and endometrial cancer, a protective effect that persists for many years after discontinuation.

When to seek urgent help

Contact your GP or call NHS 111 if you experience persistent headaches, mood changes, breast lumps, or breakthrough bleeding that does not settle after 3 cycles.

Call 999 or attend A&E if you develop sudden chest pain, breathlessness, a swollen or painful leg, sudden severe headache, sudden visual disturbance, weakness or numbness on one side of the body, or difficulty speaking.

These may be signs of a blood clot or stroke. Report suspected adverse reactions to the MHRA at yellowcard.mhra.gov.uk .

Warnings and precautions

Absolute contraindications

Katya must not be used in women with a current or past VTE, current or past arterial thromboembolism, known thrombophilia, migraine with aura at any age, current breast cancer, undiagnosed vaginal bleeding, severe liver disease or liver tumours, or multiple risk factors for cardiovascular disease.

It should not be used during the first 6 weeks postpartum in breastfeeding women or by women over 35 who smoke.

Relative contraindications and risk factors

Factors that increase VTE risk include BMI above 30, immobility, family history of VTE, and increasing age.

Combined pills should be used with caution in women with a single risk factor and avoided in women with multiple risk factors.

Women with a BMI above 35 should generally be offered alternative contraception. Hypertension (sustained blood pressure above 140/90 mmHg) is a reason to stop the combined pill.

Diabetes with vascular complications is a contraindication.

Drug interactions and effectiveness

Enzyme-inducing medicines (rifampicin, carbamazepine, phenytoin, phenobarbital, primidone, topiramate above 200 mg/day, and St John's wort) significantly reduce COC effectiveness. Women taking these medicines need alternative or additional contraception.

Some antibiotics were historically thought to affect pill efficacy, but current evidence indicates that only rifampicin and rifabutin have this effect; other common antibiotics do not reduce COC effectiveness.

Lamotrigine levels may be reduced by COCs, potentially affecting seizure control; this interaction requires specialist management.

Breastfeeding

Combined oral contraceptives are not recommended during breastfeeding, particularly in the first 6 months, as ethinylestradiol may reduce milk production. Progestogen-only methods are preferred.

How to get Katya in the UK

Katya is a prescription-only medicine.

It can be prescribed by your GP, a sexual health clinic, or an authorised online prescriber registered with the General Pharmaceutical Council (GPhC) after a clinical assessment that includes blood pressure measurement and a review of medical history and risk factors.

Contraception is provided free of charge on the NHS, so you will not pay a prescription charge regardless of which part of the UK you live in.

Sources

• Katya 30/75, Summary of Product Characteristics (EMC)
• Ethinylestradiol with gestodene, British National Formulary (BNF)
• FSRH Clinical Guideline: Combined Hormonal Contraception
• Combined oral contraceptive pill, NHS
• MHRA Yellow Card Scheme