@Dr_Paula combined pill advice


Hi Dr Paula, I’d really appreciate if you could advise me on what type of pill I should be taking. I’ve been on Maexeni (150/30 mcgs Levonorgestrel/ Ethinylestradiol) for some years, I stopped about a year ago (not because of any side effects, I just wanted a break).

I believe to have PCOS- a couple of years ago an ultrasound showed a cyst on my ovary, I’ve had irregular periods ever since I stopped taking COC (my last one was 4-5 months ago), my skin because oilier accompanied by acne, I developed some chest hair and my hair also started becoming progressively thinner. I’ve done a blood test a week ago, my results came back normal- besides my testosterone levels which is at 2.2 nmol/L.

I believe to have androgenic alopecia too, but I haven’t been diagnosed yet- it’s a bit hard scheduling an appointment with a derm these days. (More precisely, I believe to have both AGA and chronic telogen effluvium).

I am concerned both about my hair loss and no periods, and would definitely like to avoid getting pregnant. So I would like to start tackling the problem. Would an oral contraceptive with less androgenic progestins be the right solution for me, what brands would you recommend and how could I get one during these difficult times if I can’t go to a clinic?

I am a 31yr old female, a light smoker (up to 10 a day)- but planning to quit because I know I shouldn’t be both smoking and taking the pill at the same time.

Thank you very much for your time and advice.


Hello @arsonbunny

Many thanks for your question.

Combined pills are often classified as ones where the oestrogen elements of the pill are stronger and those where the progestagen elements of the pill are stronger.

Oestrogen is usually good for hair and skin so it may be good to start an oestrogen dominant pill.

Maexeni is progestagen dominant.

So you could try something like marvalen/gedarel 30 or Cilest/Eloine.

Hope helpful