Women seek alternatives as desogestrel contraceptive stock runs out

Women are struggling to find desogestrel in pharmacies after a shipment delay left it out of stock for weeks.

Desogestrel is a widely used progestogen-only contraceptive that is also used to manage endometriosis symptoms, help with heavy or painful periods and, occasionally, in perimenopause management. 

It is the active ingredient in the progestogen-only pill (POP) which, unlike combined oral contraceptives, contains no oestrogen. This makes it suitable for women who cannot take oestrogen, especially those with a history of thrombosis.

However, both the branded pill Lamya and the generic version of desogestrel are now out of stock in Malta, forcing women to either source the medication from abroad or switch to a combined pill that contains oestrogen, which could be risky for certain patients. 

Importers have told pharmacies that the shortage is due to a shipment delay. The medicine was already out of stock in November, briefly came back into stock and has now gone out of stock again. 

One woman said she was worried about the effect that a break from the pill would have on her body. She had been taking the combined pill for 25 years before switching to desogestrel three months ago.

“My body has just got used to it or is still getting used to it,” she said. “My greatest fear is stopping the POP after spending my adult life on the combined pill without a break. It could wreak havoc on my system.”

She switched to desogestrel upon the recommendation of her gynaecologist, after raising concerns about possible blood clots and symptoms linked to perimenopause.

Hundreds

“Some might think we are being petty and that we can use other forms of contraception. I don’t have a partner, so I’m not using it as a contraception but to regulate my hormones. Going back to the combined pill in my late 40s could risk a blood clot. It is for health reasons that I need desogestrel,” she said. 

Gynaecologist Isabel Stabile said that at least 50 of her own patients had contacted her in recent weeks about the shortage. “There are probably hundreds of women in Malta now unable to obtain the contraceptive they need. Usually, they’re taking this pill for a reason: breastfeeding, migraines, high blood pressure, thrombosis risks. Now these women have been left high and dry.”

Another gynaecologist, who preferred not to be named, said he was also aware of the shortage, adding it can be an issue for patients taking this particular medication for health reasons. “Women at risk of thrombosis can’t use oral contraceptive pills. That’s the biggest contraindication,” he said. 

Desogestrel was introduced in the market about four or five years ago and is sold as both a branded product, Lamya, and as a generic product. Lamya went out of stock in November last year. When the local importer of the generic product found out, they asked the provider to send more packages to meet the shortfall. Now, even the generic product is unavailable. There is no product of this type available on the market. However, another branded progesterone-only pill, Azalia is expected to come into the market in the coming weeks to help resolve the shortage.