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Bunck MC, Corner A, Eliasson B, et al

The manufacturer advises careful monitoring of liver function at the commencement of therapy and in the presence of any symptoms indicative of liver injury

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The general mechanism of action of combined hormonal contraceptives (estrogens + progestogens) is based on the negative feedback that estrogens induce on the hypothalamus, inhibiting the secretion of gonadotropin release stimulating hormone (GnRH) and, consequently, preventing the increase in the secretion of gonadotrophins by the pituitary to stimulate ovulation in the middle of the cycle