Lo Loestrin Fe: The Ultra-Low-Dose Birth Control Pill

Lo Loestrin Fe is a combination birth control pill that contains a low dose of ethinyl estradiol, a synthetic form of the hormone estrogen, and norethindrone acetate, a synthetic form of progesterone, also called a progestin. Lo Loestrin Fe provides effective contraception with the lowest dose of estrogen possible, which may reduce side effects, especially in perimenopausal women.

Lo Loestrin Fe offers an efficacy of 92% to 99.7%, which is comparable to popularly-prescribed birth control pills. With typical use, three of every 100 women will get pregnant within a year of use, according to the manufacturer.

The effectiveness of the pill has not been studied in women with a body mass index (BMI) greater than 35. Discuss your birth control options with your healthcare provider if weight is an issue for you.

Non-Contraceptive Benefits

When you choose to use Lo Loestrin Fe for contraception, you may experience some benefits beyond preventing pregnancy, including:

• Easing of endometriosis-related pain
• Reduction in severe menstrual cramps
• Regular and more predictable periods
• Lighter and shorter periods
• Acne management
• A decreased risk of ovarian cysts
• A decreased risk of ovarian cancer and endometrial cancer

Women over 35 who smoke cigarettes should not use Lo Loestrin Fe due to the increased risk for heart attack, blood clots, and stroke. Your risk increases due to age as well as the number of cigarettes you smoke each day.

People with liver disease, breast cancer, and other estrogen- or progesterone-sensitive cancers should not use Lo Loestrin Fe. The pills are also be avoided by women at high risk of conditions related to blood clots, such as thrombotic stroke, heart attack, and deep vein thrombosis.

Lo Loestrin Fe is considered is an ultra-low-dose hormonal contraceptive, as it contains only 10 micrograms (mcg) of estrogen.

The pack contains 30 pills, which is why the drug is categorized as a mini extended cycle pill (typical birth control packs have 28 pills).

The first Lo Loestrin Fe 26 pills are combination estrogen and progestin pills. This is followed by two days of estrogen-only pills and two more days of placebo pills containing no hormones.

To use, take one pill at the same time every day, and avoid skipping pills. The pills should be taken in the order indicated on the blister pack.

The most common side effects of Lo Loestrin Fe include:

• Nausea
• Vomiting
• Headaches
• Bleeding irregularities

In premarket clinical research, around 4% of women also reported breast tenderness, menstrual cramps, or changes in weight, while 3% reported acne or abdominal pain.

Compared to other combination birth control pills, the lower estrogen dose appears to minimize some of the common side effects, both in duration and severity.

Some medications or herbal supplements may decrease the effectiveness of Lo Loestrin Fe or increase your likelihood of experiencing breakthrough bleeding. If you're using any of these drugs or herbs, talk with your doctor about the need for backup contraception or if you should use another method:

• Barbiturates
• Bosentan
• Carbamazepine
• Felbamate
• Griseofulvin
• Oxcarbazepine 
• Phenytoin
• Rifampin 
• St. John’s wort
• Topiramate  

The first generic formulation of Lo Loestrin Fe was approved by the U.S. Food and Drug Administration (FDA) in 2016, reducing the average retail price to around $150 per month.

A Word From Verywell

Lo Loestrin Fe is just one of many effective methods of oral contraception. Talk with your healthcare provider before deciding to switch to a low-estrogen birth control pill.