Lo Loestrin Fe Review: The Worst Birth Control?

Lo Loestrin Fe Review: The Worst Birth Control?

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Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regard to birth control and family planning.

Lo Loestrin Fe, sometimes called LoLo, is a hormonal birth control pill that's approved by the FDA for the prevention of pregnancy. It’s made of a progestin compound and an estrogen compound. The brand claims their medication is the “#1 prescribed branded birth control pill by OB/GYNs.”

But is Lo Loestrin Fe proven in clinical studies to prevent pregnancy? How effective is it and how does its effectiveness compare to other birth control methods? Does the pill cause any side effects? And how do real users rate it?

In this article we’ll answer all of these questions and more as we review clinical studies on Lo Loestrin Fe to determine how effective it is, compare its efficacy to other birth control methods, document side effects of the drug and share real, unsponsored user reviews of Lo Loestrin Fe.

Does Lo Loestrin Fe Prevent Pregnancy?

Lo Loestrin Fe has been studied in published medical research for its ability to prevent pregnancies.

clinical trial published in the Obstetrics & Gynecology journal tested Lo Loestrin Fe in sexually active women. 26 pregnancies occurred and there were 1,555 trial participants, which equates to a failure rate of 1.67%.

Surprisingly, this appears to be the only clinical trial conducted on Lo Loestrin Fe. The brand's website has an FAQ page describing “the clinical trial,” suggesting that there is only one clinical trial on the drug.

We can conclude from the available research that Lo Loestrin Fe is effective for reducing pregnancy, but we're surprised that there only appears to be one trial on this drug prior to FDA approval.

It’s also worth noting that there is no proof that Lo Loestrin Fe works in women with a body mass index (BMI) of 36 or greater, and the brand even states this on their website, because the clinical trial excluded this group.

Does Lo Loestrin Fe Cause Side Effects?

Lo Loestrin Fe black box warning

Lo Loestrin Fe's FDA label has a "black box" warning, shown above, indicating an increased risk of "serious cardiovascular events" from using the medication and smoking. 

Not only should women who smoke avoid the medication, but the brand's FAQ page also states that women who have had blood clots, who have uncontrolled high blood pressure, breast cancer, liver disease or liver tumors should not use Lo Loestrin Fe.

Increased risk of blood clots is unfortunately a common side effect of hormonal birth control methods. A 2018 medical review found that women using hormonal birth control were at a 3x to 9x risk of serious blood clots compared with nonusers.

The more common, and less severe, side effects reported by Lo Loestrin Fe are nausea, headache and increased menstrual bleeding.

We located a concerning animal study proving that ethinyl estradiol (one of the active ingredients in Lo Loestrin Fe) was carcinogenic (cancer-causing), even at doses as low as two parts per billion (ppb). This study was funded by the National Toxicology Program run by the United States Department of Health.

Real, Unsponsored Lo Loestrin Fe User Review

One of the most popular YouTube reviews of Lo Loestrin Fe comes from a creator named "Lovee Sammi" who shares her experience using the medication and explains the pros and cons:

Lo Loestrin Fe vs. Other Birth Control Methods

Women considering birth control options are often curious about the relative efficacy, given that there are so many different contraceptives on the market. We do not consider Lo Loestrin Fe to be as effective as some birth control methods available.

As we discussed in our recent review of contraceptive device Nexplanon, long-acting reversible contraceptive (LARC) methods of birth control have been shown to be around 20x more effective than contraceptive methods like hormonal pills and condom use. A medical review titled “Preventing Unplanned Pregnancy” documented this.

Male condoms are proven to have average failure rates of 2% with perfect use and 13% with typical use, while the same research review found that combined hormonal contraceptives (CHCs) like Lo Loestrin Fe have average failure rates of 1% with perfect use and 7-9% with typical use.

The failure rate of Lo Loestrin Fe is likely to be higher than that of other CHCs, because it’s lower-dosed. The clinical trial on Lo Loestrin Fe, cited in a previous section, even states so: “this could lead to a higher failure rate.”

Lo Loestrin Fe appears to be similarly effective to other hormonal birth control pills and male condoms, but significantly less effective than LARC methods like intrauterine devices (IUDs).

We recommend that women who want to take every precaution to avoid pregnancy speak with their doctor about LARC contraceptives.

A YouTube creator named "J Karwowski" published a video comparing Lo Loestrin Fe to other birth control methods, and explained the side effects experienced from each one:

Is Generic Lo Loestrin Fe Available?

Lo Loestrin Fe’s website states that there is no generic equivalent available at the time of updating this article.

Since this is a recently-approved drug, with an approval date of 2010 according to the FDA, there may not be be a generic version available for 9 or 10 more years.

Generic drugs are only available after a branded drug’s patent expires, which takes 20 years.

Teva Pharmaceuticals, which is one of the industry leaders in generic drug manufacturing, sells a product called “Loestrin Fe,” which has the same active ingredients as Lo Loestrin Fe but at a higher dosage.

Lo Loestrin Fe Dosage

Lo Loestrin Fe tablets image

Lo Loestrin Fe is composed of three different pills: blue pills which are taken for 24 days of a 28-day cycle, white pills which are taken for 2 days of a 28-day cycle and brown pills which are taken for the final 2 days.

The dosage of the blue pills is 1 milligram (mg)  norethindrone acetate and 10 micrograms (mcg) ethinyl estradiol. 

The dosage of the white pills is 10 mcg ethinyl estradiol.

The dosage of the brown pills is 75 milligrams (mg) iron.

Requiring patients to take three separate types of pills within a 28-day cycle may increase likelihood of user error and noncompliance, which is medically proven to be one of the leading risk factors for unplanned pregnancy while using hormonal birth control.

Lo Loestrin Fe's FDA label states that these pills need to be taken in the proper order as well.

Lo Loestrin Fe Patient Reviews

Lo Loestrin Fe has been reviewed over 1,500 times on Drugs.com, which is a website that allows prescription medication users to publish personal reviews and ratings of drug(s) they're taking.

The medication has an average rating of 5.7 out of 10.

The top positive review comes from a user named "Livvy" who claims that the drug had minimal side effects compared to other birth control methods they had tried:

"Lolo has helped me regulate my hormones all together. Ladies remember, people will often times leave a bad review over a good one. I wanted to give up on my birth control because of how bad it made me feel at first, but I’m so happy I stuck it through and found a pill I absolutely LOVE."

The top negative review is written by a user named "Lauren" who claims to have experienced serious side effects:

"I didn’t realize Lo Lo was making me crippling depressed up until the last month on, I had MAJOR suicidal thoughts and immediately stopped taking it and within a couple days I didn’t have those thoughts or crippling depression. Would not recommend in the slightest if you struggle with mental health to begin with as I do."

Lo Loestrin Fe Cost

The cost of Lo Loestrin Fe for U.S. patients will vary significantly depending on health insurance coverage.

According to GoodRx, the retail price of the medication is currently $196.75, but most patients don't end up paying the full retail price.

Lo Loestrin Fe's website has a Savings Program resource page suggesting that patients who text the brand receive a coupon code that may allow them to pay as little as $25 per 1-month or 3-month prescription fill.

We recommend that patients considering Lo Loestrin Fe speak with both their doctor and health insurance company about whether they can access the drug at a subsidized price.

How Does Lo Loestrin Fe Work?

The active ingredients in Lo Loestrin Fe are both hormones that prevent ovulation. Norethindrone acetate is a synthetic form of the natural female sex hormone progesterone. Ethinyl estradiol is a synthetic form of the natural female sex hormone estrogen.

Both of these compounds are prescribed individually for birth control treatment, and the combined effect may be more effective than either in isolation.

For the treatment to be maximally effective in reducing unplanned pregnancies, women should take Lo Loestrin Fe at the same time each day, so that there are no drops in circulating hormone levels. The clinical trial recommends this approach.

Our Birth Control Picks

PlushCare Online Birth Control Appointment is our top birth control pick, because it allows patients to speak with a doctor to get a personalized recommendation. The optimal birth control option varies individual-to-individual based on factors like genetics, current medications and age.

PlushCare is a leading online health platform that accepts major health insurers like United and Aetna, and also accepts patients paying out-of-pocket.

Interested consumers can check out an PlushCare Online Birth Control Appointment along with their insurance coverage at this link to the official brand's website.

Most birth control methods come with substantial side effects, but a smartphone app called Natural Cycles is cleared by the FDA for birth control. The app determines fertility status by body temperature, and claims to have a 93% efficacy rate which is comparable to oral birth control with typical use.

The benefit of Natural Cycles is that it works with the body and doesn’t require users to ingest any hormonal compounds that can have side effects.

Those interested can check out Natural Cycles at this link to the brand’s official website.

We want to be clear that we do not consider Natural Cycles likely to be as effective as LARC methods of preventing pregnancy, but for women who prioritize side effect reduction or who have had bad side effects from birth control in the past, it may be a useful option.

Stay up-to-date on our research reviews


Lo Loestrin Fe is clinically proven to prevent pregnancies. However, the drug only appears to have been studied in one clinical trial which is uncommon in our experience.

We would recommend that patients speak with their doctor about LARC methods of birth control like IUDs which appear to be more effective based on medical studies than oral, hormonal birth control pills.

Lo Loestrin Fe can cause side effects, including an increased risk of cardiovascular events in at-risk populations, nausea, headache and increased menstrual bleeding.

There are not any generic alternatives for Lo Loestrin Fe on the U.S. market at the time of updating this article.

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