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 family planning.
Lo Loestrin Fe is a hormonal birth control prescription medication. It’s made of a progestin compound and an estrogen compound. The company claims their medication is the “#1 prescribed branded birth control pill by OB/GYNs.”
In this article we’ll review the medical research on Lo Loestrin Fe to determine if it’s likely to be safe and effective for preventing unplanned pregnancy. We’ll also highlight the side effects, and compare the efficacy of this type of birth control to other types such as condom use and Intrauterine Devices (IUDs).
Does Lo Loestrin Fe Work?
Lo Loestrin Fe has been studied in medical research. One clinical trial published in the Obstetrics & Gynecology journal evaluated its effectiveness in reducing pregnancies. The researchers found the treatment to be “effective in preventing pregnancy,” as the cumulative pregnancy rate dropped to 2.1 for the trial population.
Surprisingly, this single clinical trial appears to be the only trial evaluating the efficacy and safety of Lo Loestrin Fe. We’ve searched extensively for other trials on this drug and cannot find any.
On Lo Loestrin Fe’s website FAQ page, the brand uses the terminology “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, and is certainly better than nothing, but we’re unimpressed by the relative lack of research backing for this drug compared to other, more well-established forms of birth control.
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 they even state this on their site, because the clinical study excluded this group.
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.
Lo Loestrin Fe Side Effects
The most severe side effect listed on Lo Loestrin Fe’s FAQ page is the increased risk of blood clots, which can be life-threatening. Women who smoke, are obese, or are over the age of 35 are at higher risk of treatment-related blood clots according to the brand.
This risk of blood clots is standard for hormonal birth control. A medical review published in The Linacre Quarterly 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 was carcinogenic (cancer-causing), even at doses as low as 2 parts per billion (ppb). This study was funded by the National Toxicology Program run by the United States Department of Health, so there was less bias than a typical manufacturer-funded medical trial.
The previously-linked clinical trial on Lo Loestrin Fe also had a surprisingly high discontinuation rate of 41.7%. This represents the number of trial participants who stopped treatment during the trial for personal reasons, some citing side effects as the reason they were discontinuing.
We find Lo Loestrin Fe’s side effect profile to be unfavorable compared to other forms of birth control.
What Is The Generic Form Of Lo Loestrin Fe?
Lo Loestrin Fe’s marketing materials state that there is no generic equivalent available.
Since this is a recently-approved drug, with an approval date of 2010 according to the Food and Drug Administration (FDA) in the U.S., there likely won’t be a generic version out for 9 or 10 more years.
Generic drugs are only available after the brand name drug’s patent expires, which often takes upwards of 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
The dosage of Lo Loestrin Fe is 1 milligram (mg) norethindrone acetate and 10 micrograms (mcg) ethinyl estradiol. These are the blue tablets which are taken for 24 days of a 28-day cycle.
The following two days patients take the white pills, which contain 10 mcg ethinyl estradiol.
The final two days of the 28-day cycle, patients take two inactive pills containing 75 mg iron.
In our opinion, requiring patients to take three separate types of pills within a 28-day cycle increases 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 Vs. Other Birth Control Methods
As we outlined in the efficacy section, Lo Loestrin Fe drops cumulative pregnancy rate in sexually active, heterosexual females to 2.1. There were 26 pregnancies during 15,596 at-risk cycles during the medical trial. 1,660 patients participated in the trial, but 614 of them dropped out.
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 non-LARC methods such as condom use and birth control. A medical review titled “Preventing Unplanned Pregnancy” documented this.
Male condoms are typically less effective than oral, hormonal birth control methods. 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. Their clinical trial even states so: “this could lead to a higher failure rate.”
If Lo Loestrin Fe has a higher failure rate than other CHCs, it would have a similar failure rate to the male condom.
Lo Loestrin Fe Cost
The cost of Lo Loestrin Fe will vary significantly depending on health insurance. We typically recommend generic versions of pharmaceutical medications because they contain the same active ingredient as branded versions and are often significantly cheaper (especially for patients paying out-of-pocket), but unfortunately there is no generic version of Lo Loestrin Fe.
This makes it likely that this medication will cost more than generic hormonal birth control products.
We recommend that patients on low income compare the cost of various hormonal birth control options, because we haven’t come across any evidence that Lo Loestrin Fe is more effective than other CHCs.