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I was prescribed Nora QT. The leaflet states that if you have regular periods, you will not be completely protected. Is this true and if so, what should I do about additional protection?&n

I was recently prescribed Nor QD because I have high blood pressure (found out this past fall) and am just now getting it regulated with medication (have had good readings for a month now). The pharmacist filled it with Nora BE. Are they the same? If I start them on the first day of my cycle, will I be protected immediately? Also, the leaflet talks about that it may cause spotting/breakthrough but it may not (regular cycles possible). Later on in the leaflet it says that if you continue to have regular periods, then you aren't protected and need another form of protection. I'm confused! How will I know?

Teacher 






Nora BE (0.35 mg norethindrone) is exactly the same as Nor QD, Micronor, Errin, Jolivette and Camila.

 

            The World Health Organization, 2004 Selected Practices Guidelines suggest a backup contraceptive is NOT needed if a woman starts progestin-only pills within 5 days of the start of a period.

 

            If a woman is ovulating on mini-pills (progestin-only pills), then periods will be regular.  A woman whose periods are regular on mini-pills is more likely to become pregnant than a woman whose periods are very irregular.  Some counselors and clinicians do suggest use of a backup contraceptive for women whose periods are very regular on POPs.  However, POPs are quite effective regardless of ovulation since mini-pills have multiple contraceptive effects.

 

            The following information is found on the website under CHOICES:

WHAT ARE PROGESTIN-ONLY PILLS (POPs)?

Progestin-only pills contain just one hormone, a progestin. A cycle does not have hormone-free days or placebo pills. They work by making cervical mucus thicker so sperm cannot reach the egg, and by making the lining of the uterus thinner. Sometimes they stop ovulation (release of an egg). Among typical couples who use progestin-only pills, about 8% will experience an accidental pregnancy in the first year. This is because some women do not take their pills correctly. But if these pills are used consistently and correctly, just 3 out of 1,000 women will become pregnant. Complete information about this contraceptive is available from your clinician or the package insert accompanying the specific pills you are taking.

WHAT ARE THE ADVANTAGES OF POPs?

  • There are no estrogen side effects. POPs can be taken by some women who have had side effects or complications using estrogen-containing pills.
  • The amount of the progestin in POPs is less than in combined pills.
  • Mini-pills are also easier to take than combined pills. You take exactly the same kind of pill every single day.
  • Nursing mothers can take progestin-only pills. Nursing moms who find that they like POPS may continue on them indefinitely.
  • There are decreased cramps and pain during periods. There may also be decreased pain at the time of ovulation.
  • Mini-pills can be taken by women who have had any of several types of blood clots:  thrombophlebitis, deep vein thrombosis or a pulmonary embolus.
  • They can be taken by women who smoke and are over 35.
  • A woman on mini-pills may experience fewer headaches than she had on combined pills.

WHAT ARE THE DISADVANTAGES?

  • Do NOT start this method of birth control unless you will find it acceptable to have your periods change.  They WILL change a lot.
  • Menstrual irregularity is the most common problem with mini-pills. While the amount of blood lost is less, bleeding may be at irregular intervals and there may be spotting between periods.
  • Mini-pills tend to make periods very short and scanty. You may go several months with no bleeding at all. (Some women go years without a period and love it!)
  • You have to remember to take a pill every single day at the same time. Staying on schedule is important because progestin-only pills cause cervical mucus to thicken for only about 22-24 hours.
  • Progestin-only pills do not protect you from HIV or other sexually transmitted infections. Use a condom if you or your partner may be at risk.

Key Words:  Nor QD, high blood pressure, pharmacist, Nora BE, protected immediately, spotting, breakthrough bleeding, regular cycles

 

Posted 3-18-2007, Updated 10-27-2007

Robert A. Hatcher MD, MPH
Emeritus Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA
---2007-10-27


Managing Contraception for Your Pocket 2013-2014
  

The directors and owners of this website and any publications and information concerning health matters offered here advise a person with a particular problem to consult a primary-care clinician or a specialist in obstetrics, gynecology, or urology (depending on the problem or the contraceptive) as well as the product package insert and other references before diagnosing, managing, or treating the problem.
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