Norinyl-1

What is Norinyl?

Norinyl is a type of hormonal contraceptive used to prevent pregnancy. More commonly referred to as ‘the pill’, it contains both oestrogen and progesterone hormones. The combined pill is one of the most popular methods of contraception in the UK.

How does Norinyl work?

Norinyl works by essentially preventing ovulation, replacing your natural menstrual cycle so that you cannot get pregnant. In a normal cycle, your ovaries release an egg which enters the womb ready to be fertilised. The womb lining thickens, ready to receive a fertilised egg. If fertilisation doesn't occur, the lining breaks down and it is released from the body as menstrual blood. The hormones contained in Norinyl stop an egg from being released and change the thickness of the womb lining. They also cause the mucus lining the womb entrance to thicken. This prevents sperm from entering from the vagina.

When does Norinyl start to work?

Norinyl will have an immediate effect if you start taking it at the beginning of your menstrual cycle. If you have a shorter menstrual cycle, start taking it on days 1-3 of your period. Otherwise you can start it up to day five and you'll be protected from pregnancy right away. If you start taking Norinyl at any other time during your cycle, it will take seven days to work. Switching from a different type of pill will not affect your contraception. You can usually just start taking Norinyl right away.

How effective is Norinyl?

Norinyl is over 99% effective at preventing pregnancy as long as it is taken correctly. Before starting the pill, ensure you carefully read the instructions so you can be sure you know how and when to take it and what to do if you miss a pill, get sickness or diarrhoea or take medications which may interfere with it.

Active ingredients

The active ingredients in Norinyl are mestranol and norethisterone.

Inactive ingredients

The inactive ingredients are: maize starch, polyvidone, magnesium stearate and lactose.

How to start Norinyl

Start taking Norinyl during the first 1-5 days of your period. If your cycle is shorter, then you'll need to start it in the first three days. This will ensure you are protected from pregnancy right away. You should choose a time of the day that is convenient for you to take it to ensure you remember and can access your pill easily. 

How to take Norinyl

Norinyl should be taken at the same time each day for three weeks out of the month. Your pill strip will have the days of the week printed on it. Follow this until you reach the end of the pack and then wait 7 days until starting the next one. The pill free week is when you'll have your withdrawal bleed, similar to your period. Begin the next pack on time, even if you are still bleeding.

What should I do if I took a pill too late?

Norinyl should be taken at around the same time each day but if you take one later than usual this will not affect your contraception. Regularly taking your pill late makes it difficult to determine when you have missed a pill should you forget to take one so you may want to set an alarm to remind you.

What should I do if I missed a pill?

Missed pills are a common occurrence and it's important that you know what to do in case this happens as your contraception may be affected. If you've missed one pill, take it as soon as possible. It doesn't matter if this causes you to take two at once. Continue with the rest of your pack as usual. If you have missed two or more pills, you won't be protected against pregnancy. Take the most recent missed pill right away and continue with the rest of your pack as scheduled. You will need to use condoms for the next 7 days and you should visit your local pharmacy or sexual health clinic if you have had unprotected sex during this time to get emergency contraception. 

How to take Norinyl for period delay

To delay your period with Norinyl, simply skip the seven day break between packs. This means you will not have a period until the following month.

Norinyl side effects

Possible side effects include: 

• Nausea
• Breakthrough bleeding or spotting
• Breast tenderness/soreness 
• Weight gain
• Acne
• Mood changes 
• Depression 
• Headache 
• Appetite changes 
• Vomiting 
• Blood clots
• Breast cancer 

Seek immediate medical attention if you experience an allergic reaction or signs of a blood clot. Signs of an allergic reaction are: 

• Difficulty breathing
• Wheezing 
• Swollen tongue, neck or mouth
• An itchy rash
• Chest pain
• Fever

Signs of a blood clot include:

• Swollen or tender stomach
• Coughing up blood 
• Sharp chest pain
• Pain while breathing
• Stabbing pain in the leg
• Painful or swollen veins
• An unusual or severe migraine 
• Dizziness
• Fainting
• Trouble with sight or speech

Contraindications

Norinyl is not suitable for everyone. Your doctor will assess your situation and health before prescribing you the pill to ensure it is safe for you to take. Do not take Norinyl if:

• You are allergic to any of the ingredients 
• You have, or have previously experienced, a blood clot
• There is a history of blood clots in the family
• You have a history of breast cancer
• You have unexplained vaginal bleeding 
• You may be pregnant 
• You have had a stroke or heart attack
• You have angina 
• You have a high level of fat in the blood
• You have cervical, vaginal or womb cancer
• You have jaundice 
• You have pruritus
• You have pemphigoid gestationis
• You have a severe liver disease 
• You suffer from migraines 

Inform your doctor if any of the following apply to you:

• Asthma 
• Epilepsy 
• Headaches 
• Migraines
• Heart disease
• High blood pressure
• Diabetes
• Kidney disease
• Multiple sclerosis 
• Varicose veins
• Severe depression
• Gallstones 
• Fibroids in the uterus 
• Porphyria
• Sickle cell anemia 
• Chloasma 

Drug interactions

There are certain medicines which interact with Norinyl, causing it to stop working correctly. These include: 

• Rifabutin 
• Rifampicin 
• Griseofulvin 
• Modafinil 
• HIV treatments 
• Hepatitis C treatments
• Epilepsy treatments 
• St John's wort

Norinyl and alcohol

Norinyl is not affected by alcohol so it is safe to drink while you are on the pill. 

Norinyl vs the mini pill

Norinyl is a form of the combined contraceptive pill, meaning it contains synthetic versions of both progesterone and oestrogen hormones. These are norethisterone, which is a progesterone, and mestranol which is converted into oestrogen by the body. The mini pill has less hormones, containing only progesterone. This makes it suitable for women who are unable to take oestrogen or who suffer unpleasant side effects from the combined pill. 

Alternatives to Norinyl

There are many different types of the pill available in the UK. Some alternative brands include Microgynon, Ovranette, Cilest and Yasmin. The mini pill is a good alternative for women who are unable to take Norinyl, as it only contains the progesterone hormone and poses less of a health risk. Long term reversible Contraceptives are a more secure option if you are on medications which affect the pill or are liable to forget to take it. These options include the implant, injection and the coil. There are two different types of the coil; the IUS which is hormonal and the IUD which is made from copper and does not contain hormones.

Norinyl for non-contraceptive purposes

Taking Norinyl also provides some non-contraceptive benefits. It can also be used to ease painful, heavy periods and reduce the symptoms of PMS. Taking the pill also gives you a regular cycle so this can help women with irregular periods to gain relief and control over their menstrual cycle.

Can you use Norinyl for period delay?

You can delay your period with Norinyl. It's usually taken for 21 days and then you have a break for 7 days. To skip your period, start your next pack the day after you take the last pill in your current pack instead of taking the usual pill free week.

Switching contraceptive pill

You may wish to switch contraceptive pill if your current brand is not working for you. Different types contain varying amounts of hormones so many women find they need to try a few before finding the one that's best suited to them. Switching contraceptive pill is straightforward. Simply start taking Norinyl the day after you stop your old one. If you are currently taking the progesterone only pill (known as the mini pill) wait until the first day of your period until taking Norinyl.

If I have vomited, will Norinyl still work?

Vomiting within two hours of taking Norinyl means it is unlikely that the pill has been absorbed into the body. Should this happen, take another pill as soon as possible and then continue to take the rest of your Norinyl pack as usual. If the vomiting continues, don't take another pill right away. Keep taking them as usual and use additional contraception until you have felt better for seven days as you won't be protected against pregnancy.

When can I get pregnant after taking Norinyl?

When you stop taking Norinyl, you can get pregnant at any time. Your natural menstrual cycle will usually take a couple of months to return to normal so you may be advised to wait until then before trying to start a family. The timing will differ from woman to woman as everyone's body is different and there are numerous factors which affect fertility. 

Can Norinyl be used as emergency contraception?

Norinyl cannot be used as emergency contraception. If you have had unprotected sex, the morning after pill or the copper coil are the only recommended options for effective emergency contraceptives. These need to be used as soon as possible after having unprotected sex.

Sources

• Patient Information Leaflet
• NHS > Combined Contraceptive Pill