Zoely

What is Zoely?

Zoely is a type of combined contraceptive pill. It contains synthetic versions of two types of hormones which work to prevent pregnancy; estradiol which is structurally identical to the main oestrogen hormone produced by the body and nomegestrol, which is similar to progesterone.

How does Zoely work?

Zoely works by releasing these hormones into the body, which in turn prevent ovulation from occurring each month. They also work to thin the lining of the womb and thicken the cervical mucus, creating an additional barrier against sperm. 

How effective is Zoely?

Zoely is effective and prevents unwanted pregnancy in around 91% of cases. However, when taken perfectly, with no instances of forgotten pills, vomiting, or taking medications which might interact, Zoely can be over 99% effective.

When does Zoely start to work?

Zoely will start to work right away if you start taking it on the first day of your period. If you miss the first day of your cycle, you can still start Zoely within days 2–5 of your period, but you will need to use an additional barrier method of contraception for the first 7 days.

Zoely for non-contraceptive purposes

Zoely is primarily used to prevent pregnancy, but it may also help to regulate your bleeding and may make it lighter and less painful. This can provide relief for women with endometriosis.

Can you use Zoely for period delay?

Zoely can be used to delay your period by skipping the yellow placebo pills at the end of your pill pack and beginning a new pack the next day. 

Switching contraceptive pill

If you are switching to Zoely from a different type of the combined pill, wait until you have finished your current pack and begin taking Zoely the day after taking your last active pill. This means you won't have a 7-day break between packs. If you are currently taking the progestogen-only pill, or mini pill, you can stop taking it at any time and start Zoely the next day. You will need to use additional contraception for the next 7 days as you won't be protected against pregnancy right away.

If I have vomited, will Zoely still work?

There is a chance that Zoely will not work properly if you vomit within 3–4 hours of taking one of the white active pills as the hormones may not have been absorbed by the body yet. If this happens, take another pill once your stomach settles down. If you are unable to do this within 24 hours of your usual scheduled time, then treat it as a missed pill. If you continue to vomit, your protection will be affected and you will need to use condoms, or another barrier method of contraception, until you have stopped being sick and for 7 days after. If you vomit after taking one of the yellow inactive pills, it does not matter and you can continue as usual as these pills do not contain hormones.

When can I get pregnant after taking Zoely?

You can get pregnant at any time when you stop taking the pill. It may take some women several months to get pregnant, as your natural menstrual cycle may not return right away. A family planning clinic can advise you on how to come off the pill and prepare for pregnancy so that you can be in optimum health.  

When will my period start again after I stop taking Zoely?

If you stop taking Zoely, your periods may return after 2–3 weeks or 1–2 months. The timescale is different for all women, so do not worry if your period doesn't arrive right away.

Active ingredients

The white tablets contain the active ingredients nomegestrol and estradiol. The yellow tablets are placebo pills and do not contain any active ingredients.

Inactive ingredients

The other ingredients contained in Zoely are: Lactose monohydrate, microcrystalline cellulose (E460), crospovidone (E1201), talc (E553b), magnesium stearate (E572) and colloidal anhydrous silica 

The white tablets also contain: poly(vinyl alcohol) (E1203), titanium dioxide (E171), macrogol 3350 and talc (E553b)

The yellow tablets also contain: poly(vinyl alcohol) (E1203), titanium dioxide (E171), macrogol 3350, talc (E553b), iron oxide yellow (E172) and iron oxide black (E172)

Which ingredients can cause an allergic reaction?

The active or inactive ingredients listed above in Zoely have not been linked to cases causing a severe allergic reaction in people. However, if you notice facial/lip swelling, dizziness and difficulty breathing, you might be having a severe allergic reaction so make sure to get emergency medical attention right away. Zoely does contain an ingredient called lactose monohydrate which is safe for those who are lactose intolerant.

How to start Zoely?

Start taking Zoely on the first day of your period. This means you will be protected from pregnancy right away. If you start it later than this, you will need to be sure you are not already pregnant, and use an additional barrier method of contraception for the first 7 days. To switch to Zoely from a different combined contraceptive pill, wait until you reach the end of your current pack and begin taking Zoely the next day. You can swap to Zoely at any time if you are using the progestogen-only pill but you will need to use additional contraception for the first 7 days to ensure you are protected against pregnancy.

Zoely dosage

Each active pill contains 2.5mg of nomegestrol and 1.5mg estradiol. 

What should I do if I miss a pill?

If you miss one of the yellow placebo pills, discard it and take the next one as usual. Or if it was the last pill in your pack, begin your pill-free week. Your contraception will not be affected. If you miss an active white pill, the action you should take will depend on where you are in your cycle. It's considered a missed pill if you are 24 hours or later in taking it. 

• Week one: if you miss a pill in the first 7 days of your cycle, take it as soon as you can, even if this means you are taking two at once. Keep taking the rest of your pills on time and use an additional method of contraception for the next 7 days. If you have had sexual intercourse in the week leading up to your missed pill, there is a risk of pregnancy and you should seek advice from a GP or pharmacist right away 
• Week two: if you miss a pill in the second week of your cycle, take it as soon as you remember and continue with the rest as usual. Your contraception will not be affected. If you have missed more than one pill, use an additional barrier method of contraception for the next 7 days 
• Week three: If you miss a pill during the third week of your cycle, the risk of pregnancy is higher. If you have taken your pills correctly for the past 7 days then you don't need to take any action. If not, take the missed pill as soon as possible and start the next pack of pills the day after you take the last active white tablet, discarding the yellow placebo pills.

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

If you take a pill later than usual, but within 24 hours of the usual time, this won't affect your contraception. It is considered a missed pill if it has been more than 24 hours since you were due to take it so if you have taken it within this time frame there is nothing to worry about.

Is it safe to take Zoely for a long time?

Zoely, like any contraceptive pill, increases the risk of blood clots for all women who take it. This means it is not suitable for women with particular types of medical conditions or medical history. Your doctor will assess whether or not the pill is safe for you to take, including measuring your blood pressure. If you are in good health and do not experience any adverse symptoms then the pill is usually safe to take long term. You will also need to have your blood pressure monitored at least once a year.

How to use Zoely for period delay?

To use Zoely for period delay, skip the 4 yellow inactive pills and start on the next pack of pills right away. This will delay your period until you reach the yellow pills in the new pack.

Zoely side effects

Common side effects include: 

• Absent or irregular periods 
• Acne
• Mood changes, depression or decreased sex drive 
• Headaches or migraines 
• Nausea 
• Heavy periods 
• Breast pain 
• Pelvic pain 
• Weight gain 

Uncommon side effects may include: 

• Fluid retention 
• Increased appetite 
• Hot flushes 
• Bloating 
• Increased sweating 
• Hair loss 
• Itching 
• Dry skin 
• Heaviness in limbs 
• Enlarged breasts 
• Benign breast lumps 
• Breast secretion 
• PMS
• Pain during sex 
• Vaginal dryness 
• Irritability 
• Increased liver enzymes 

Rare side effects include: 

• Blood clots 
• Decreased appetite 
• Increased libido 
• Difficulty concentrating 
• Poor tolerance of contact lenses 
• Dry mouth 
• Chloasma 
• Gallbladder disease

Contraindications

You shouldn't use Zoely if any of the following apply to you: 

• If you have ever had a blood clot 
• If you have a condition which affects your blood clotting 
• If you need an operation 
• If you have ever had a heart attack or stroke 
• If you have ever had angina
• If you have severe diabetes with blood vessel damage 
• If you have very high blood pressure
• If you have high levels of fat in the blood 
• If you have hyperhomocysteinaemia 
• If you have ever had a migraine with aura 
• If you have ever had pancreatitis 
• If you have had liver disease and you still have decreased liver functioning 
• If you have ever had a liver tumour 
• If you have ever had cancer of the breast, vagina, cervix or ovaries 
• If you are allergic to any of the ingredients 

 
Extra care should be taken if: 

• You smoke
• You are overweight or obese
• You are over the age of 35
• You have angioedema 
• You have a family history of breast cancer 
• You have epilepsy 
• You have liver or gallbladder disease 
• You have diabetes 
• You have depression 
• You have chronic inflammatory bowel disease 
• You have systemic lupus erythematosus 
• You have haemolytic uraemic syndrome 
• You have sickle cell anaemia 
• You have elevated levels of fat in your blood 
• You have recently given birth 
• You have superficial thrombophlebitis 
• You have varicose veins 
• You have a condition which first appeared during pregnancy or previous use of hormonal contraceptives 
• You have ever had chloasma

Drug Interactions

There are certain types of medications which can affect Zoely. These include: 

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

 Tell your doctor if you are taking any regular medicines.

Zoely vs the mini pill

Zoely is a type of combined pill whereas the mini pill only contains a progestogen as opposed to both an oestrogen and a progestogen. The mini pill may suit women who are unable to take the combined pill as it does not pose the same health risks. 

Alternatives to Zoely

Zoely is a relatively new type of pill and contains similar ingredients to Qlaria, another type of combined contraceptive pill. Dr Felix stocks all available types of the pill within the UK. The mini pill is a good alternative for women who cannot take the combined pill for health reasons. The vaginal ring or patchwork in the same way as the pill, without the need to remember to take it every day. If you would prefer a longer term option, a GP or family planning clinic can administer the injection, implant, hormonal or copper coil.