Zoely

What is Zoely?

Zoely is a type of the combined contraceptive pill. It contains two types of hormones which work to prevent pregnancy; estradiol which is identical to the estrogen hormone produced by the body and nomegestrol, a type of 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 very effective when it is used correctly and prevents unwanted pregnancy in more than 99% of cases. Forgetting to take your pill, vomiting and certain medications are factors which can make it less 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 also helps to regulate your period, making it lighter and less painful. This can also 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, 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 progesterone 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 the pill 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. 

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 active ingredients in Zoely are nomegestrol and estradiol.

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 

Tablet coat (white active film-coated tablets): Poly(vinyl alcohol) (E1203), titanium dioxide (E171), macrogol 3350 and talc (E553b)

Tablet coat (yellow placebo film-coated tablets): Poly(vinyl alcohol) (E1203), titanium dioxide (E171), macrogol 3350, talc (E553b), iron oxide yellow (E172) and iron oxide black (E172)

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 then 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 in adverse symptoms then the pill is safe to take long term. You will also need to have your blood pressure monitored at least once a year.

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 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 progesterone only pill but you will need to use additional contraception for the first 7 days to ensure you are protected against pregnancy. 

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

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.

Common side effects include: 

• Absent or irregular periods 

• Acne

• Decreased sex drive 

• Depression 

• Mood changes 

• Headaches 

• 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 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 of these medicines. 

Zoely vs the mini pill

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

Sources

Patient Information Leaflet https://www.medicines.org.uk/emc/files/pil.3038.pdf

NHS> The Combined Pill https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/