7 Lo Loestrin Fe Side Effects You Should Know About

Lo Loestrin Fe is a combination oral contraceptive (birth control pill). It contains two hormones — norethindrone acetate and ethinyl estradiol — as well as ferrous fumarate, an iron supplement. The hormones work together to prevent pregnancy. And the iron lowers your risk of anemia (low red blood cells) during the week you have your period.

Because Lo Loestrin Fe contains hormones, it affects everyone differently. In some cases, it can cause side effects, such as headache or nausea. Before starting Lo Loestrin Fe, it’s important to understand its possible side effects and what you can do if they happen.

Lo Loestrin Fe side effects at a glance

Lo Loestrin Fe can cause similar side effects to other combination birth control pills. In most cases, these are mild and get better with time. While rare, serious side effects are possible. So it’s good to know what to watch out for and when to seek help.

Common or mild Lo Loestrin Fe side effects include:

• Headache

• Nausea and vomiting

• Period changes or breakthrough bleeding

• Menstrual cramps

• Breast tenderness

• Acne

• Weight changes

• Stomach pain

Rare but serious Lo Loestrin Fe side effects and risks include:

• Blood clots

• Heart attack

• Stroke

• Liver problems

• Breast cancer

• Depression or serious mood changes

• Raised blood pressure or cholesterol

• Gallbladder problems

Lo Loestrin Fe also has a boxed warning (the FDA’s strictest medication warning) for people over age 35 who also smoke. People in this group have a higher risk of experiencing serious cardiovascular side effects while taking combination birth control pills. So it’s recommended that you avoid Lo Loestrin Fe if you’re over 35 and smoke.

Below are more details about seven Lo Loestrin Fe side effects, plus ways to manage them.

1. Headache

Birth control pills, such as Lo Loestrin Fe, can sometimes cause headaches. This side effect is more common when you first start taking the pill. But it often goes away after about 2 or 3 months of treatment.

Headaches from Lo Loestrin Fe are typically mild and treatable at home. Try these tips:

• Apply a cold compress to painful areas.

• Rest in a dark room until the pain lets up.

• Drink extra water.

• Optimize your sleep hygiene so you can get adequate rest.

• Limit caffeine and alcohol.

• Ask a healthcare professional if you can take over-the-counter (OTC) headache medications, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).

If the headaches are severe or persistent, talk to your prescriber. Lo Loestrin Fe may not be the right birth control option for you. There could also be a different cause for your headaches. And in rare cases, a severe headache can be a symptom of a stroke.

2. Nausea, vomiting, or stomach pain

Nausea, vomiting, and stomach pain are common Lo Loestrin Fe side effects. These are also common with other hormonal birth control methods. Digestive side effects tend to be more noticeable when you first start Lo Losterin Fe. They should be mild and improve as your body gets used to the medication.

While you’re waiting for your body to adjust, there are some things you can do to make yourself more comfortable:

• Take your doses with food.

• Eat several smaller meals per day, instead of two or three larger meals.

• Avoid foods or beverages that could trigger nausea, such as spicy foods or alcohol.

• Drink ginger or peppermint tea to help settle your stomach.

Tell your prescriber if your digestive side effects are too bothersome. They might suggest trying a different birth control method. If you have a fever or other symptoms of an infection along with digestive issues, tell a healthcare professional. Your symptoms may be due to an infection and not Lo Loestrin Fe.

3. Breast tenderness

Breast tenderness is another common Lo Loestrin Fe side effect. It happens because of the hormones in the pill. It’s most common during the first few months after starting Lo Loestrin Fe. It should improve or resolve on its own with time.

Try these tips to help relieve breast pain at home:

• Apply heat or ice packs to painful areas.

• Wear a well-fitted, supportive bra, such as a sports bra.

• Ask a healthcare professional if it’s safe for you to take OTC pain relievers.

If the pain continues to get worse or won’t go away, tell your prescriber. If you notice any lumps, color changes in breast skin, or discharge from your nipples, see a healthcare professional right away. These are possible signs of breast cancer, a rare but serious Lo Loestrin Fe side effect.

4. Acne

Acne is another possible Lo Loestrin Fe side effect. It’s caused by the progestin component of the pill (norethindrone acetate). Norethindrone has a higher chance of causing acne than other progestins.

This side effect could happen the entire time you’re taking Lo Loestrin Fe. But it’s typically mild and can usually be managed with OTC acne treatments. Just keep in mind that it’s common for acne to appear worse for the first few weeks after starting acne medications before it improves.

If your acne seems severe or is just too bothersome, tell a healthcare professional. They may suggest trying a different contraceptive. Some birth control pills are less likely to cause acne than others. But if Lo Loestrin Fe is working well for you otherwise, they may recommend prescription acne medications.

5. Breakthrough bleeding and period changes

Breakthrough bleeding and menstrual period changes are common side effects for all hormonal birth control, including Lo Loestrin Fe. It’s even possible that you may stop getting your period while taking it. These side effects aren’t typically harmful. But they can be frustrating.

Bleeding changes are most noticeable when you first start Lo Loestrin Fe. They should improve and your periods should regulate within the first 6 months of taking it. Until then, you may want to wear dark-colored underwear and carry period supplies when you’re on-the-go in case you unexpectedly need them.

If you’re uncomfortable with period changes from Lo Loestrin Fe, tell your prescriber. You may react differently to another birth control method.

6. Blood clots, heart attacks, or stroke

Rarely, people have developed blood clots while taking Lo Loestrin Fe. In the most serious cases, blood clots could lead to a heart attack or stroke. In general, the risk of blood clots while taking birth control pills is lower than the risk of blood clots during and shortly after pregnancy. So for most people, it’s safe to take birth control pills such as Lo Loestrin Fe.

But if you’re over age 35 and smoke, your risk of a heart attack or stroke is higher. So it’s not recommended for these people to take combination birth control pills. If you have a history of blood clots or cardiovascular problems, tell your prescriber before starting Lo Loestrin Fe. They may prefer that you use a different type of birth control that’s safer in these situations.

Seek immediate medical help or call 911 if you are having symptoms of a blood clot, such as:

• Pain, redness, and swelling in your arms or legs

• Chest pain

• Shortness of breath

• Weakness on one side of your face or body

7. Allergic reactions

Allergic reactions and side effects are different. But it’s still good to know that allergic reactions to Lo Loestrin Fe are possible, although they’re very rare. Reactions could be mild, such as a minor rash. But in the most severe cases, they could be life-threatening, such as anaphylaxis.

If you’re having symptoms of a more mild allergic reaction, contact your prescriber right away. They’ll likely ask you to stop taking the medication. They may also prescribe medications to help ease your reaction.

If you’re having life-threatening symptoms, such as trouble breathing or swelling of the lips, mouth, or throat, call 911 or go to the nearest ER.

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Written by:

Kristine Foley, PharmD

Kristine Foley is a licensed pharmacist with over 13 years of community pharmacy experience. She earned her Doctor of Pharmacy degree from Rutgers University.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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