Norgestimate
progestogen · hormonal contraception
Our referenceBy the Layer Nutrition editorial team · How the atlas classifies the 664 molecules
What this medicine is for
Norgestimate belongs to the category "progestogen (hormonal contraception)". This hormone is used in hormonal contraception: taken each day, it prevents ovulation and makes the body unfavourable to pregnancy, reversibly.
In the case of Norgestimate, this means: Component of a hormonal contraception. It is most often a maintenance treatment, taken at regular times over long periods; its benefit is judged over time, not by how you feel on the day.
Under which brands it is found
Norgestimate is part of the composition of about 7 presentations listed in France. It is found under several brand names and as generics.
- Femi
- Naravela
- Optikinzy
- Triafemi
- Triafemi Continu
- Trinara
- Trinara Continu
Original brand-name products and generics deliver the same active substance; the choice between them is made with your doctor or pharmacist.
Our product for this treatment
Norgestimate is one of the everyday treatments for which we have formulated a targeted supplement.
Layer Nutrition Contraception
Vitamin B6 helps you regulate your hormonal activity and reduce tiredness. Folate supports normal blood formation.
- Contributes to the regulation of hormonal activity (vitamin B6)
- Contributes to the reduction of tiredness (B6, folate, B12)
- Contributes to normal psychological function (B6, folate, B12)
B6 10 mg · Folate 250 µg · B2 4.2 mg · B12 50 µg
One bottle, one dose per day. Reduced price from the second box, free delivery from two boxes.
How norgestimate works
Norgestimate is a progestin of the gonane family, derived from testosterone, used in combination with ethinylestradiol in combined oral contraceptives. It is a prodrug: once taken, it is rapidly and completely converted by intestinal and hepatic first-pass effect into its two active metabolites, norelgestromin and norgestrel. It is these metabolites that carry the effect, with elimination half-lives of about 22.3 hours for norelgestromin and 40.2 hours for norgestrel, compared with about 15.9 hours for ethinylestradiol. In the blood, they circulate more than 97 % bound to proteins: norelgestromin to albumin, norgestrel mainly to sex hormone-binding globulin (SHBG).
Control of ovulation relies on negative feedback exerted at the level of the hypothalamus. The progestin slows the frequency of GnRH pulses, which lowers the secretion of FSH and LH by the pituitary and suppresses the LH surge that normally triggers ovulation. Without this surge, the ovary does not release an egg. Added to this central effect are peripheral barriers: cervical mucus thickens and hinders the progression of sperm, the endometrium thins and the transport of the egg through the tubes slows.
Why this treatment is prescribed
The primary indication for the norgestimate/ethinylestradiol combination is oral contraception in women of childbearing age. By blocking ovulation and altering the mucus and the endometrium, it offers a reversible and predictable contraception, paced on 28-day cycles. Its effectiveness depends closely on the regularity of intake, which distinguishes real protection from theoretical protection.
The same combination is also approved for the treatment of moderate acne vulgaris, in women aged 15 and over who wish to use contraception and have no contraindication. This effect works through the reduction of available androgens: ethinylestradiol raises SHBG, which captures part of the circulating testosterone and reduces its free fraction active on the skin. Contraception and the improvement of acne thus rely on the same hormonal lever.
How to take it day to day
It is taken orally, one tablet per day, in the order imposed by the blister pack and over 28-day cycles. The effect of food on absorption has not been studied: the tablet is taken with or without food, what matters is timing regularity. Setting a stable daily marker, always at the same time, maintains constant concentrations of the active metabolites and keeps ovulation suppressed.
The margin of tolerance is narrow. Tablets must be taken at roughly the same time each day, without exceeding a 24-hour interval. A single missed tablet is made up according to the instructions on the blister pack, but missing two or more tablets calls for backup contraception, because the hormonal axis can reactivate and ovulation become possible again. Treatment is not stopped on one's own initiative: any stop or change is decided with the doctor or midwife who oversees the contraception.
The effects to know about
In clinical trials, headaches and migraines are by far the most reported effect, in 33.6 % of women. Next come breast disorders (8.0 %), vaginal infection (7.1 %), abdominal or digestive pain (5.6 %), mood disorders (3.8 %), genital discharge (3.2 %) and weight changes (2.5 %). Intermenstrual bleeding, or spotting, is also among the common effects of combined oral contraceptives, along with nausea and breast tenderness, and often eases after the first cycles.
Other effects are rarer but guide monitoring. A rise in blood pressure occurs in about 4 to 5 % of healthy women, and the risk of venous thrombosis is increased, especially during the first year of use. On the arterial side, combined oral contraceptives are associated with a moderate increase in the risk of ischemic stroke (relative risk of about 1.7) and myocardial infarction (relative risk of about 1.6). These events remain infrequent in absolute terms in young women without risk factors, which the initial assessment and follow-up seek to identify.
On the plate
Combined oral contraception shifts the status of several micronutrients. Studies report, in users, a decrease in folate, riboflavin (B2), vitamin B6, vitamin B12, vitamin C, vitamin E, zinc, magnesium and selenium. The plate works on this same ground. Spinach, kale and lentils provide folate; banana and chickpeas provide vitamin B6; pumpkin seeds, almonds and dark chocolate provide magnesium; red meat, pumpkin seeds and eggs provide zinc.
Not all micronutrients move in the same direction. The supplement focuses on those whose status falls under contraception, not on all minerals. A varied diet, rich in green vegetables, legumes, nuts and seeds, covers a good part of the needs that the treatment draws on more heavily. When daily intake stays tight on the nutrients precisely affected, a targeted supplement makes sense, in addition to your contraception and never in its place.
Interactions and monitoring
Several medicines lower the effectiveness of contraception by speeding up the elimination of its hormones. CYP3A4 inducers such as phenytoin, barbiturates, carbamazepine, rifampicin, topiramate and St John's wort decrease the plasma concentrations of the contraceptive and can let an ovulation slip through. The exchanges go both ways: combined oral contraceptives can sharply lower lamotrigine levels, while certain statins such as atorvastatin and rosuvastatin increase the area under the curve of ethinylestradiol by 20 to 25 %. Any new combination must therefore be reported to the prescriber.
Follow-up focuses on the metabolic effects of the treatment. The estrogen component can raise the serum levels of thyroxine-binding globulin (TBG), SHBG and cortisol-binding globulin, decrease glucose tolerance and alter the lipid profile. An annual visit with blood pressure control is recommended. Prediabetic or diabetic women are closely monitored because of the effect on blood sugar, and alternative contraception should be considered in case of uncontrolled dyslipidemia.
Sources
Related molecules
To explore in the « Hormones and contraception » family and its neighbours.
See the whole « Hormones and contraception » family · Back to the atlas
Frequently asked questions
What is norgestimate used for?
Norgestimate is a progestin used in combined birth control pills, paired with ethinyl estradiol. It has a dual indication, contraception and the treatment of acne. For the indication that applies to you, refer to the leaflet of your specific product and to your doctor.
What are the side effects of norgestimate?
Reported effects include headaches, cycle disturbances, breast tenderness, and changes in mood or libido. Norgestimate was designed to limit androgenic effects compared with older progestins. The full list appears in the leaflet, to go through with your pharmacist or your doctor.
Does the norgestimate pill cause weight gain?
Weight gain is among the adverse effects sometimes reported, but the data remain variable from one person to another. Norgestimate is considered less androgenic than other progestins. If you notice a bothersome change, talk to your doctor rather than stopping on your own.
Is norgestimate used for acne?
Yes, norgestimate has an indication for the treatment of acne, in addition to its contraceptive role. The decision and follow-up are up to your doctor, and the precise terms are detailed in the leaflet of the prescribed product.
Does norgestimate increase the risk of blood clots?
As with any combined hormonal contraception, there is a risk of venous thromboembolism, which varies according to the progestin and individual factors such as smoking, age or medical history. This point should be assessed with your doctor before and during use. Seek care without delay if you have unusual pain or swelling in a limb.
What should I do if I miss a pill?
What to do depends on how much time has passed since the usual time and where you are in the pack. The leaflet of your pill describes precisely the steps to follow depending on the situation. If you have any doubt about contraceptive protection, ask your pharmacist or your doctor for advice.
Does norgestimate interact with other products?
Certain enzyme inducers, such as St. John's wort, rifampicin or several antiepileptics, can reduce contraceptive efficacy. Report any medication, supplement or herb to your doctor or your pharmacist. The leaflet lists the interactions to be aware of.
What happens if I get pregnant while taking norgestimate?
If a pregnancy is discovered while taking it, the contraception is stopped and medical advice is needed promptly. What to do and the precautions appear in the leaflet of your specific product. Reach out to your doctor, who will assess your situation.
Can I take norgestimate while breastfeeding?
Combined contraceptives containing an estrogen are generally not the preferred choice during breastfeeding, and other options exist. This is a decision to make with your doctor, depending on your situation. Also refer to the leaflet of the product concerned.
Can I drink alcohol on this pill?
The leaflet does not describe any direct interaction between alcohol and norgestimate. Excessive consumption can, however, make it more likely to miss a dose. For any question about your situation, your pharmacist or your doctor remains the right person to ask.
Does the norgestimate pill change my vitamin or mineral needs?
Review articles on oral contraception link its use to variations in folate, vitamin B6 and magnesium status (Palmery et al., Eur Rev Med Pharmacol Sci, 2013). This is an association observed in the literature, not an automatic deficiency. Only a blood test, discussed with your doctor, reflects your actual situation.
Which form of folate, B6 and magnesium should I consider?
For folate, the methylated form (5-MTHF) is directly usable. Vitamin B6 comes as pyridoxine or, in a more active form, as pyridoxal-5-phosphate. For magnesium, the bisglycinate or citrate forms are well tolerated by the digestive system. Layer Nutrition's CO01 reference brings these three nutrients together, alongside a varied diet.
Ces réponses portent sur le volet nutritionnel. Pour toute question sur votre médicament, la notice et votre médecin ou pharmacien font foi.