Last update: July 16, 2017

Estradiol + Nomegestrol

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.

Combined contraceptive with Estrogen (Estradiol hemihydrate) plus Progestin (Nomegestrol acetate) for daily oral administration.

ESTRADIOL is excreted in breast milk in clinically non-significant amount without problems having been observed in infants whose mothers have received it. Plasma levels of drug in those infants were undetectable or very low. There was higher excretion into milk when administered vaginally.
There is some evidence (though not definite) that estrogens may decrease milk production, especially if they are used during the first few days postpartum.
Estrogens may decrease the protein content of breastmilk.
No problems have been observed in infants whose mothers were on estrogens, except for rare cases of transient gynecomastia in infants whose mothers received higher doses than usual.
Exposure to estrogen in childhood or adolescence does not influence subsequent milk production.

NOMEGESTROL is a third generation synthetic progestogen which is structurally related to progesterone.
It has been used as a part of only-one-component contraceptives which have one year lasting effect in subdermal implants. Also orally used alone or associated to estrogen (see info on Estradiol + Nomegestrol).

In a study comparing effects on breastfeeding women (120 with a Nomegestrol implant and 120 with an intrauterine device (IUD), there were no significant differences on duration of breastfeeding nor somatic follow-up criteria nor health issues in infants (Abdel -Aleem 1996).

Differences on frequency of breastfeeding, amount of milk production and the weight gain of breastfed infants with similar combined contraceptives compared to other contraceptive methods (intrauterine devices, isolated progestogens) have not been observed. However, it would advisable to avoid them until breastfeeding is well established (4 to 6 weeks).

During lactation, progestogen-only contraceptives are preferred over those combined with estrogen. Otherwise, those with lower doses of estrogen should be used.
Within the first 6 weeks postpartum, non-hormonal contraceptive methods should be the first option.

Hormonal contraceptives do not change the milk composition whether minerals (Mg, Fe, Cu, Ca, P), fats, lactose or calories but a little protein.


See below the information of these related products:

Alternatives

We do not have alternatives for Estradiol + Nomegestrol.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Estradiol + Nomegestrol in other languages or writings:

Group

Estradiol + Nomegestrol belongs to this group or family:

Tradenames

Main tradenames from several countries containing Estradiol + Nomegestrol in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 5 / 63 %
Molecular weight 272 / 371 daltons
Protein Binding 98 / 98 %
VD - / 1,7 l/Kg
Tmax 1 - 4 / 2 hours
T1/2 20 - 26 / 46 (28 - 83) hours

References

  1. EMA. Estradiol + Nomegestrol acetato. Ficha técnica. 2016 Full text (in our servers)
  2. EMA. Estradiol + Nomegestrol acetate. Drug Summary. 2016 Full text (in our servers)
  3. Lopez LM, Grey TW, Stuebe AM, Chen M, Truitt ST, Gallo MF. Combined hormonal versus nonhormonal versus progestin-only contraception in lactation. Cochrane Database Syst Rev. 2015 Abstract
  4. Tepper NK, Phillips SJ, Kapp N, Gaffield ME, Curtis KM. Combined hormonal contraceptive use among breastfeeding women: an updated systematic review. Contraception. 2015 Abstract
  5. Berens P, Labbok M; Academy of Breastfeeding Medicine. ABM Clinical Protocol #13: Contraception During Breastfeeding, Revised 2015. Breastfeed Med. 2015 Abstract Full text (link to original source) Full text (in our servers)
  6. Berens P, Labbok M; Academy of Breastfeeding Medicine. Protocolo clínico de la ABM n.º 13: Anticoncepción durante la lactancia, revisado en 2015. Breastfeed Med. 2015 Full text (link to original source) Full text (in our servers)
  7. Pinheiro E, Bogen DL, Hoxha D, Wisner KL. Transdermal estradiol treatment during breastfeeding: maternal and infant serum concentrations. Arch Womens Ment Health. 2015 Abstract Full text (link to original source) Full text (in our servers)
  8. Bahamondes L, Bahamondes MV, Modesto W, Tilley IB, Magalhães A, Pinto e Silva JL, Amaral E, Mishell DR Jr. Effect of hormonal contraceptives during breastfeeding on infant's milk ingestion and growth. Fertil Steril. 2013 Abstract Full text (link to original source) Full text (in our servers)
  9. Espey E, Ogburn T, Leeman L, Singh R, Ostrom K, Schrader R. Effect of progestin compared with combined oral contraceptive pills on lactation: a randomized controlled trial. Obstet Gynecol. 2012 Abstract
  10. Abdel-Aleem H, Abol-Oyoun el-S M, Shaaban MM, el-Saeed M, Shoukry M, Makhlouf A, Salem HT. The use of nomegestrol acetate subdermal contraceptive implant, uniplant, during lactation. Contraception. 1996 Abstract
  11. Nilsson S, Nygren KG, Johansson ED. Transfer of estradiol to human milk. Am J Obstet Gynecol. 1978 Abstract

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