Estradiol + Norethisterone

Combined oral contraceptive (COC) of estrogen (estradiol) and progestogen (norethisterone) in the form of pills for oral use. Daily administration.

For a detailed discussion with references:

• on why non-hormonal methods are the first choice during the first 4–6 weeks postpartum, followed by IUDs and progestin implants,
• on the potential problems associated with the use of combined estrogen-progestin contraceptives,
• the possible decrease in milk production with estrogen use,
• and why progestin-only contraceptives are preferable during breastfeeding,

see below: “(Combined Estrogen + Progestin Contraceptives, COCs)”

ESTRADIOL is excreted into breast milk in clinically insignificant or null amounts and no problems have been observed in infants whose mothers were treated. Plasma levels of these infants were undetectable or very low. After administration in the form of transdermal patches milk levels have been undetectable. These details, along with references, can be found below under “Estradiol"

NORETHISTERONE (norethindrone) is a progestin derivative of 19-nortestosterone. 

Norethindrone and progestins in general are considered the contraceptives of choice during breastfeeding because they are not significantly excreted in breast milk, do not alter the quantity or composition of breast milk, do not cause side effects, and do not affect the growth and development of infants or the duration of breastfeeding. These details, along with references, can be found below under “Norethisterone”

American Academy of Paediatrics: COCs are usually compatible with breastfeeding. ^{(AAP 2001)}

See below the information of these related products:

• (Combined oestrogen-progestogen contraceptives, COCs) (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
• Estradiol (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
• Norethisterone (Safe product and/or breastfeeding is the best option.)