Both norethisterone and desogestrel are synthetic versions of the hormone progesterone. While they are both derived from progestogens, they are used for different purposes and are prescribed at different doses. Combining them is not only unnecessary but can also be harmful due to the hormonal overload it can cause. A thorough understanding of each medication's purpose is crucial to appreciate why they should not be mixed.
Understanding Norethisterone and Desogestrel
To grasp why combining these medications is ill-advised, it is important to understand their specific uses and pharmacological profiles. While both are progestins, they serve distinct roles in women's health.
What is Norethisterone?
Norethisterone is a synthetic progestin most commonly prescribed for short-term use, such as delaying a menstrual period. It is also used to treat various menstrual disorders, including heavy or painful periods and endometriosis. When taken for period delay, the dose is higher than the contraceptive dose found in some pills, and it is not considered a reliable contraceptive. This means a person taking norethisterone for period delay must still use other forms of contraception, like condoms, to prevent pregnancy. Norethisterone is typically taken for a specific, short duration to achieve a temporary effect.
What is Desogestrel?
Desogestrel is also a synthetic progestin, but its primary use is as a highly effective, long-term oral contraceptive, also known as the 'mini-pill'. Unlike many progestin-only pills that primarily thicken cervical mucus, desogestrel works by consistently suppressing ovulation, preventing the release of an egg entirely. It is designed to be taken daily at the same time and provides continuous pregnancy protection. Because of its specific mechanism and continuous dosage, it is a complete contraceptive method on its own.
Why Combining Norethisterone and Desogestrel is Not Recommended
There are several critical reasons why healthcare professionals caution against taking these two medications concurrently.
Risk of Hormone Overload
Since both medications are progestin-based, taking them simultaneously creates an excessive and unmonitored level of hormones in the body. This hormone overload is not medically necessary and can disrupt the body's natural balance more severely than either medication alone. In the case of using norethisterone for period delay while already on desogestrel, the norethisterone is redundant and simply adds unnecessary hormonal load.
Increased Side Effects
Adding more hormones to your system significantly increases the likelihood and severity of side effects. Common side effects associated with progestin medications include:
- Irregular bleeding or spotting between periods
- Breast tenderness or swelling
- Headaches and dizziness
- Nausea
- Mood changes and irritability
- Fluid retention and weight fluctuations
Combining these pills could intensify these symptoms and lead to more severe side effects that are difficult to manage.
No Added Contraceptive Benefit
For someone already taking desogestrel for contraception, adding norethisterone does not provide any extra protection against pregnancy. Desogestrel is already a highly effective contraceptive, and more progestin will not increase its efficacy. The risks of increased side effects simply outweigh any non-existent benefits.
Comparison of Norethisterone and Desogestrel
To clearly illustrate the differences between these two medications and why they should not be used together, consider the following comparison table:
| Feature | Norethisterone | Desogestrel (Mini-Pill) |
|---|---|---|
| Primary Use | Short-term period delay, treating menstrual issues | Long-term, continuous contraception |
| Hormone Type | Synthetic Progestin | Synthetic Progestin |
| Contraceptive Function | Not a reliable contraceptive when used for period delay | Highly effective contraceptive by preventing ovulation |
| Duration of Use | Short-term, specified course (e.g., up to 20 days) | Continuous, daily use for ongoing pregnancy prevention |
| Timing | Not as time-sensitive, used on a short course | Must be taken at the same time each day (within a 3-hour window) |
What to Do If You Need to Delay Your Period While on Desogestrel
If you are currently on a desogestrel contraceptive and wish to delay your period, the correct course of action is not to add norethisterone. Instead, you should consult your healthcare provider. Depending on your health profile and the specific formulation of your pill, a doctor may advise a different method. For some, continuous use of their current desogestrel pill may be an option for temporary period management. Discussing your options with a professional ensures both safety and effectiveness.
What to Do If You Have Accidentally Taken Both
If you have accidentally taken a dose of norethisterone while on your regular desogestrel pill, you should contact a doctor or pharmacist for advice. While a single, accidental dose may not be harmful, it is essential to seek professional guidance to monitor for any potential side effects or determine if any action is needed. Do not continue taking both medications. Resume your regular contraceptive schedule as advised by a healthcare professional and use backup contraception if instructed.
Conclusion
It is generally not recommended and potentially risky to combine norethisterone and desogestrel due to the risk of hormonal overload and an increase in adverse side effects. Each medication has a specific and distinct purpose: desogestrel is a highly effective long-term contraceptive, while norethisterone is typically used for short-term period delay or managing menstrual issues. For your safety and well-being, never mix hormonal medications without explicit, professional medical advice. Always speak with a qualified healthcare provider about your health goals and medication needs.
For more information on progestin-only pills and their uses, the CDC offers comprehensive guidance for healthcare professionals that can provide further context on these medications.
