Is Zoely anti-androgenic? A deep dive into its pharmacological profile

October 7, 2025 •

5 min read

According to the Therapeutic Goods Administration (TGA) in Australia, Zoely contains the progestogen nomegestrol acetate, which exhibits a moderate anti-androgenic effect. So, is Zoely anti-androgenic? Yes, but its clinical impact on symptoms like acne and hirsutism warrants a more detailed look into its pharmacological profile and comparative clinical trial results.

Quick Summary

Zoely contains nomegestrol acetate, a progestogen with a mild to moderate anti-androgenic effect, and natural estradiol, which also has anti-androgenic properties. The clinical effect on androgenic symptoms like acne may be less potent than some other birth control pills containing stronger anti-androgens, such as Yasmin.

Key Points

Moderate Anti-Androgenic Progestin: Zoely's progestin, nomegestrol acetate, has a weak to moderate anti-androgenic effect by blocking androgen receptors.
Natural Estrogen: It contains natural 17β-estradiol, which increases SHBG to lower free testosterone, enhancing the anti-androgenic action.
Varying Clinical Effectiveness: Despite its anti-androgenic profile, clinical studies have shown higher rates of acne in Zoely users compared to those taking Yasmin, a pill with a stronger anti-androgenic progestin.
Key Pharmacological Action: Nomegestrol acetate is a 19-norprogesterone derivative with high selectivity for the progesterone receptor, minimizing unwanted hormonal activity.
Comprehensive Patient Counseling: Choosing Zoely for anti-androgenic symptoms requires careful consideration, and patients seeking strong acne relief may need to discuss other options with their doctor based on clinical trial comparisons.
Bleeding Pattern Differences: A key clinical difference reported is that Zoely users experience shorter and lighter withdrawal bleeding, and often more amenorrhea, compared to Yasmin.

Understanding the Hormonal Components of Zoely

To understand if Zoely is anti-androgenic, it is necessary to examine its two active components: nomegestrol acetate and 17β-estradiol. The hormonal actions of both ingredients contribute to its overall pharmacological profile, including its effect on androgens, or male hormones.

Nomegestrol Acetate: The Progestogen Component

Nomegestrol acetate (NOMAC) is the synthetic progestogen in Zoely. Unlike some older progestins derived from 19-nortestosterone, NOMAC is a derivative of 19-norprogesterone. This structural difference gives it a distinct hormonal profile. Sources describe its anti-androgenic activity as ranging from weak to moderate. Specifically, NOMAC acts as an antagonist of the androgen receptor, and its effect may be useful in alleviating some androgen-dependent symptoms like acne and seborrhea. Furthermore, it has a high affinity for the progesterone receptor and is notably selective, showing no significant binding to androgen, glucocorticoid, or mineralocorticoid receptors. This selectivity helps minimize potential off-target hormonal effects associated with less specific progestins.

17β-Estradiol: The Estrogen Component

Zoely is also unique because it contains 17β-estradiol (E2), a natural estrogen that is identical to the one produced by the ovaries. Most combined oral contraceptives use a synthetic estrogen called ethinyl estradiol. The estrogen component in birth control pills also has an anti-androgenic effect by increasing sex hormone-binding globulin (SHBG) production in the liver. SHBG binds to androgens in the bloodstream, effectively lowering the levels of free, active testosterone. This synergistic effect, combined with the moderate anti-androgenic properties of nomegestrol acetate, contributes to Zoely's overall anti-androgenic profile.

Clinical Evidence for Zoely's Anti-Androgenic Effects

While preclinical studies confirm the anti-androgenic activity of nomegestrol acetate, clinical trials provide more nuanced results, particularly when comparing Zoely to other contraceptives known for their anti-androgenic properties, such as Yasmin (containing drospirenone).

Zoely vs. Yasmin: A Clinical Comparison

Two randomized trials compared Zoely with Yasmin, a combined pill often prescribed for its strong anti-androgenic effects. While both pills showed high contraceptive efficacy, the clinical outcomes for androgenic symptoms were surprising to some:

Acne: The trials reported that acne was more commonly reported in women taking Zoely compared to those on Yasmin.
Weight Gain: Weight gain was also reported more frequently by Zoely users.
Withdrawal Bleeding: Zoely resulted in shorter, lighter, and more frequent absent withdrawal bleeds.

Interpreting the Findings

The higher reported incidence of acne in Zoely users, despite its anti-androgenic properties, highlights a key pharmacological principle: the overall clinical effect is a complex interplay of hormonal and individual factors. Drospirenone in Yasmin has a more potent anti-androgenic effect than nomegestrol acetate. Therefore, while Zoely is anti-androgenic, it may not be the optimal choice for individuals primarily seeking treatment for moderate to severe acne or other androgen-related skin conditions. The efficacy of a combined oral contraceptive against androgenic symptoms depends on both the progestin's specific anti-androgenic strength and the dose of estrogen, which influences SHBG levels.

Comparison of Zoely and Yasmin


Feature	Zoely (nomegestrol acetate/estradiol)	Yasmin (drospirenone/ethinylestradiol)
Active Hormones	Nomegestrol acetate (NOMAC), 17β-estradiol (E2)	Drospirenone, Ethinylestradiol
Progestin Type	19-norprogesterone derivative	Spironolactone analog
Anti-Androgenic Strength	Weak to moderate	Strong
Clinical Acne Outcome	Higher incidence reported in trials compared to Yasmin	Lower incidence reported in trials compared to Zoely
Estrogen Type	Natural 17β-estradiol	Synthetic ethinylestradiol

Considering Zoely for Androgenic Symptoms

For those concerned about androgenic side effects like acne and hirsutism, it's crucial to have a comprehensive discussion with a healthcare provider. While Zoely's nomegestrol acetate does possess anti-androgenic activity, the clinical trial data comparing it to Yasmin suggests it may not be the most effective birth control for managing acne.

If you are considering birth control for androgen-related issues, here are some points to discuss with your doctor:

Symptom Severity: Describe the severity of your acne, hirsutism, or other androgenic symptoms.
Past Experience: Share any previous experience with hormonal birth control and how it affected your skin or hair.
Pill Options: Ask your doctor about different pill formulations, particularly those with a stronger anti-androgenic progestin like drospirenone, if managing these symptoms is your primary goal.
Overall Profile: Consider the complete profile of the pill, including its effect on bleeding patterns, mood, and other potential side effects. Zoely is associated with a higher rate of amenorrhea (absence of withdrawal bleed), which some women may prefer.

Conclusion

In conclusion, is Zoely anti-androgenic? Yes, due to both the moderate anti-androgenic activity of its nomegestrol acetate component and the systemic effects of 17β-estradiol. However, this pharmacological action does not guarantee superior clinical results for androgen-related symptoms such as acne. Clinical studies comparing Zoely with Yasmin have shown higher reported rates of acne among Zoely users, suggesting that other combined oral contraceptives with more potent anti-androgenic progestins may be more effective for this specific purpose. Patients should consult a healthcare provider to determine the most suitable contraceptive based on their individual needs and treatment goals, especially if managing acne or hirsutism is a priority.

For further reading, the preclinical pharmacological profile of nomegestrol acetate is detailed in a review published in the journal Reproductive Biology and Endocrinology(https://rbej.biomedcentral.com/articles/10.1186/1477-7827-10-85).

How does nomegestrol acetate in Zoely exert its anti-androgenic effect?

Nomegestrol acetate functions as an antagonist of the androgen receptor, meaning it blocks androgens from binding to their receptors. This action reduces the effect of androgens in the body, which can help alleviate symptoms like acne and excess hair growth.

Does the estradiol in Zoely also contribute to its anti-androgenic properties?

Yes, the 17β-estradiol component of Zoely plays a role in its anti-androgenic effects. Estrogens increase the liver's production of sex hormone-binding globulin (SHBG), which binds to androgens in the bloodstream. By reducing the amount of free, active testosterone, the estradiol contributes to the overall anti-androgenic profile.

Is Zoely a good option for treating acne?

While Zoely does have anti-androgenic properties, clinical studies comparing it to Yasmin (a pill with a stronger anti-androgenic progestin, drospirenone) have shown higher rates of acne reported by Zoely users. This suggests that other oral contraceptives may be more effective for managing acne. A discussion with a healthcare provider is recommended to find the best option for your specific needs.

How does the anti-androgenic effect of Zoely compare to Yasmin?

Clinical trial results indicate that the anti-androgenic effect of Yasmin, which contains drospirenone, appears to be stronger in practice for reducing acne compared to Zoely's nomegestrol acetate. Though both have anti-androgenic properties, the strength and clinical manifestation differ.

Does Zoely have other benefits related to its hormonal profile?

Yes, studies have shown that Zoely is associated with lighter and shorter withdrawal bleeding, and a higher incidence of amenorrhea (no withdrawal bleed), which some women may find beneficial. The use of a natural estradiol and a highly selective progestin may also contribute to a favorable metabolic profile.

What should a patient consider when choosing a birth control for anti-androgenic benefits?

A patient should consider the primary reason for choosing birth control. If controlling acne or hirsutism is a main priority, discussing pills known for strong anti-androgenic effects, such as those containing drospirenone, with a healthcare provider is crucial. If other factors like natural hormones or bleeding patterns are more important, Zoely may still be a good option.

Are there side effects related to Zoely's anti-androgenic activity?

Side effects are a possibility with any hormonal medication. Clinical trials with Zoely have shown acne and weight gain to be more commonly reported compared to Yasmin users, despite Zoely's anti-androgenic properties. Mood changes and breast tenderness are also reported side effects.

Frequently Asked Questions

Yes, Zoely contains nomegestrol acetate, a synthetic progestogen with a weak to moderate anti-androgenic effect. The natural estradiol in Zoely also contributes by increasing SHBG, which reduces free testosterone.

While Zoely does have anti-androgenic properties that can help with acne, clinical trial data suggests that its effectiveness for this purpose may not be as strong as other birth control pills, such as those containing drospirenone.

Nomegestrol acetate acts as an antagonist to the androgen receptor. By blocking the receptor, it prevents androgens from exerting their effects on the body's cells, which can help alleviate symptoms like acne and excessive hair growth.

The progestin in Zoely is nomegestrol acetate, which has a moderate anti-androgenic effect. The progestin in Yasmin is drospirenone, which is known for its stronger anti-androgenic effect.

While Zoely is anti-androgenic, clinical studies comparing it with Yasmin found higher rates of reported acne among Zoely users. Other reported side effects include weight changes, mood swings, and breast tenderness.

Zoely contains 17β-estradiol, which is identical to the natural estrogen produced by a woman's body. Many other combined oral contraceptives use a synthetic estrogen called ethinyl estradiol.

It is difficult to say without a direct comparison to older pills. However, comparative clinical trials show that pills with stronger anti-androgenic effects, like Yasmin, may be more effective for managing acne. The best choice depends on individual needs and a healthcare provider's recommendation.

Any medication switch should be made in consultation with a healthcare provider. The effects of switching, especially regarding androgen-related symptoms, may vary depending on the specific hormone levels and individual response.