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Zoely Contraceptive Pill

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What is Zoely?

Zoely is a combined contraceptive pill that prevents pregnancy. It works by changing your hormone levels, which affects your monthly cycle. It was approved in Europe in July 2011.

Zoely is different from other pills because it contains estradiol, which is a more natural form of oestrogen. Most common pill brands, like Microgynon or Yasmin, contain ethinylestradiol.

Before Zoely, Qlaira was the only pill available with natural oestrogen. However, unlike Qlaira, Zoely is monophasic. This means the dose of hormones in each pill is the same.

How does Zoely work?

Zoely prevents pregnancy by changing your hormone levels. This prevents the things that need to happen for a pregnancy, including:

  • Ovulation - your ovaries release an egg into the womb to be fertilised.
  • Womb lining thickening to prepare to implant the fertilised egg.
  • Cervical mucus thinning to make it easier for the sperm to enter the womb.

Throughout your menstrual cycle, the levels of sex hormones, oestrogen and progesterone rise and fall to trigger these different reproductive processes.

Zoely contains a natural oestrogen and a synthetic progesterone. So, when you take the pill, you supplement these hormones to keep their levels stable. This means none of these critical processes ever happen and therefore you cannot get pregnant.

What are the benefits of Zoely?

Zoely has several benefits when it comes to contraception.

  • It is highly effective - it is over 99% effective with perfect use, meaning you won’t have to worry about pregnancy while using it.
  • It is a pill you take once a day - it is easier to use than other contraceptive methods like the ring or an injectable, and less invasive than the IUD.
  • It contains a natural oestrogen - estradiol is a less potent natural oestrogen. This means it has a lower risk of side effects than other pills that contain synthetic oestrogens.

Contraception has to work with your lifestyle. So, it’s important to consider all the pros and cons of each method before starting a new contraceptive.

How effective is Zoely?

Zoely is over 99% effective when used correctly. This is sometimes known as perfect use. However, with typical use, it is around 93% effective. This means 7 in every 100 women will get pregnant on Zoely.

How do I take Zoely?

When to start taking it

Start taking Zoely on the first day of your cycle. This means it will be effective immediately and you won’t need to use additional contraception.

If you start it any other time, you will need to use barrier contraception (e.g. condoms) or not have sex for at least 7 days.

Switching to Zoely from another contraceptive

If you are switching to Zoely and you were previously using a different contraceptive, the advice on when to start will depend on which contraceptive you previously used.

  • A combined pill - Start taking Zoely after the last pill and skip the pill-free week. If your previous pill also has active and inactive pills, skip the inactive pills.
  • A progestogen-only pill (mini-pill) - You can stop taking the mini-pill any day and immediately start taking Zoely. However, you will need to use barrier contraception for at least 7 days or not have sex.
  • The patch or ring - Start taking Zoely on the day you remove the patch or ring or on the day you would normally change to the next ring or patch.
  • The hormonal IUD, copper IUD or progestogen-only injectable - Start taking Zoely on the day the IUD is removed or on the day your next injectable is due. You will need to use barrier contraception for at least 7 days or not have sex.

After having a baby

You should start taking Zoely between days 21 and 28 after having your baby.

If you start later than day 28, you will need to use barrier contraception for the first 7 days of taking Zoely. If you have just had a miscarriage, ask your doctor for advice on taking Zoely.

If you are not sure when to start taking Zoely, always ask your doctor or pharmacist.

When to take it

You need to take Zoely every day for it to be effective. You do not need to take it at the exact same time each day. However, it’s a good idea to take it around the same time to help you remember.

You could set a reminder on your phone to remind you to take it daily or download an app that helps remember your pill schedule.

How to take it

Each strip of Zoely contains 28 pills: 24 active pills which contain hormones and 4 inactive pills. The active pills are white and the inactive ‘placebo’ pills are yellow.

You must take the 24 active pills and then the 4 inactive pills. Each blister pack is numbered to help you take the pills correctly.

You do not take a pill-free week like other contraceptive pills. Once you finish a strip, you must start a new strip the next day. You should have a withdrawal bleed (period) whilst taking the 4 inactive pills.

Diagram of Zoely blister pack.

Each pack also comes with stickers of the days of the week to help you take your pill correctly. If you start taking Zoely on a Wednesday for example, choose the sticker that starts with Wednesday and place it at the top of the blister pack.

What happens if I miss a pill?

A missed Zoely pill is a pill that is more than 12 hours late. This also includes if you have had persistent vomiting or diarrhoea for 12 hours or more.

The advice is different depending on when you miss a pill. You are at a higher risk of pregnancy if you miss pills at the beginning of the pack or towards the end.

Use our tool below to find out what to do if you have forgotten to take Zoely.

Missed Zoely Pill Guide

How many hours late is your pill?

What to do:

Take the pill as soon as you remember

Take the next pill at your usual time

Your contraceptive protection is not affected

Low risk: Continue as advised

If you're less than 12 hours late, the pill's effectiveness is maintained. Just take it as soon as you can and continue your regular schedule.

Which day of your pack are you on?

What to do:

Take the last missed pill immediately

Continue taking pills at the normal time

Use a barrier method for 7 days

Contact your doctor if you had sex in the past week

You may be at risk of pregnancy

High risk: Take immediate action

Missing pills in the first week can increase your risk of pregnancy. Additional contraception is crucial, and you may need emergency contraception if you've had unprotected sex.

What to do:

Take the missed pill immediately

Continue taking pills at the normal time

Your contraceptive protection is not affected

Low risk: Continue as advised

Missing one pill in the middle of your pack is less risky. Your body's hormone levels are usually stable enough to maintain protection.

What to do:

Take the last missed pill immediately

Continue taking pills at the normal time

Use a barrier method for 7 days

Your contraceptive protection may be reduced

Medium risk: Follow instructions carefully

Missing multiple pills can significantly reduce your protection. Using additional contraception helps ensure you're protected while your hormone levels stabilize.

What to do:

Take the last missed pill immediately

Continue taking pills at the normal time

Skip the inactive pills

Start a new pack immediately after active pills

Use a barrier method for 7 days

Alternative Option:

Stop taking active pills

Start taking inactive pills immediately

Start your next pack as normal

Follow Option 1 if unsure about the number of missed pills

High risk: Take immediate action

Missing pills near the end of your pack can extend the hormone-free interval, increasing pregnancy risk. Starting the next pack immediately (Option 1) helps maintain hormone levels and is safer if you're unsure about the number of missed pills.

What to do:

Discard the missed inactive pill(s)

Continue taking pills as normal

Your contraceptive protection is not affected

Low risk: Continue as advised

Inactive pills don't contain hormones, so missing them doesn't affect your contraceptive protection. However, taking them on schedule helps maintain the habit of daily pill-taking.

Important: If you have forgotten any active pills and do not have the expected withdrawal bleeding while taking the inactive pills, you may be pregnant. Take a pregnancy test and consult your doctor before starting a new pack.

Emergency contraception may be an option within 2-5 days of unprotected sex. Always consult your healthcare provider for personalized advice.

Please note: this missed pill advice is for Zoely only. If you take another combined contraceptive pill, you can use our handy missed pill tool here.

Who can take Zoely?

Zoely is suitable for most women who can become pregnant. However, your doctor will want to monitor your health whilst on Zoely. This includes monitoring your weight, blood pressure and lifestyle habits.

Some women may be more at risk of side effects so may not be eligible.

Who cannot take Zoely?

If you have any of the following conditions, you must not use Zoely. This is because there is a very high risk of side effects if you take it.

Do not take Zoely if you:

  • have ever had a blood clot in the legs, lungs or other organs
  • have a disorder that affects your blood clotting
  • need an operation or have been off your feet for a long time
  • have ever had a heart attack or stroke
  • have severe diabetes with blood vessel damage
  • have very high blood pressure or high cholesterol
  • have ever had a migraine with aura
  • have ever had pancreatitis (inflammation of the pancreas) due to high levels of fat in your blood
  • have ever had severe liver disease or a tumour in your liver
  • have ever had cancer of the breast or genital organs (e.g. cervical, vaginal, vulvar, ovarian or uterine cancers)
  • have unexplained vaginal bleeding
  • are allergic to estradiol, nomegestrol or any of the other ingredients

Your doctor will advise you on what birth control options are safe for you to take.

Cautions

Some other women may be able to take it but may need specialist advice or regular monitoring to ensure it’s safe for them to take.

This includes if you:

  • carry the breast cancer gene mutations BRCA1 or BRCA2
  • have experienced cholestasis during pregnancy or whilst on combined hormonal contraception
  • have gallbladder disease
  • have inflammatory bowel disease
  • have a family history of high triglycerides (a type of fat) in your blood

You will also need to be cautious if you have any risk factors for cardiovascular disease or blood clots (venous thromboembolism).

Our doctors at euroClinix will be able to know if it’s suitable for you when you complete our consultation form about your medical history before prescribing you the medication.

If you have multiple risk factors, you will need to consult your doctor before using Zoely.

What are the side effects of Zoely?

Like all prescription medicines, Zoely may cause some side effects. However, the most common side effects are mild and should go away on their own once your body adjusts to the medicine.

Common side effects of Zoely include:
  • stomach pain
  • breast abnormalities
  • diarrhoea
  • fluid retention
  • headaches
  • abnormal vaginal bleeding
  • mood changes
  • nausea and vomiting
  • low libido
  • vaginal discharge
  • weight gain
  • pelvic pain

Mild side effects can also be managed with simple lifestyle tips. Staying hydrated and taking probiotics will help with diarrhoea and vomiting.

However, if your symptoms don’t go away or you experience more severe side effects, consult your doctor as soon as possible.

Uncommon side effects

Uncommon side effects affect 1 in every 100 people who take this medicine.
  • hair loss
  • bloating
  • appetite abnormal
  • galactorrhoea (spontaneous milk flow)
  • excessive sweating
  • swelling
  • pain during sex
  • oily skin
  • feeling of pressure on the skin
  • uterine cramps
  • vulvovaginal disorders

These side effects should go away on their own once you finish treatment. However, consult your doctor.

Rare side effects

Rare side effects may affect 1 in every 1,000 people who take this medicine.

Serious but rare side effects include:
  • harmful blood clots in the vein or artery (e.g. in the leg, foot or lung)
  • blood clot that causes a stroke, heart attack or mini-stroke

However, the risk is low if you do not have any risk factors for these conditions. Your doctor will decide if it’s safe for you to take.

Unserious but rare side effects may include:
  • impaired concentration
  • contact lens intolerance
  • dry eye
  • dry mouth
  • gallbladder problems
  • excessive hair growth

For a full list of potential side effects, please consult the patient information leaflet.

Does Zoely interact with other medicines?

Zoely can interact with other medicines you take.

Some medicines may alter how Zoely works, how effective it is or may cause side effects when used together.

This includes:

  • medicines for epilepsy
  • medicines for tuberculosis
  • medicines for HIV infections
  • ketoconazole (an anti-fungal)

Always consult your doctor before using Zoely if you take any other medicines.

What safety advice should be followed when taking Zoely?

Category Status Advice
Alcohol Safe It is safe to drink alcohol whilst taking Zoely.
Smoking Caution Smoking could put you at a higher risk of side effects such as heart disease and blood clots. Consult your doctor if you smoke, have smoked or have just quit smoking.
Pregnancy Unsafe It is unsafe to take Zoely while pregnant as it can increase the risk of birth defects.
Breastfeeding Safe You can take Zoely 6 weeks postpartum and is safe for 6 months or more.
Driving Safe Zoely should not affect your ability to drive.

How do I store Zoely?

This medicine does not have any specific storage requirements. However, you should keep it out of sight and reach of children.

You should also not use it past the expiry date. You can see the expiry date on the medicine carton after EXP. The date refers to the last day of the month.

Do not discard expired medicines in general waste or in the toilet. This is bad for the environment. Take your expired medicines to your local pharmacy to dispose.

Can I buy Zoely without a prescription?

No, Zoely is not available over the counter. It is only available via prescription from a registered doctor. This is so the doctor can ensure the medicine is safe for you to use. However, if you cannot get to your GP, you can get a prescription from an online healthcare provider such as euroClinix.

How do I buy Zoely online from euroClinix?

Ordering Zoely through euroClinix is simple and secure. Follow these steps:

  • Start a confidential online questionnaire from the top of this page. Completing it takes about 5-10 minutes.
  • A UK-registered doctor will review your consultation.
  • If approved, the doctor will issue an electronic prescription.
  • A licensed UK pharmacy sends your medication in discreet packaging. The pharmacy will also share tracking information. You get free with next-day delivery.

euroClinix offers ongoing support for any questions. Privacy and security are guaranteed through compliance with the relevant regulatory standards and the use of encrypted transactions.

Why should I choose euroClinix?

euroClinix is a trusted online clinic that offers services in several European countries. All consultations and prescriptions are handled by our UK-registered doctors.

The process is convenient with online consultations and discreet home delivery. Our friendly customer service team is always happy to assist with any questions related to our services.

The euroClinix platform is user-friendly for managing prescriptions and reorders securely.

Choosing euroClinix ensures a trusted, professional, and supportive service for all your contraceptive needs.

What are the alternatives to Zoely?

The main low-dose alternative pill to Zoely is Qlaira.

Qlaira also contains estradiol. However, it is a multiphasic pill. This means that the dose of hormones varies throughout the pack to try and replicate your natural cycle.

Zoely, however, is monophasic. It has the same dose of hormones across all of the active pills. Below is a full comparison of the two.

Zoely Qlaira
Ingredients Nomegestrol and Estradiol Dienogest and Estradiol
Type of combined pill Monophasic Multiphasic
Active & inactive pills
  • 24 white active pills
  • 4 yellow inactive pills
  • 26 multicoloured active pills
  • 2 white inactive pills
Dosage instructions
  • Take the 24 white active pills.
  • Then, take the 4 yellow inactive pills.
  • A period should occur whilst taking the inactive pills.
  • Start the next pack immediately after you have finished the previous one.
  • Take all pills in the exact order in the packet.
  • Start by taking the 26 active pills then take the 2 inactive pills.
  • A period should occur towards the end of the pack.

As well as other combined pills, there are a myriad of contraception options available. You can take our contraception quiz to learn more about what option is best for your lifestyle.

Zoely FAQs

Is Zoely a low-dose pill?
Can I take Zoely for menopause?
Can Zoely stop your period?
Does Zoely cause weight gain?
Is Zoely safe?
Is it safe to order online?
Will my order be confidential?
Can I get a discount on my order?

Note: You must complete a short online consultation so that our doctor can ensure that the treatment is suitable for you. The above pricing should only be used as a reference. The final decision to issue this treatment lies with the prescribing doctor.

Medically reviewed by Dr. Caroline Fontana Written by our editorial team Last reviewed 16-10-2024
Zoely information
Group of medicationCombined hormonal contraceptives
Used forContraception
Active ingredient(s)Estradiol with nomegestrol
Works bySupplements hormone levels to prevent conception
Effective withinImmediately if taken on the first day of your cycle
Suitable forWomen who can become pregnant
Available asTablets
Available strength2.5 mg of nomegestrol/1.5 mg of estradiol
Dosage instructionsTake white tablets daily for 24 days then the yellow placebo pills for 4 days. Repeat each month.
ManufacturerMerck Sharp & Dohme Ltd.
Generic availableNo
StorageKeep out of sight and reach of children, do not store above 30°C and discontinue use after the expiry date.
Prescription requiredYes - included with our free online consultation.
Zoely reviews
Pack of Zoely 2.5mg/1.5mg nomegestrol acetate/estradiol 84 film-coated oral tablets Excellent 4.8 76 patients have reviewed Zoely on Trustpilot

Further reading

Understanding and managing side effects of the pill

Understanding and managing side effects of the pill

Reviewed by Dr. Caroline Fontana
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