Nordette is a combined oral contraceptive pill containing ethinylestradiol and levonorgestrel. It prevents pregnancy, and it is also widely used to regulate periods, reduce heavy or painful bleeding, and manage acne and premenstrual symptoms.
What is Nordette?
The South African Medicine Price Registry lists Nordette as a Schedule 3 tablet containing:
| Ingredient | Amount | Type |
|---|---|---|
| Ethinylestradiol | ~0.03 mg (30 mcg) | Oestrogen |
| Levonorgestrel | ~0.15 mg (150 mcg) | Progestogen |
(The register records these with long decimal expansions — a formatting artefact. The standard formulation is 30 mcg ethinylestradiol with 150 mcg levonorgestrel.)
This is a combined oral contraceptive — “combined” because it contains both an oestrogen and a progestogen. Levonorgestrel is a second-generation progestogen, and combinations containing it are generally considered to carry a lower risk of blood clots than those using newer progestogens, which is one reason they remain a common first choice.
Combined pills prevent pregnancy in three ways:
- They stop ovulation. No egg is released, which is the main mechanism.
- They thicken cervical mucus, making it harder for sperm to pass.
- They thin the lining of the womb, making implantation less likely.
Packs are usually 21 active tablets followed by seven days off, or 21 active plus seven inactive tablets. The bleed during the break is a withdrawal bleed, not a true period — a response to the hormone drop rather than a natural cycle.
Used perfectly, combined pills are over 99% effective. In real use, with missed and late pills, effectiveness is around 91% — the gap between those two numbers is entirely about consistency.
What is Nordette commonly used for?
- Preventing pregnancy — the primary use.
- Regulating irregular periods, giving a predictable cycle.
- Reducing heavy menstrual bleeding, and the iron deficiency that follows it.
- Reducing period pain (dysmenorrhoea).
- Managing acne, through the effect on androgens.
- Premenstrual symptoms.
- Endometriosis symptoms, sometimes taken continuously without a break.
- Polycystic ovary syndrome, for cycle regulation and androgen symptoms.
- Delaying a period, by running packs together — ask a pharmacist or doctor how.
It does not protect against sexually transmitted infections. Condoms do that, and the pill does not replace them.
On missed pills — the commonest real-world problem. The rules depend on how many were missed and where in the pack, so follow the leaflet or ask a pharmacist, rather than guessing. In general, one missed pill is usually manageable by taking it as soon as you remember; missing more, or missing pills at the start or end of a pack, may need additional precautions and possibly emergency contraception. Vomiting or severe diarrhoea within a few hours of taking a pill can also mean the dose did not count.
How Nordette fits into this medicine category
| Method | Examples | Notes |
|---|---|---|
| Combined pill | Nordette and similar | Daily; also regulates cycles and acne; clot risk |
| Progestogen-only pill | Desogestrel, norethisterone | Daily; suitable where oestrogen must be avoided |
| Injectable | Medroxyprogesterone, norethisterone enanthate | Every 2–3 months |
| Implant | Etonogestrel implant | Up to 3 years; among the most effective |
| Intrauterine device | Copper IUD, hormonal IUS | 5–10 years; hormonal IUS also reduces bleeding |
| Emergency contraception | Levonorgestrel, ulipristal | After unprotected sex — not routine contraception |
| Hormonal treatments | Norethisterone (Primolut N) | Menstrual conditions rather than contraception |
Long-acting methods — implant and IUD — are considerably more effective in practice, because they remove the daily adherence problem entirely. That is worth knowing if remembering a daily pill is difficult. See the sexual health and urology hub, which also covers erectile dysfunction products.
What to check before using Nordette
Combined pills are not suitable for everyone, and the reasons are specific rather than general caution. Tell your doctor if you:
- Smoke and are over 35. This combination substantially raises cardiovascular risk and is a standard reason not to use a combined pill.
- Have had a blood clot — deep vein thrombosis or pulmonary embolism — or have a clotting disorder, or a close family member who had a clot young.
- Have migraine with aura — visual disturbance, flashing lights or zigzag lines before a headache. This is an important contraindication, because it raises stroke risk with combined pills. Migraine without aura is usually acceptable.
- Have high blood pressure, heart disease, or have had a stroke.
- Have diabetes with complications, liver disease, or a history of breast cancer.
- Are breastfeeding, particularly in the early weeks.
- Are immobile for a long period, or having major surgery.
- Are very overweight, which raises clot risk.
- Take anti-epileptics (carbamazepine, phenytoin, phenobarbital), rifampicin, some HIV medicines, or St John’s wort — all of which reduce the pill’s effectiveness, sometimes to the point of failure.
Practical points: take it at the same time every day; use a reminder; start a new pack on time; know the missed-pill rules before you need them; and keep using condoms for infection protection.
Possible cautions and when to ask a pharmacist or doctor
Common effects, mostly in the first few months, are nausea, breast tenderness, headache, mood changes, breakthrough bleeding and spotting. Most settle by the third cycle, and breakthrough bleeding in early months is expected rather than a sign of failure.
Get emergency help for the warning signs, which are worth memorising:
- Pain, swelling, warmth or redness in one leg — possible deep vein thrombosis.
- Sudden breathlessness or chest pain, especially with coughing up blood — possible pulmonary embolism.
- Sudden weakness on one side, facial droop, slurred speech, or a severe unusual headache — possible stroke.
- Sudden loss of vision, or new visual disturbance.
- Severe abdominal pain, or yellowing of the skin or eyes.
Contact your doctor if:
- You develop migraine with aura for the first time, or your migraines change in character.
- Blood pressure rises.
- Breakthrough bleeding persists beyond three or four months, or starts after a settled period.
- You miss pills often, or find the daily routine difficult — a long-acting method may suit you far better.
- You are starting any new medicine, including antibiotics or herbal products.
- You have vomiting or diarrhoea, which can stop the pill being absorbed.
- You think you may be pregnant.
Related medicine guides
Frequently asked questions
What are Nordette pills used for? Preventing pregnancy, and also regulating periods, reducing heavy or painful bleeding, managing acne and easing premenstrual symptoms. It is a combined oral contraceptive.
How effective is it? Over 99% with perfect use, around 91% in real use. The difference is missed and late pills.
Does it protect against STIs? No. Only condoms do that.
What if I miss a pill? Follow the leaflet or ask a pharmacist — the rules depend on how many you missed and where in the pack. Do not guess.
Is the bleed during the break a real period? No. It is a withdrawal bleed caused by the hormone drop, not a natural cycle.
Can I skip it to delay a period? Yes, by running packs together. Ask a pharmacist or doctor how to do it with your specific pack.
Can I take it if I get migraines? Migraine without aura is usually fine. Migraine with aura — visual disturbance before the headache — is a reason to avoid combined pills, because of stroke risk.
Can I take it if I smoke? Not if you are over 35 and smoke. Below 35, discuss it with your doctor.