Lo Loestrin Fe Vs. Loestrin Fe: What Is The Difference?

In our latest question and answer, the pharmacist discusses the difference between Lo Loestrin Fe and Loestrin Fe.

3 min read Updated Jun 2026 Read by 20,646 people
Lo Loestrin Fe Vs. Loestrin Fe: What Is The Difference?
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Jenni asked

What is the difference between Lo Loestrin Fe and Loestrin Fe? Does one offer an advantage over another?

Jun 08, 2022
The quick answer
  • Lo Loestrin Fe has a lower dose of estrogen (10 mcg) compared to Loestrin Fe (20 or 30 mcg), which may reduce estrogen-related side effects like nausea and bloating but may increase breakthrough bleeding.
  • Lo Loestrin Fe contains 26 days of hormone-containing pills in a 28-day cycle, while the traditional Loestrin Fe contains 21 days of active pills followed by 7 placebo days.
  • Lo Loestrin Fe is slightly less effective at preventing pregnancy (97% efficacy) than Loestrin Fe (98% efficacy), and it's especially important to take it at the same time every day.
A quick summary of Dr. Brian Staiger, PharmD's full answer below, condensed by AI from that answer only (not from any outside source). The pharmacist's answer is the source of record.
Medications in this answer — tap to explore

Thanks for reaching out! Both Lo Loestrin Fe and Loestrin Fe contain the same hormones (ethinyl estradiol and norethindrone), but in different amounts, with Lo Loestrin Fe containing lower amounts of estrogen.

In addition, Lo Loestrin Fe is considered an "extended-cycle" birth control pill, as it contains 26 "active", hormone-containing pills, compared to the 21 active pills that Loestrin Fe contains (except for Loestrin 24 Fe which has 24).

Lo Loestrin Fe Vs. Loestrin Fe: Differences

There are several differences between these birth control pill products, with the main differences being:

  • Lo Loestrin Fe contains 10 mcg ethinyl estradiol per active pill.
  • Loestrin Fe contains 20 mcg or 30 mcg ethinyl estradiol per active pill, depending on the product.
  • Lo Loestrin Fe is an "extended-cycle" birth control pill, meaning it contains more than the usual 21 days of hormone-containing pills, although it maintains the conventional 28-day cycle. Each cycle of Lo Loestrin Fe contains:
    • 24 pills containing 10 mcg ethinyl estradiol and 1 mg norethindrone acetate (a progestin)
    • 2 pills containing 10 mcg ethinyl estradiol
    • 2 pills containing ferrous fumarate 75mg
  • Loestrin Fe contains the traditional 21 days of active pills (20 mcg ethinyl estradiol and 1 mg norethindrone acetate or 1.5/30, depending on the product) and 7 days of placebo pills (that contain ferrous fumarate). The exception is Loestrin 24 Fe which contains 24 days of active pills.

Lo Loestrin Fe

As shown above, Lo Loestrin Fe contains only 10 mcg of estradiol for 26 days, the lowest amount of estrogen contained in any combined hormone birth control pill. This is compared to the 20 or 30 mcg of estrogen contained in Loestrin Fe.

Lower doses of estrogen are intended to lessen estrogen related side effects, such as:

  • Nausea
  • Vomiting
  • Bloating
  • Decreased libido
  • Breast tenderness

However, the trade-off may be that it is less effective in preventing pregnancy than birth control pills that contain more estrogen.

According to the prescribing information for both drugs, about 3 women become pregnant for every 100 per year using Lo Loestrin Fe (97% efficacy) compared to about 2 with Loestrin Fe (98% efficacy). In addition, low estrogen content increases the risk of breakthrough bleeding. 

As Lo Loestrin Fe contains a low amount of estrogen, it is especially important to take the birth control pills consistently, at the same time every day. Taking pills late or missing doses decreases the efficacy of the pills.

Loestrin Fe

There are multiple "forms" of Loestrin Fe:

  • Loestrin Fe 1/20 (1 mg norethindrone acetate/20 mcg ethinyl estradiol)
  • Loestrin Fe 1.5/30 (1.5 mg norethindrone acetate/20 mcg ethinyl estradiol)
  • Loestrin 24 Fe (1 mg norethindrone acetate/20 mcg ethinyl estradiol)

Loestrin Fe 1/20 and Loestrin Fe 1.5/30 are the traditional 21 days of active pills followed by 7 days of placebo pills (containing ferrous fumarate) while Loestrin 24 Fe contains 24 active pills and 4 days of placebo pills (containing ferrous fumarate).

Final Words

Thanks again for your question!

Please feel free to reach back out if you need further guidance!

References & sources
  1. Lo Loestrin FE Prescribing Information — AccessFDA
  2. Loestrin Prescribing Information — AccessFDA
  3. Oral Contraceptive Pills — NIH
Glossary — Terms in This Answer
Ethinyl estradiol
A synthetic form of the hormone estrogen used in birth control pills.
Norethindrone
A synthetic progestin (progesterone-like hormone) used in birth control pills.
Extended-cycle
A birth control pill that contains more than the standard 21 days of hormone-containing pills in a cycle.
Active pills
Birth control pills that contain hormones to prevent pregnancy.
Progestin
A synthetic hormone that mimics the effects of progesterone in the body.
Placebo pills
Pills without active ingredients that allow menstruation to occur during the birth control cycle.
Ferrous fumarate
An iron supplement included in placebo pills to help prevent iron deficiency.
Breakthrough bleeding
Unexpected vaginal bleeding that occurs between menstrual periods while taking birth control.
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Dr. Brian Staiger, PharmD
About the pharmacist

Dr. Brian Staiger, PharmD

Clinical Pharmacy

Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified

Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...

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