Norethisterone

Norethisterone or Nornorethindrone is a contraceptive progestogen derived from 19-northstastterone used as a single product or associated with ethinylestradiol. Oral administration daily or in intramuscular injection every 8 weeks.

It is excreted in breast milk in clinically significant amount ^{(Betrabet 1987, Toddywalla 1980, Saxena 1977)} and no problems have been observed in infants whose mothers took it. ^{(WHO 1994, Shaaban 1991, Giner 1976, Karim 1971)}

Plasma levels of these infants were undetectable or very low.^{(Betrabet 1987)}

No alterations have been observed in the amount or composition of breast milk in mothers treated with norethindrone. ^{(Giner 1976)}

WHO List of Essential Medicines 2002: rates it as compatible with breastfeeding after the 6th postnatal week. ^{(WHO/OMS 2002)}

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During breastfeeding progestin-only contraceptives are preferable to those combined with estrogen and, in this case, those with a lower dose of estrogen. ^{(CDC 2016, WHO/OMS 2015, Altshuler 2015, Berens 2015, CLM 2012, Moretti 2000)}

For the first 4-6 weeks postpartum, non-hormonal methods are the first choice, followed by IUDs and progestogen implants. ^{(Berens 2015, Mwalwanda 2013, Rowe 2013, CLM 2012)}

See below the information of these related products:

• Estradiol (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
• Estradiol + Norethisterone (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
• Ethinylestradiol + Norethisterone (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
• Mestranol + Norethindrone (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
• Norethisterone (Safe substance and/or breastfeeding is the best option.)