Lolo Birth Control: The Lowest-Estrogen Pill Available in Canada

Most combined birth control pills contain somewhere between 20 and 35 micrograms (mcg) of estrogen. Lolo contains 10 mcg — the lowest dose of any combined pill available in Canada. For many people, that lower number is the reason for choosing Lolo, often after a higher-dose pill caused side effects they’d rather not repeat.

Lolo pairs a low dose of estrogen with a progestin called norethindrone acetate, taken on an unusual 24/2/2 schedule. The minimal hormone dose in Lolo can come with differences in bleeding compared to other birth control pills, which is worth understanding before you start.

In this article, we cover what Lolo is, how it works, and what to expect from your periods on it. We also go through its side effects, who Lolo tends to suit best, and what it costs in Canada.

An Overview of Lolo Birth Control

Lolo is a combined oral contraceptive. Its two active ingredients are 10 mcg of ethinyl estradiol (a synthetic estrogen) and 1 mg of norethindrone acetate (a progestin). At 10 mcg of estrogen, Lolo sits below every other combined pill on the Canadian market. Common low-dose pills like Alesse and Yaz contain 20 mcg of estrogen, and many pills use 30 to 35 mcg.

A Lolo pack is organised on a 24/2/2 schedule — 24 blue tablets that contain both hormones, then 2 white tablets that contain estrogen only, then 2 inactive tablets. This schedule leaves just a two-day gap without active hormones each month, shorter than the week-long break on many other contraceptive pills.

Lolo is made by AbbVie and is approved in Canada to prevent pregnancy. It is brand-only in Canada, with no generic version. The same pill is sold in the US as Lo Loestrin Fe; the names differ because the American pack ends in two iron tablets that the Canadian pack doesn’t include. One product not to confuse Lolo with is Loestrin 24 Fe, a separate, higher-estrogen (20 mcg) pill.

How Lolo Birth Control Works

Like other combined pills, Lolo works mainly by switching off ovulation. With no egg released, there is nothing for sperm to fertilise. This is the pill’s main contraceptive action, and it is well established. Backing it up are two supporting effects: the hormones thicken the cervical mucus so sperm find it harder to pass, and they keep the lining of the womb thin.

With Lolo, a hormone-containing tablet is taken on 26 of the 28 days (24 with both hormones, then 2 with estrogen alone), so the only gap without active hormones is the final two days. The reasoning behind this design is that a shorter hormone-free stretch gives the ovaries less chance to release an egg mid-pack, which may help the low 10 mcg dose of estrogen work reliably.

Lolo’s progestin, norethindrone acetate, is a long-established hormone that mainly adds to the contraceptive effect.

How Effective Is Lolo Birth Control?

Taken correctly, Lolo birth control is a reliable contraceptive. However, as with any pill, its effectiveness relies on taking it consistently.

With perfect use, fewer than 1 in 100 people become pregnant over a year when taking an oral contraceptive pill. With typical use, which allows for the occasional missed or late pill, that figure is closer to 9 in 100. In Lolo’s own year-long clinical trial, there were about 3 pregnancies per 100 women (a measure known as the Pearl Index). That study followed women up to age 35 with a BMI of 35 or under and wasn’t set up to rank Lolo against other pills, so the number is best read as a general guide.

Timing matters a little more on Lolo than on a higher-dose pill. Because the estrogen dose is so low, the labelling advises against skipping a tablet or taking one more than 24 hours late. Whether 10 mcg is genuinely less forgiving of a late pill than 20 mcg isn’t settled, but keeping to the same time each day is the simplest way to stay protected.

How to Take Lolo

Lolo comes as a 28-day pack and is taken as one tablet a day, in order, with no break between packs. Here’s how to take it:

• The 24/2/2 sequence: Take the 24 blue tablets first (these contain both hormones), then the 2 white tablets (estrogen only), then the 2 lilac tablets (inactive). The white tablets are active pills, not placebos — only the final two lilac tablets are hormone-free. Start the next pack of Lolo the day after finishing the last one.
• Same time each day: Take Lolo at roughly the same time daily. Because the estrogen dose is so low, the labelling advises against skipping a tablet or letting more than 24 hours pass between pills.
• When to start: Your doctor or pharmacist will tell you which day to begin, and whether to use backup contraception such as condoms for the first seven days (this depends on where you are in your cycle).
• If you’re unwell: Vomiting or diarrhoea within about three to four hours of taking a Lolo tablet can stop it from being absorbed, which counts as a missed pill. Ask your pharmacist what to do if this happens.
• If you miss a pill: Take it as soon as you remember, then carry on. Because Lolo’s dose is low, a missed or late pill leaves less margin than on a higher-dose pill, so follow the pack’s missed-pill instructions and use backup contraception if advised.

Lolo and Your Period

Lolo tends to change the pattern of monthly bleeding more than other birth control pills. The two main changes to expect are more spotting between periods, especially in the early months, and lighter or absent periods over time.

Breakthrough bleeding or light spotting is common when you first start. In the clinical trial, this unscheduled bleeding was most frequent in the second month and then eased steadily, settling down for most people by the end of the first year. For most people, it’s a passing nuisance rather than a reason to stop the pill.

Monthly bleeds on Lolo tend to be very short, and as the months go on, close to half the people taking it have no period at all. With the smaller amount of estrogen reaching the womb lining, that lining stays thin, so there is less to shed each month. 

A missed period on Lolo can be unsettling, but by itself it isn’t a sign the pill has failed (provided you’ve taken every tablet on time). If you’ve missed or delayed pills and then miss a period, take a pregnancy test. The same applies if you’ve taken Lolo correctly and go two months in a row with no bleeding at all.

Side Effects of Lolo Birth Control

Most side effects of Lolo are mild and tend to ease within the first few months as your body gets used to it.

The most commonly reported Lolo side effects include:

• Nausea
• Headache
• Breast tenderness
• Spotting or changes to your bleeding pattern
• Period pain
• Mood changes, such as low mood or feeling anxious
• Skin breakouts

Weight gain is one of the most common worries about the pill. In Lolo’s trial, the average weight change over a year was under a kilogram, within the range of ordinary fluctuation. Larger reviews of combined pills haven’t found that they cause meaningful weight gain. Any short-term change tends to be fluid rather than fat.

Like every combined pill, Lolo carries a small increase in the risk of blood clots. In plain numbers, clots affect roughly 8 to 10 in 10,000 women a year on a low-estrogen pill, compared with about 4 in 10,000 who don’t take the pill. The risk is real but small, and lower than the clot risk that pregnancy itself carries.

Who Should Not Take Lolo

A combined pill like Lolo isn’t suitable for everyone. Doctors usually don’t prescribe it for people who:

• Smoke and are over 35
• Have had a blood clot or have a clotting disorder
• Get migraines with aura
• Have had breast cancer or another hormone-sensitive cancer
• Have uncontrolled high blood pressure, serious liver disease, or certain heart conditions

These cautions are the reason a doctor asks about your medical history and any other medications before starting Lolo.

Lolo Cost and Coverage in Canada

What you pay for Lolo depends on your location and insurance, so treat any figure as a rough guide and confirm the current price with your pharmacist. Because Lolo is brand-only, there’s no cheaper generic to bring the cost down, and retail prices generally fall somewhere around $20 to $50 for a 28-day pack.

Coverage varies across the country. British Columbia now covers Lolo in full. Since the province’s free contraception program expanded to include Lolo in early 2025, the pill has been a full PharmaCare benefit, covered at no cost with no top-up to pay.

More broadly, prescription contraception is gradually becoming free across Canada under the new federal pharmacare plan, though exactly what’s covered still depends on where you live.

Frequently Asked Questions

Is Lolo a good birth control pill? Taken consistently, Lolo is a reliable contraceptive, and most people who start it carry on with it. If you’ve come across Lolo birth control reviews, the most common complaint is the bleeding changes, such as spotting and irregular periods, rather than the pill failing.

Does Lolo help with acne? Lolo isn’t an acne treatment, and you shouldn’t expect it to clear breakouts. Some other combined pills, like Yaz and Alesse, carry a Health Canada approval for moderate acne, but Lolo’s progestin works differently and isn’t approved for that purpose. If acne is your main concern, that’s worth raising with your doctor.

Can Lolo be used during perimenopause? Low-dose combined pills are occasionally used in the lead-up to menopause to steady irregular cycles while still preventing pregnancy, and Lolo’s low estrogen dose can make it an option in some cases. This is an off-label use rather than something Lolo is officially approved for, so it’s a decision to make with your doctor.

Is Lolo Right for You?

Lolo is the lowest dose estrogen combined pill available in Canada. This makes it worth considering if you want to keep your hormone dose to a minimum, or if a higher-dose pill has caused side effects before. Taken correctly, it prevents pregnancy just as reliably as other oral contraceptive pills.

The main thing to weigh up with Lolo is bleeding. The same low dose that appeals to many people makes spotting more likely in the early months and often leads to lighter or absent periods. For some, that’s a welcome change, while for others, it’s a downside.

Whether Lolo is right for you is a decision best made with a doctor who can weigh it against your health history, personal preferences, and other birth control options.

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