How It Works
By maintaining a constant presence of estrogen and progestin in the body, Jolessa overrides the natural hormonal signals that trigger a typical cycle.
Jolessa works through several mechanisms:
- Stopping ovulation: The pill’s primary function is to prevent the ovaries from releasing an egg. If no egg is released, sperm cannot fertilize it.
- Thickening cervical mucus: The progestin in Jolessa makes the cervical mucus thick and sticky. This makes it difficult for sperm to enter the uterus.
- Altering the uterine lining: Jolessa thins the uterine lining (endometrium). This ensures that even in the unlikely event that an egg is released and fertilized, it would be difficult for it to attach to the uterine wall to grow.
| Quick Facts | |
|---|---|
| Common Brands | Seasonale (discontinued), Introvale, Setlakin |
| Drug Class | Combined oral contraceptive (COC) |
| Generic Status | Generic of ethinyl estradiol and levonorgestrel COC available |
| Availability | Prescription only |
Dosing
The effectiveness of Jolessa is dependent on adhering to consistent daily dosing. Because the cycle is extended over three months, keeping track of your pills is essential.
- The 91-day pack: Each pack of Jolessa contains 91 tablets: 84 active pink hormone pills and 7 inactive white placebo pills.
- Standard dosage: The standard regimen is to take one pill at the same time every day for 91 days.
- The schedule: The typical schedule is one active (pink) pill daily for 84 days, followed by 7 days of white placebo pills. You will usually experience your period during the week you take the white pills.
- The same-time rule: Taking the pill at the same time each day is important to reduce breakthrough bleeding and ensure maximum protection.
- Missing a dose: If you miss one active pill, take it as soon as you remember, even if that means taking two pills in one day. If you miss two or more active pills, refer to the patient insert or ask your doctor or pharmacist for specific catch-up instructions, and use backup protection (like condoms) for the next seven days.
Note: The dosing information below is for educational purposes only. Your provider will determine your specific dose based on your individual health needs. Always follow your healthcare provider’s instructions for exact dosing.
Uses
FDA-Approved Uses
Jolessa is FDA-approved for the prevention of pregnancy. It is used as an oral contraceptive for women of reproductive age.
Off-Label Uses
You may see Jolessa prescribed for uses that are not FDA-approved. This is a common and legal practice called off-label prescribing, where a doctor uses their clinical judgment to prescribe a drug for a different purpose.
Jolessa may be prescribed off-label for the following conditions:
- Endometriosis management. By suppressing ovulation and thinning the uterine lining, Jolessa can help reduce the chronic pelvic pain associated with endometriosis.
- Polyendocrine metabolic ovarian syndrome (PMOS): Doctors may use Jolessa to regulate cycles and help lower the high androgen levels that cause acne and excess hair growth.
- Menstrual-related migraine: For individuals who get severe headaches during their period, reducing the number of periods may reduce the frequency of attacks. Jolessa should not be used by women who have migraine with aura.
- Anemia prevention: For those with iron deficiency due to heavy bleeding, having fewer periods may help the body maintain more normal iron levels.
Side Effects
Most people tolerate Jolessa well, though your body may need several months to adjust to the extended hormone schedule.
Common Side Effects
- Breakthrough bleeding
- Headache
- Nausea
- Breast tenderness
- Period-like cramps
Serious Side Effects
Serious side effects are rare, but it’s important to know what to look for if they do occur.
Get emergency medical help right away for symptoms of a blood clot, stroke, or heart attack. Call your doctor right away for other serious side effects.
- Blood clots (DVT/PE): Watch for sudden leg pain, swelling, or warmth; or sudden shortness of breath and chest pain.
- Stroke or heart attack: Seek immediate help for sudden weakness (especially on one side), severe headache, vision changes, or confusion.
- Liver or gallbladder problems: Watch for yellowing of the eyes or skin (jaundice), dark urine, or upper stomach pain.
- Mood changes: Contact your provider if you experience symptoms of mood changes or depression.
Call your doctor immediately if you experience any other concerning or prolonged symptoms.
Pharmacist Tips
Be Patient With Spotting
Breakthrough bleeding is a common reason people stop taking extended-cycle pills. Spotting tends to decrease significantly after the first few packs.
No STI Protection
Remember that Jolessa only prevents pregnancy and does not prevent sexually transmitted infections (STIs). Use barrier protection like condoms to protect against HIV and other STIs.
Avoid Smoking
If you are over age 35 and smoke, do not take combination birth control pills. Smoking significantly increases the risk of serious heart problems and blood clots.
Stomach Bugs
If you vomit or have severe diarrhea within 3 to 4 hours of taking an active pill, your body may not have absorbed the hormones. Take another active pill as soon as possible. If vomiting or diarrhea lasts more than one day, use a backup method of birth control until you check with your doctor.
Sun Sensitivity
Jolessa may cause brownish patches on the face (chloasma). Wear sunscreen and avoid tanning beds to help prevent these patches from darkening.
Set An Alarm
Because missing a pill in an extended cycle can trigger unscheduled bleeding, a daily phone alarm or reminder is a highly recommended tool.
Drug Interactions
Certain medications can interact with Jolessa, making it less effective (which could lead to an unplanned pregnancy) or causing side effects.
Let your doctor know if you take:
- Antiseizure medications: Drugs like carbamazepine or phenytoin can cause your body to break down birth control hormones faster, which may make your birth control less effective.
- Specific antibiotics: While many common antibiotics are fine, rifampin is known to make birth control pills less effective.
- St. John’s wort: This herbal supplement is a well-known cause of birth control failure.
- Hepatitis C medications. Taking certain hepatitis C medications with Jolessa can cause liver problems.
Always give your doctor and pharmacist a complete list of all your medications, vitamins, and supplements to check for potential interactions.
FAQs
What does Jolessa do that a standard monthly birth control pill doesn’t?
Jolessa is designed for convenience and symptom management. While standard pills typically give you 12 or 13 periods a year, Jolessa is structured to give you only four scheduled periods a year (once every three months).
How many days do I need to take Jolessa before I am protected against getting pregnant?
Start taking Jolessa on the first Sunday after your period starts. If your period starts on a Sunday, you can start Jolessa on that day. Use a non-hormonal backup method (like condoms) for the first 7 days of treatment.
Does taking an extended-cycle pill like Jolessa cause more weight gain or bloating than a normal pill?
Clinical studies have not shown that extended-cycle pills cause more weight gain than monthly pills. A slight weight change may be due to temporary water retention.
Will taking this hormone combination help clear up my hormonal acne?
It may. While not FDA-approved specifically for acne, the hormones in Jolessa can help stabilize the oil production that leads to breakouts. However, some people may experience a slight increase in acne when first starting.
Is it normal to have a heavier period or worse cramps during the placebo week?
Because of the extended cycle, some users report changes in bleeding, which may level out over time as your body adjusts to the medication.
Does taking Jolessa increase my risk of getting a blood clot?
All combination birth control pills carry a small risk of blood clots. Discuss your medical and family history and risk with your doctor.
Will Jolessa help manage pelvic pain from my endometriosis?
Jolessa is frequently used off-label to provide relief from the chronic pain associated with endometriosis.
Is it best to take my daily pill right before bed so I don’t feel nauseous during the day?
Many users find that taking the pill at night or with their evening meal helps reduce the nausea that can occur during the first few weeks of treatment. Once you find the best time for you, be sure to take your pill at the same time every day.
What happens if I get a stomach bug and throw up right after taking my daily pill?
If you vomit within 3 or 4 hours of taking Jolessa, take another active pill as soon as possible. If the vomiting lasts more than a day, use backup birth control (such as a condom) until you check with your doctor.
Comparable Medications
Seasonique, Sprintec, or Amethyst?
Choosing between different birth control cycles depends on how your body handles hormone-free intervals.
Seasonale
Seasonale was the original brand name (which is no longer available), and Jolessa is an identical generic version.
Seasonique
Seasonique is no longer available as a brand-name drug, but generic versions are available. Like Jolessa, Seasonique has an extended cycle where you get your period once every three months. The difference is in the off week. Jolessa uses inactive (placebo) pills for 7 days. Seasonique uses low-dose estrogen pills during that week instead of placebos, which may help reduce headaches and bloating for some users.
Sprintec
Sprintec is a traditional 28-day pill. It provides a monthly period. Jolessa may be preferred by those who want to avoid monthly bleeding, while Sprintec may be preferred by those who prefer a regular monthly cycle.
Amethyst
Amethyst is a continuous-cycle pill. Unlike Jolessa, which has a placebo week every three months, Amethyst is taken 365 days a year with no placebo pills at all, aiming to eliminate periods.
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Important: Information on this page is for educational purposes only. Prescribing decisions are made by independent, licensed providers. TelyRx operates technology-enabled pharmacies and a telehealth platform that connects patients with licensed providers. Prescriptions, when provider-approved and issued, are filled and shipped by TelyRx-affiliated pharmacies. We do not employ physicians or make prescribing decisions. Learn more about our editorial standards here.