Aurovela Fe 1/20 is a combination birth control pill containing two hormones: norethindrone acetate (1 mg) and ethinyl estradiol (20 mcg). The “Fe” in the name refers to iron, specifically ferrous fumarate tablets included in the pack for the days you’re not taking active hormones. It’s a generic equivalent of Loestrin Fe 1/20 and works the same way at the same doses.
What’s in Each Pack
A standard Aurovela Fe 1/20 pack contains 28 tablets. The first 21 are active pills, each delivering 1 mg of a synthetic progestin (norethindrone acetate) and 20 mcg of a synthetic estrogen (ethinyl estradiol). The remaining 7 tablets are brown iron pills containing ferrous fumarate. These iron tablets are not hormonal and do not prevent pregnancy. They exist for two reasons: to help you stay in the habit of taking a pill every day, and to provide a small iron supplement during the week you have your period, when iron loss from bleeding is highest.
The “1/20” in the name is a shorthand for the hormone doses: 1 mg of progestin and 20 mcg of estrogen. The 20 mcg estrogen dose puts this on the lower end of combination pills, which range from 20 to 50 mcg. Lower-estrogen formulations are generally associated with fewer estrogen-related side effects like bloating and breast tenderness, though individual responses vary.
How It Prevents Pregnancy
Aurovela Fe 1/20 works through three overlapping mechanisms. The primary one is stopping ovulation. The hormones suppress the signals from your brain that normally trigger an egg’s release each month. Without an egg, fertilization can’t happen.
As a backup, the pill also thickens cervical mucus, making it harder for sperm to reach the uterus. It additionally thins the uterine lining, which reduces the likelihood of implantation in the unlikely event that fertilization occurs. These layered effects are why combination pills are highly effective when used correctly.
How Effective It Is
With perfect use, meaning you take the pill at roughly the same time every day without missing any, the failure rate is less than 1%. That translates to fewer than 1 pregnancy per 100 women per year. In real-world conditions, where people occasionally miss pills or take them late, the typical failure rate rises to about 3% per year. The gap between those numbers is almost entirely explained by human error, not the drug itself failing.
Common Side Effects
The most frequently reported side effects are nausea, vomiting, spotting or bleeding between periods, weight gain, breast tenderness, and difficulty wearing contact lenses. Of these, irregular bleeding and nausea are the ones most likely to show up early. Many women experience spotting or light bleeding, or feel nauseous, during the first one to three packs. This is your body adjusting to a new hormonal baseline, and it typically resolves on its own without any change in dose or brand.
Breakthrough bleeding and spotting are especially common in the first three months. If they persist beyond that window, it may be worth discussing with your prescriber, but stopping the pill early because of first-month spotting often means abandoning a medication that would have settled down within weeks.
Who Should Not Take It
Combination birth control pills carry a well-established risk of blood clots, and that risk increases significantly for women who smoke and are over 35. If you fall into that category, combination pills like Aurovela Fe 1/20 are not recommended. The same applies to people with a history of blood clots, stroke, certain heart conditions, breast cancer, or liver disease. Severe migraines with aura also raise concern, because combination estrogen can increase stroke risk in that population.
Medications That Can Reduce Effectiveness
Certain drugs speed up how your liver processes hormones, which can lower the pill’s effectiveness. The most well-known culprits are some seizure medications, certain HIV drugs, and the antibiotic rifampin (used for tuberculosis). The herbal supplement St. John’s wort can have a similar effect. If you’re taking any of these, a backup contraceptive method or an alternative form of birth control is worth considering. Routine antibiotics like amoxicillin, despite the persistent myth, do not meaningfully interfere with the pill.
What to Expect for Your Period
Your withdrawal bleed, which functions like a period, will typically arrive during the 7 days you’re taking the brown iron tablets. It’s usually lighter and shorter than a natural period because the pill keeps the uterine lining thin. Some women find their periods become barely noticeable after a few months on this formulation.
It can take up to three cycles for your body to fully adjust. During that window, cycle length and flow may be unpredictable. After three months, most women settle into a consistent, predictable pattern. If you stop taking the pill, your natural cycle may take one to three months to return to its previous rhythm.
What to Do If You Miss a Pill
If you miss one active pill, take it as soon as you remember, even if that means taking two pills in one day. You’re still protected against pregnancy. If you miss two or more active pills in a row, take the most recent missed pill as soon as possible, skip any earlier missed ones, and use a backup method like condoms for the next 7 days. Missing the brown iron tablets at the end of the pack does not affect your pregnancy protection at all, since those pills contain no hormones. Just discard any missed brown tablets and stay on schedule.
Timing matters more than most people realize. Taking the pill at the same time each day keeps hormone levels steady. Setting a daily alarm is one of the simplest ways to stay consistent and keep the pill working at its highest effectiveness.