Progesteroneis a naturally occurring hormone that helps prepare the lining of your uterus for pregnancy.
Progestin is any natural or man-made substance that has progesterone-like properties.
Progestins are categorized by generation, indicating when they were introduced.
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Progestin is used incombination(estrogen plus progestin) and progestin-only birth control pills.
This article looks at the brand and generic names for progestin and what these progestins do in your body.
The estrogen in combination birth control pills is usually ethinyl estradiol, a synthetic form of estrogen.
For example, some may have lower progestational effects but higher androgenic effects, or vice-versa.
Progestin Generations
There are four generations of progestins.
Different generations have different qualities.Keep in mind that newer isn’t always better.
Some combination pills that sound very similar have different progestins.
For example, Ortho-novum 1/35 and 7/7/7 contain norethindrone.
Ortho-novum 1/50 contains norgestrel.
Combination Oral Contraceptives
Combination pills contain estrogen and different doses and types of progestin.
The different types are listed below.
Norethindrone
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Norethindrone is a first-generation progestin.
It is available in the followingformulations:
Norethindrone has low progestational activity.
It also has slight estrogenic activity.
It tends to be less androgenic than second-generation progestins.
It may be more androgenic than newer progestins.
This progestin may improve your cholesterol in pills that contain less than 50 micrograms of ethinyl estradiol.
It can help raise good cholesterol and lower bad cholesterol.
Other advantages of norethindrone include the following:
Disadvantages may include limited effects against acne.
Examples of pills that contain this progestin include:
Norethindrone Acetate
Norethindrone acetate is another first-generation progestin.
It has low progestational activity and slight estrogenic effects.
This progestin tends to be less androgenic than second-generation progestin.
It also tends to be more androgenic than newer progestins.
The brand of birth control pill called Estrostep was designed to mimic a woman’s natural cycle closely.
This pill provides increasing levels of estrogen with a constant progestin dose.
It is the only triphasic brand with this progestin.
This brand may be helpful for women who have minor estrogen-related side effects with other combination pills.
These side effects may include:
Disadvantages of this progestin include limited effects against acne.
Ethynodiol Diacetate
Ethynodiol diacetate is a first-generation progestin.
It has viable progestational activity but weak estrogenic effects and little androgenic activity.
Ethynodiol diacetate is made from norethindrone.
This means it is easily converted to norethindrone within the body.
Side effects of pills that contain this progestin include breast tenderness andbreakthrough bleeding.This is menstrual-like bleeding that happens mid-cycle.
Levonorgestrel
Levonorgestrel is a second-generation progestin.
It is the most widely prescribed birth control progestin worldwide.
It has progestational and androgenic effects.
Severallow-doseestrogen brands containing this progestin are available.
Levonorgestrel birth control has also been FDA-approved for emergency contraception.
This bang out of birth control is taken after unprotected sex.
Examples includePlan B One-StepandNext Choice.
The FDA says all combination pills with this progestin are safe and effective foremergency contraceptionunder the Yuzpe method.
This emergency contraception method involves taking two doses of combination birth control pills 12 hours apart.
According to a 2018 review, levonorgestrel was associated with the lowest riskofblood clotsof all combination birth control pills.
Norgestrel
Norgestrel is a second-generation progestin.
It is a mixture of dextro-norgestrel and levonorgestrel.
Levonorgestrel is the active ingredient.
Norgestrel has high progestational activity.
It also has strong antiestrogen effects.
It is high in androgenic activity.
This progestin may help prevent endometriosis.
Unwanted side effects may include acne and weight gain.
Desogestrel
Desogestrel is a third-generation progestin.
It has high progestational selectivity.
This means it minimizes the androgenic effects and estrogenic activity.
It may cause slight increases in good cholesterol.
Clinical trials show a possibly higher risk of non-fatal blood clots with desogestrel pills.
This is compared to pills that contain levonorgestrel.
Mircette is a low-dose estrogen/desogestrel pill.
This medicine includes only two placebo days.
Norgestimate
Norgestimate is a third-generation progestin.
It has high progestational activity.
It shows slight estrogenic effects.
It tends to be less androgenic.
It has minimal effect on cholesterol.
It also has little impact on carbohydrate metabolism.
This means it probably won’t have an effect on the way your body processes blood sugar.
This progestin may help improve acne.
In fact, birth control pills containing norgestimate are the only ones approved by the FDA for treating acne.
Ortho Tri-Cyclen Locontains norgestimate and a mid-level dose of estrogen.
This pill may help reduce side effects like nausea and vomiting.
Pills containing this progestin may increase your risk for headaches.
They may also cause a reduced libido or sex drive.
Drospirenone
Drospirenoneis a fourth generation progestin.
It has low androgenic activity.
This throw in of progestin may help reduce acne.
Drospirenone and estrogen seem to reduce the symptoms of mildPMS.
This is because it may cause higher potassium levels.
The brandsYAZand Beyaz have 24 days of active pills and four days of placebos.
This combination may cause fewer hormone fluctuations than other pills.
YAZ has also been FDA-approved to help treat the mood disorderpremenstrual dysphoric disorder(PMDD).
Drospirenone has been linked to an increased risk of blood clots in several studies.
A 2017 review looked at 17 studies on drospirenone.
It found that the risk of blood clots ranged from no increase to a 3.3 times increased risk.
This is compared to levonorgestrel, the birth control pill thought to have the lowest risk.
Based on the best studies the review concluded that the risk is only slightly increased.
The study included over 55,000 participants.
The risk was 1.96 times higher in restarters.
In some cases, an entirely different form of birth control may be preferable.
They may be prescribed if you experience intolerable side effects when using a combination birth control pill.
They are sometimes referred to as “the mini-pill.”
Progestin-only pills work by thickening the mucus in the cervix, which helps prevent sperm from entering the uterus.
It also thins the lining of the uterus.
Progestin may also prevent ovulation, but not for everyone.
Progestin-only birth control pills are made with the first-generation progestin norethindrone.
Opill is the first and only birth control pill available without a prescription.
Summary
Progestin is thesynthetic form of the hormone progesterone.
It is used in combination birth control pills and in progestin-only birth controls.
Progestin helps prevent ovulation and may reduce monthly bleeding.
It may also have unwanted side effects like acne.
Progestin types are grouped according to generation, or the time they became available.
First-generation progestins have been around longer and have more data associated with their use.
Second-generation progestins like levonorgestrel have also been well-studied and widely used.
Newer third and fourth-generation progestins have advantages, too.
All progestins come with potential side effects.
verify you discuss these with your healthcare provider before deciding which combination birth control pill is right for you.
Casper RF.Progestin-only pills may be a better first-line treatment for endometriosis than combined estrogen-progestin contraceptive pills.Fertil Steril.
Memorial Sloan Kettering Cancer Center.Eithinyl estradiol and ethynodiol diacetate.
National Center for Biotechnology Information.PubChem compound summary for CID 13109, levonorgestrel.
World Health Organization.Emergency contraception.
2018;24(5):13030/qt6wm945xf.
Mayo Clinic.Progestin (oral route, parenteral route, vaginal route).
