II. Physiology
III. Mechanism
- Progesterones are used in many contraceptives (e.g. Oral Contraceptives, mini pill, IUD, Depo Provera, Implanon)
- Progestins inhibit Ovulation
- Progestins thicken Cervical Mucus, preventing sperm from reaching the ovum
- Synthetic Progestins have Endometrial Activity, but also androgenic, Estrogenic and anti-Estrogenic Activity
IV. Types
-
First Generation Progestin
- Norethindrone (e.g. Ortho-Novum)
- Norethynodrel (Enovid)
-
Second Generation Progestin
- Norethindrone Acetate (e.g. Loestrin)
- Ethynodiol Diacetate (e.g. Demulen)
-
Third Generation Progestin
- Levonorgestrel (e.g. Triphasil)
- dl-Norgestrel (e.g. Ovral)
-
Fourth Generation Progestin
- Desogestrel (e.g. Desogen)
- Gestodene
- Norgestimate (e.g. Ortho-Cyclen)
-
Pregnane Progestin
- Chlormadinone acetate
- Megestrol acetate
- Medroxyprogesterone acetate
V. Adverse Effects: Hyperlipidemia
- Overall Effect
- Lowers HDL-2 to Total Cholesterol ratio
- Factors related to unfavorable HDL effects
- Higher Progestational Activity
- Lower Estrogen to Progestin ratio
- Progestins most adversely effecting lipid (androgen)
- Progestins with most favorable lipid effects
- Progestin only formulations (mini pill)
- Desogestrel
- Norethindrone (low dose)
VI. References
- Cerel-Suhl (1999) Am Fam Physician 60(7):2073 [PubMed]
- Speroff (1993) Obstet Gynecol 81:1034-47 [PubMed]
- Dickey (1998) Managing Contraceptive Pill Patients
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Related Studies
progesterone (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
PROGESTERONE 100 MG CAPSULE | Generic | $0.25 each |
PROGESTERONE 200 MG CAPSULE | Generic | $0.44 each |
PROGESTERONE 500 MG/10 ML VIAL | Generic | $1.98 per ml |