Types of progestogens in combined oral contraception: effectiveness and side-effects

Lawrie, Theresa A; Helmerhorst, Frans M.; Maitra, Nandita; Kulier, Regina; Bloemenkamp, Kitty W. M.; Gülmezoglu, A. Metin

doi:10.1002/14651858.cd004861.pub2

Cited by 54 publications

(52 citation statements)

References 79 publications

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“…This finding differs from that of previous studies that showed that the DSG group had higher nausea rate than the levonorgestrel group (12% vs. 4%) [4]. Nausea related to the use of oral contraceptives is caused by a decrease in the lower esophageal sphincter pressure or because of the inducing effect of the chemoreceptor trigger zone caused by the binding of the pills with the receptor in the digestive tract.…”

Section: Nausea/vomitingcontrasting

confidence: 90%

“…No EE-DSG respondents complained of breast tenderness. This finding differs from that of a previous study that showed that the incidence of breast tenderness with the use of LNG and DSG was 4% and 8%, respectively [4]. As with headaches, breast tenderness can be associated with estrogen increase before menstruation [16].…”

Section: Brest Tendernesscontrasting

confidence: 90%

“…Merki-Feld et al 's study showed that 60% of participants experienced decreased headache incidence, frequency and intensity and need of medication when using pills containing only DSG [18]. This contradicts the findings of another study that showed that combined DSG pills have a higher headache incidence rate compared to LNG pills (24% vs. 5.8%) [4]. This may be caused by the difference in assessment methods and subject bias.…”

Section: Headachementioning

confidence: 88%

“…Some studies also showed no significant difference in weight gain with the use of combined oral contraceptives [1]. Reviews also showed that the incidence rate of weight gain in DSG and LNG groups was similar (2% vs. 2.3%) [4]. Progestin has a large androgenic effect and is associated with appetite increase.…”

Section: Weight Gainmentioning

confidence: 99%

“…Studies have shown that the use of second-generation combined oral contraceptives has a higher withdrawal rate than that of third-generation ones because of their side effect such as menstruation cycle disturbance [4]. Second-generation combined oral contraceptives available in Indonesia include pills containing progestin levonorgestrel (LNG), and third-generation contraceptives include pills containing drospirenone, gestodene, and desogestrel (DSG).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Comparison of Adverse Drug Reactions of Second- And Third-Generation Oral Contraceptives

Dps

Andrajati

Supardi

2017

Asian J Pharm Clin Res

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Objective: Oral contraceptives are the second-most widely used contraceptives in Indonesia; however, a high percentage rate of withdrawal is seen owing to adverse drug reactions (ADRs). Only a small proportion of users have been provided information about other oral contraceptives such as newer generation progestin as an alternative option to minimize ADR. This study aimed to compare the prevalence of ADR between combined oral contraceptives containing levonorgestrel (LNG) (second generation) and desogestrel (DSG) (third generation), which was expected to have less side effects. Methods:The study has a cross-sectional comparative design with random sampling from users in six villages in Depok City, Indonesia. Data were collected through interviews. The sample includes 60 users of LNG and 40 users of DSG.Results: ADR complaints include intermenstrual bleeding (16.7% vs. 5%), headache (16.7% vs. 5%), nausea/vomiting (25% vs. 0%), breast tenderness (13.3% vs. 0%), impaired sexual intercourse (23.3% vs. 7.5%), weight gain (35% vs. 22.5%), acne (3.3% vs. 7.5%), and face spots/chloasma (28.3% vs. 5%). The LNG group showed significantly higher impaired sexual intercourse (odds ratio (OR): 3.75, 95% confidence interval (CI): 1.003-14.050, p=0.039) and chloasma (OR 7.51, 95% CI: 1.629-34.647, p=0.004). Conclusion:Users' low knowledge of ADR and how to treat it could be a reason for drug withdrawal. Pharmacies must make efforts to provide counseling in this regard.

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Section: Nausea/vomitingcontrasting

confidence: 90%

Section: Brest Tendernesscontrasting

confidence: 90%

Section: Headachementioning

confidence: 88%

Section: Weight Gainmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Comparison of Adverse Drug Reactions of Second- And Third-Generation Oral Contraceptives

Dps

Andrajati

Supardi

2017

Asian J Pharm Clin Res

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Hormone therapy in postmenopausal women and risk of endometrial hyperplasia

Furness

Roberts

Marjoribanks

et al. 2012

Cochrane Database of Systematic Reviews

101

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Analysis 1.6. Comparison 1 Unopposed estrogen versus placebo, Outcome 6 Additional investigations (unscheduled biopsy)..... Analysis 1.7. Comparison 1 Unopposed estrogen versus placebo, Outcome 7 Withdrawals because of adverse events............... Analysis 2.1. Comparison 2 Estrogen (E) + progestogen (continuous) vs placebo, Outcome 1 Endometrial hyperplasia at 1 year.... Analysis 2.2. Comparison 2 Estrogen (E) + progestogen (continuous) vs placebo, Outcome 2 Cumulative endometrial

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Combined oral contraceptives: the risk of myocardial infarction and ischemic stroke

Roach

Helmerhorst

Lijfering

et al. 2015

Cochrane Database of Systematic Reviews

173

149

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This meta-analysis showed that the risk of myocardial infarction or ischemic stroke was 1.6-fold increased in women using COCs . The risk was highest for pills with > 50 microgram estrogen. When combined with the results of studies on the risk of venous thrombosis in COC users, it seems that the COC pill containing levonorgestrel and 30 μg of estrogen is the safest oral form of hormonal contraception.

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Types of progestogens in combined oral contraception: effectiveness and side-effects

Cited by 54 publications

References 79 publications

Comparison of Adverse Drug Reactions of Second- And Third-Generation Oral Contraceptives

Comparison of Adverse Drug Reactions of Second- And Third-Generation Oral Contraceptives

Hormone therapy in postmenopausal women and risk of endometrial hyperplasia

Combined oral contraceptives: the risk of myocardial infarction and ischemic stroke

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