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Question
67 out of 98
 

Most common progesterone preparation used in Low dose OC pills: (AIPG 2011)



A Levonorgestrel
B Gestodine

C Desogestrel
D Norethestrone

Ans. A

Levonorgestrel.

Low dose OC pills

Defined as OC pills with estrogen content of > 50 microgram.However in developed countries nowadays used low dose OC pills contain 20 microgram estrogen, while in India the estrogen content is 30 micrograms (Mala-N, Mala-D).

Simple regimen of “3 weeks on and 1 week of “ is followed.

Levonorgestrol is ofetn used.

1. Minipills (Progesterone only pills)—

e.g., Levonorgestrol 30 mcg, norethistrone 350 mcg.

2. Advantages

a. Side-effects attributed to estrogen totally eliminated

b. Lactation pill

c. May be used by patients with hypertension, fibroid, DM, epilepsy, smoking, thromboembolism

d. No “on and off “regimen.

3. Side-effects

a. Amenorrhea, at times breakthrough bleeding

b. All side-effects attributed to progestrone may be evident

c. Simple cyst of ovary

d. Failure rate of 0.5–2 HWY

4. Contra-indications

a. Pregnancy, undiagnosed vaginal bleeding, severe arterial disease, liver adenoma, porphyria, after evacuation of molar pregnancy until HCG levels return to normal.

b. The current formulations are made from synthetic estrogens and progestins. The estrogen component of the pill consists of ethinyl estradiol or mestranol, which is metabolized to ethinyl estradiol. Multiple synthetic progestins are used. Norethindrone and its derivatives are used in many formulations. Low-dose norgestimate and the more recently developed progestins (desogestrel, gestodene, drospirenone) have a less androgenic profile; levonorgestrel appears to be the most androgenic of the progestins and should be avoided in patients with hyperandrogenic symptoms.

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