A subdermal progestin implant for long-term contraception

Article Abstract:

A newly-introduced method of contraception, the Norplant System, consists of the a synthetic progestin, levonorgestrel, which is sealed in six siloxane copolymer capsules. The capsules are then implanted under the skin of the woman, on the inside of the upper arm. The drug diffuses through the wall of the capsules into the blood, and provides contraception for up to five years. The capsules initially release 80 to 85 micrograms daily, which decreases to 30 to 35 micrograms daily after one year. Levonorgestrel is metabolized by the liver more slowly than progestins produced by the body. Differences in metabolism and body weight influence the level of drug in the blood. The drug is not detected in the blood 5-to-14 days after removal of the implant. Levonorgestrel decreases the release of follicle-stimulating hormone and luteinizing hormone, and suppresses ovulation in some patients. The drug causes the production of a thick, scanty mucus that prevents movement of the sperm in patients who do ovulate. Low levels of this progestin decrease the development and growth of the endometrium (the inner lining of the uterus) and secretion of progesterone during the luteal phase of the menstrual cycle. The Norplant System is about 5-to-10 times more effective than oral contraceptives, but may be less effective in heavier patients and patients taking the anticonvulsant agents phenytoin or carbamazepine. After removal of the implant, women have a 50 percent chance of becoming pregnant within three months and 86 percent chance of conceiving after one year. Adverse effects of levonorgestrel, including menstrual irregularities, are described. Levonorgestrel contained in Norplant subdermal implants provides an effective and safe method of contraception for five years without adverse effects on fertility. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Progestational hormones, Synthetic, Progestational agents, Contraceptive drug implants, Norplant System (Contraceptive)

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Desogestrel - a new progestin for oral contraception

Article Abstract:

Desogen and Ortho-Cept are two new types of oral contraceptives that have been approved by the Food and Drug Administration. Both of these drugs contain a low dosage of ethinyl estradiol and a higher dosage of desogestrel. Desogestrel is synthetic form of progestin, a female sex hormone. It is made from a substance found in wild yams from Mexico. Mexican women have eaten these yams to prevent pregnancy for many years. Desogestrel itself has no effect in the body, but it metabolized by the gastrointestinal tract to a metabolically active form. Research studies found that the combination of desogestrel and ethinyl estradiol prevented pregnancy in 13,290 women during 74,967 menstrual cycles. The effect of desogestrel on glucose tolerance and blood lipids may be less than other types of oral contraceptives. Women who take desogestrel-containing contraceptives may be less likely to gain weight or develop acne.

Usage, Pharmaceutical industry, Product introduction, Oral contraceptives, Privileges and immunities, Ortho-Cept (Contraceptive), Desogen (Contraceptive)

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A progestin-releasing intrauterine device for long-term contraception

Article Abstract:

The FDA has approved Mirena, an IUD that releases levonorgestrel over a five-year period. The cost will probably be around $500 plus the cost of inserting the IUD. This is considerably less expensive than a five year supply of oral contraceptives, which would cost about $1,800.

Intrauterine contraceptives, Intrauterine devices, Levonorgestrel, Mirena (Contraceptive)

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