Progestin Contraceptives Flashcards
CONS of Progestins
-
-Increase LDL levels
PROS of Progestins
-
-Increases quality and duration of lactation
First-Generation Progestins
- Norethindrone
- Norethindrone acetate
- Ethynodiol diacetate
MOA = Has affinity for progesterone and androgen receptors (at lower affinity than 2nd generations)
Second-Generation Progestins
- Norgestrel
- Levonorgestrel
MOA= Has affinity for progesterone and androgen receptors (higher affinity than 1st generations)
- Less breakthrough bleed or spotting d/t higher affinity for progesterone receptors
- May cause more acne, hirsutism, dyslipidemia, weight gain b/c higher affinity for androgen receptors
Third-Generation Progestins
- Norgestimate
- Desogestrel
MOA = Lower activity on androgen receptors. Also binds to progesterone receptors
-Less androgenic side effects (Acne, DLP, wt gain, hirsutism)
Other New Progestins
- Drospirenone
- Dienogest
MOA = Binds primarily to progesterone receptors with little to no affinity for other steroid receptors. Possible anti-androgen effects
Signs of “TOO MUCH” Progestin
- Breast tenderness
- Headache
- Fatigue
- Mood changes
Signs of “TOO LITTLE” Progestin
-Breakthrough bleeding in late cycle
Progestin-only Pills (POPs) “minipills”
Available as “Norethindrone 350 mcg (Micronor, Jencycla)
- Short half-life, so if taken more than 3 hrs late, it can increase risk of pregnancy (use backup contraceptive)
- No hormone-free days
- PRO = Less bleeding during menstruation
- CON = More irregular/unpredictable breakthrough bleeding/spotting