According to ACOG , high levels of androgens can also play a role in acne and excess hair growth. Some people may want to use the birth control pill to help treat these conditions. Different types of progestin vary in how androgenic they are. Other progestins do not act in this way and may help those who experience acne or excess hair growth. However, at present, there is no data to support one particular birth control pill being more effective than others at treating acne or excess hair growth.
People might consider talking to a doctor or healthcare professional about which type of progestin will suit them best. Some people may prefer to use a birth control pill that contains the progestin desogestrel.
According to a article, it may help those with hair growth and acne. However, the article also indicates that there is limited evidence to confirm that it is better than other options is limited.
Some of these birth control pills contain the same drugs in identical dosages but have different names. For example, a doctor may prescribe Azurette and Kariva, or Reclipsen and Apri interchangeably because they have the same contents.
Which drug a person gets may depend on a variety of factors, such as their insurance policy or availability of a specific brand. Some people prefer birth control pills that contain the progestin drospirenone because it has diuretic properties , which helps prevent bloating.
It is important to note, that according to the Food and Drug Administration FDA , drospirenone may increase the chance of blood clots. However, ACOG state that the risk is low.
According to a study , drospirenone can also help treat premenstrual dysphoric disorder PMDD , which is a severe type of premenstrual syndrome PMS. As before, it is important to note that a doctor may prescribe some brands interchangeably when they contain the same dosages, such as with Loryna and Yaz.
The birth control pills that contain levonorgestrel appear to have lower risks of side effects, such as venous thrombosis, than some of the other progestin options.
Doctors consider pills containing levonorgestrel and ethinyl estradiol as first-line, and they are effective as long as a person takes them correctly. A doctor may prescribe these brands interchangeably, providing they contain the same ingredients and dosages, as in the case of Aviane, Lessina, and Sronyx.
Norethindrone is a progestin that derives from testosterone. Those who take birth control pills containing norethindrone may experience androgenic side effects. People who use birth control pills containing norgestimate or norgestrel may also experience androgenic side effects, such as hair growth and acne. There are also extended-cycle birth control pills, such as Seasonique , which contain 12 weeks of combined hormones ethinyl estradiol and levonorgestrel and one week of placebo or low dose ethinyl estradiol.
Some people prefer extended cycles because they only bleed once every 3 months. Studies show that continuous use is safe for up to 12 months. According to DailyMed , triphasic birth control pills contain 21 days of active hormonal pills with different doses of estrogen and progestin each week.
An example of a triphasic birth control pill is Ortho Tri Cyclen. Each pill contains 35 mcg of ethinyl estradiol, but the dose of norgestimate increases each week.
Manufacturers of triphasic birth control attempted to reduce side effects by mimicking the natural fluctuation in hormones throughout the menstrual cycle. However, healthcare professionals are leaning away from triphasic birth control as, according to a study , they do not appear to be any more effective than monophasic birth control.
Many healthcare professionals prefer to prescribe monophasic birth control pills. These are birth control pills that provide the same level of hormones for 21 days, followed by 1 week of placebo.
They also noted that the effect of progestin dose couldn't be analyzed because of the wide variation in potency of different progestin types. Possible explanations include the triphasic pills more closely mimicking normal hormone fluctuations or the fact that the triphasic pills in the study had a lower cumulative progestin dose than corresponding monophasic pills, Lortscher and colleagues suggested.
The copper-releasing IUD was not included in the study. Since this long-acting reversible contraceptive doesn't contain hormones, it's unlikely to have a significant effect on acne, the researchers noted. They pointed out that a study comparing a levonorgestrel-releasing IUD to a copper-releasing IUD showed that the former led to an increase in acne scores while the latter did not. Source Reference: Lortscher D, et al "Hormonal contraceptives and acne: a retrospective analysis of patients" J Drugs Dermatol ; Action Points Different hormonal contraceptives have significantly varied effects on acne, according to self-reported assessments by women who sought consultation for acne while using hormonal contraceptives.
It is the only triphasic brand with this progestin. This brand may be helpful for women who experience minor estrogen-related side effects such as nausea, migraines, or fluid retention with other pill combinations. Advantages : May help women who experience migraines or nausea on birth control pills. Disadvantages : In between effects on acne.
Examples : Loestrin , Junel, Estrostep. Ethynodiol diacetate is a first-generation progestin of medium progestational activity. It has minor estrogenic effects and little androgenic activity. Ethynodiol diacetate is a derivative of norethindrone, so it is easily converted to norethindrone within the body. Birth control pills containing ethynodiol diacetate tend to be associated with increased early or mid-cycle spotting as compared to other combination pills.
However, higher estrogen dosages can counteract the likelihood of breakthrough bleeding , so pill brands that contain higher levels of estrogen can alleviate this side effect. Advantages : May be helpful for women with endometriosis. Disadvantages : Breakthrough bleeding spotting. Examples : Demulen, Kelnor, Zovia. Levonorgestrel is a second-generation progestin and is the most widely prescribed contraceptive progestin worldwide.
It has high progestational and androgenic effects. Levonorgestrel negatively affects serum lipoproteins. Several low-dose estrogen brands containing this progestin are available. The FDA has stated that all combination pills with this progestin are safe and effective for emergency contraception under the Yuzpe method. According to a systematic review , levonorgestrel was associated with the lowest risk of blood clots venous thromboembolism of all combined oral contraceptives.
Certainly, the lowest possible dose of ethinyl estradiol is recommended as well. Advantages : Lowest risk of blood clots of all combined oral contraceptives. Disadvantages : Negative effect on lipids affects serum lipoproteins ; increased incidence of androgenic side effects such as acne. Norgestrel a second-generation progestin is a mixture of both an inactive and active isomer—dextro-norgestrel inactive and levonorgestrel biologically active.
Norgestrel has high progestational and strong antiestrogen effects while also being high in androgenic activity. Advantages : May be helpful in endometriosis prevention. Disadvantages : Acne; weight gain. Desogestrel is a third-generation progestin with high progestational selectivity, minimizing androgenic effects and estrogenic activity. It shows a lower negative impact on metabolism, weight gain, acne, and other side effects typical of older progestins.
It shows positive effects on lipoproteins as seen by a slight rise of HDL cholesterol. Clinical trials show a possibly higher risk of non-fatal venous thrombosis blood clots with desogestrel pills versus those with levonorgestrel. Along with drospirenone, desogestrel appears to have a higher risk of blood clots than other options, especially levonorgestrel, with the highest risk of all combination birth control pills being desogestrel combined with 30 to 40 micrograms of ethinyl estradiol see study below under desogestrel.
Advantages : May help with menstrual cramps; Reduced risk of menstrual migraines; positive effects on lipids; Less weight gain. Disadvantages : Higher risk of blood clots. Norgestimate, a third-generation progestin, has high progestational activity while showing slight estrogenic effects and tends to be less androgenic.
It also has minimal effect on serum lipoproteins as well as on carbohydrate metabolism. The low androgenic effects of norgestimate have resulted in successful treatment of acne. In fact, birth control pills that contain norgestimate are the only ones FDA approved to help reduce acne. Ortho Tri-cyclen Lo is a brand that provides norgestimate and a mid-level dose of estrogen, so this pill may be helpful in lowering side effects such as nausea and vomiting while not causing an increased incidence of spotting typically associated with low-estrogen pills.
Disadvantages : May have a higher rate of headaches; Reduced libido. Drospirenone is the only progestin derived from 17a-spironolactone.
It helps suppress the secretion of the hormones that regulate the body's water and electrolytes. It also has low androgenic activity. Drospirenone and estrogen seem to lessen symptoms associated with mild PMS increased appetite, negative mood, and water retention.
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