Safety, efficacy and patient satisfaction with continuous daily administration of levonorgestrel/ethinylestradiol oral contraceptives

Figures & data

Figure 1 Norgestrel: 8R,9S,10R,13S,14S,17S-13-ethyl-17-ethynyl-17-hydroxy- 1, 2, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16-dodecahydrocyclopenta[a]phenanthren-3-one.

Figure 2 The “Progestogen Tree.”

Courtesy Prof. A Genazzani, University of Pisa, Italy.

Abbreviations: CMA, chlormadinone acetate; CPA, cyproterone acetate; DNG, dienogest; DRSP, drospirenone; DSG, desogestrol; GST, gestodenes; MGA, megestrol acetate; LNG, levonorgestrol; MPA, medroxyprogesterone acetate; NETA; norethindrone acetate; TMG, trimegestone

Table 1 Biological activity of different progestogens, using two different tests

	Ovulation inhibiting dose (mg/die)	Endometrial transformation (mg/cycle)
Progesterone	>10	60
Dihydrogesterone	>30	140
MPA	10	80
Lynestrenol	2	70
Chlormadinone ac	1.5	20–30
Cyproterone ac	1	20
Noretisterone	0.5	100–150
Norgestimate	0.2	2
Desogestrel	0.06	6
Levonorgestrel	0.05	7
Gestodene	0.04	2

Abbreviations: MPA, medroxyprogesterone ac.

Table 2 Hormonal contraceptives containing norgestrel or levonorgestrel

Combined oral contraceptives
Monophasic
NGS	500 μg + EE 50 μg
NGS	500 μg + EV 2 mg
NGS	300 μg + EE 30 μg
LNG	250 μg + EE 50 μg
LNG	125 μg + EE 50 μg
LNG	250 μg + EE 30 μg
LNG	150 μg + EE 30 μg
LNG	100 μg + EE 20 μg
Phasic
LNG	50/150 μg + EE 50 μg
LNG	20/150 μg + EE 30/40 μg
LNG	50/75/125 μg + EE 30/40/30 μg
Progestin-only pills
LNG 75 μg, daily without interruption
Subcutaneous implants
Norplant 1
Norplant 2 (Jadelle)
Sinoimplant 1
Sinoimplant 2

Abbreviations: EE, ethinyl estradiol; EV, estradiol valerate; NGS, norgestrel; LNG, levonorgestrel.

Figure 3 Percentage of subjects reporting no bleeding in each treatment cycle. Asterisks indicate significant difference (p = 0.05) within a cycle.

Reproduced with permission from Kwiecien M, Edelman A, Nichols MD, Jensen JF. Bleeding patterns and patient acceptability of standard or continuous dosing regimens of a low-dose oral contraceptive: a randomized trial. Contraception. 2003;67:9–13.⁸³ Copyright © 2003 Elsevier.

KwiecienMEdelmanANicholsMDJensenJFBleeding patterns and patient acceptability of standard or continuous dosing regimens of a low-dose oral contraceptive: a randomized trialContraception20036791312521651

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