Birth control pills come in a variety of formulations. The main division is between combined oral contraceptive pills, containing both estrogens and syntheticprogestogens (progestins), and progestogen only pills. Combined oral contraceptive pills also come in varying types, including varying doses of estrogen, and whether the dose of estrogen or progestogen changes from week to week.
Combination pills usually work by preventing the ovaries from releasing eggs (ovulation). They also thicken the cervical mucus, which keeps sperm from penetrating into the uterus and joining with an egg. The hormones in combination and progestogen-only pills also thin the lining of the uterus. This could prevent pregnancy by interfering with implantation of a blastocyst.
Main action in typical use is prevention of ovulation.
Combined oral contraceptive pillsedit
All contain an estrogen, ethinylestradiol or mestranol,[1][2] in varying amounts, and one of a number of different progestogens. (Regarding the estrogen, the inactive 3-methyl ether of ethinylestradiol, which must be metabolized by the liver into the active ethinylestradiol; 50 μg of mestranol is equivalent to only 35 μg of ethinylestradiol and should not be used when high-dose [50 μg ethinylestradiol] estrogen pills are needed; mestranol was the estrogen used in the first oral contraceptive, Enovid). They are usually taken for 21 days with then a seven-day gap during which a withdrawal bleed (often, but incorrectly, referred to as a menstrual period) occurs. These differ in the amount of estrogen given, and whether they are monophasic (the same dose of estrogen and progestogen during each of the 21 days) or multiphasic (varying doses). The introduction of extended-cycle monophasic pills (i.e. Seasonale) has shown that the withdrawal bleeding intervals can be decreased.
Monophasicedit
These are typically given as 21 tablets of estrogen and progestogen, followed by seven tablets of placebo or an iron supplement,[3][4] although some newer formulations contain more active tablets and fewer placebos. Everyday regimens (Microgynon 30 ED, Femodene ED, Logynon ED), which include seven inactive placebo pills, are rarely used in UK practice.[5] Different formulations contain different amounts of estrogen and progestogen:
15 μg ethinylestradiol
60 μg gestodene: 24 days + 4 days placebo (Spain: Melodene-15; Israel: Minesse)[6]
ethinylestradiol/norgestimate combination with 7 tablets 25 μg/180 μg, 7 tablets 25 μg/215 μg, 7 tablets 25 μg/250 μg followed by 7 placebos (Ortho Tri-Cyclen Lo from Ortho-McNeil, Tri-Lo Sprintec back from Teva, Tri-Lo Marzia from Lupin, and norgestimate/ethinylestradiol from Mylan)[9]
ethinylestradiol/desogestrel combination with 7 tablets 25 μg/100 μg, 7 tablets 25 μg/125 μg, 7 tablets 25 μg/150 μg, followed by 7 tablets of ferric oxide (US: Cyclessa, Organon; Velivet, Barr)
20/30/35 μg ethinylestradiol: estrophasic
ethinylestradiol/norethisterone acetate combination with 5 tablets 20 μg/1000 μg, 7 tablets 30 μg/1000 μg, 9 tablets 35 μg/1000 μg, followed by 7 tablets of ferrous fumarate 75 mg (US: Estrostep Fe, Warner Chilcott)
estradiol valerate/dienogest combination with 2 tablets 3 mg/0 mg, followed by 5 tablets 2 mg/2 mg, 17 tablets 2 mg/3 mg, 2 tablets 1 mg/0 mg, and 2 placebos. (AU, EU, RU: Qlaira, US: Natazia, Bayer)[10][11]
Progestogen-only pillsedit
Progestogen-only pills (POPs) use a progestogen alone with doses taken continuously and no or a short gap between packs taken. People who use them may experience irregular light bleeds, and whilst irregular in the first few months of taking, usually settles to a regular pattern in time.
Generally oral contraceptives should not be used in people who currently have the following conditions:
Thrombophlebitis or thromboembolic disorders
A history of deep vein thrombophlebitis or thromboembolic disorders
Cerebrovascular or coronary artery disease (current or history)
Valvular heart disease with thrombogenic complications
Severe hypertension
Diabetes with vascular involvement
Headaches with focal neurological symptoms
Major surgery with prolonged immobilization
Known or suspected carcinoma of the breast or personal history of breast cancer
Carcinoma of the endometrium or other known or suspected estrogen-dependent neoplasia
Undiagnosed abnormal genital bleeding
Cholestatic jaundice of pregnancy or jaundice with prior pill use
Hepatic adenomas or carcinomas, or active liver disease
Known or suspected pregnancy
Hypersensitivity to any component of the product
More comprehensive guidelines that include analysis of risks and benefits can be found in the World Health Organization Medical Eligibility for Contraceptive Use Guidelines[12] which are reflected in the CDC Medical Eligibility for Contraceptive Use Guidelines.[13]
^Hatcher, Robert A.; Nelson, Anita (2004). "Combined Hormonal Contraceptive Methods". In Hatcher; Robert A. (eds.). Contraceptive Technology (18th rev. ed.). New York: Ardent Media. pp. 391–460. ISBN0-9664902-5-8.
^Speroff, Leon; Darney, Philip D. (2005). "Oral Contraception". A Clinical Guide for Contraception (4th ed.). Philadelphia: Lippincott Williams & Wilkins. pp. 21–138. ISBN0-7817-6488-2.
^. PatentStorm LLC. Archived from the original on June 13, 2011. Retrieved 2010-11-19.
^Serge Herceberg; Paul Preziosi; Pilar Galan. (PDF). Public Health Nutrition: 4(2B). pp. 537–545. Archived from the original (PDF) on 2011-07-26. Retrieved 2010-11-19.
^FFPRHC (2007). (PDF). Archived from the original (PDF) on 2007-07-04. Retrieved 2007-07-07.
^(PDF). Archived from the original (PDF) on 2011-07-22. Retrieved 2011-04-20.{{cite web}}: CS1 maint: archived copy as title (link)
^(PDF). Archived from the original (PDF) on 2015-05-03. Retrieved 2014-11-29.{{cite web}}: CS1 maint: archived copy as title (link)
^(PDF). Archived from the original (PDF) on 2011-10-05. Retrieved 2011-12-01.
^. Archived from the original on 2009-12-26. Retrieved 2009-12-29.
^"Medical eligibility criteria for contraceptive use". World Health Organization. Retrieved 2016-03-11.
^"United States Medical Eligibility Criteria (USMEC) for Contraceptive Use | Unintended Pregnancy | Reproductive Health | CDC". www.cdc.gov. Retrieved 2016-03-11.
November 16, 2023
birth, control, pill, formulations, this, article, needs, additional, citations, verification, please, help, improve, this, article, adding, citations, reliable, sources, unsourced, material, challenged, removed, find, sources, news, newspapers, books, scholar. This article needs additional citations for verification Please help improve this article by adding citations to reliable sources Unsourced material may be challenged and removed Find sources Birth control pill formulations news newspapers books scholar JSTOR September 2009 Learn how and when to remove this template message Birth control pills come in a variety of formulations The main division is between combined oral contraceptive pills containing both estrogens and synthetic progestogens progestins and progestogen only pills Combined oral contraceptive pills also come in varying types including varying doses of estrogen and whether the dose of estrogen or progestogen changes from week to week Contents 1 Mechanism of action 2 Combined oral contraceptive pills 2 1 Monophasic 2 2 Multiphasic 3 Progestogen only pills 4 Contraindications 5 See also 6 ReferencesMechanism of action editCombination pills usually work by preventing the ovaries from releasing eggs ovulation They also thicken the cervical mucus which keeps sperm from penetrating into the uterus and joining with an egg The hormones in combination and progestogen only pills also thin the lining of the uterus This could prevent pregnancy by interfering with implantation of a blastocyst Main action in typical use is prevention of ovulation Combined oral contraceptive pills editAll contain an estrogen ethinylestradiol or mestranol 1 2 in varying amounts and one of a number of different progestogens Regarding the estrogen the inactive 3 methyl ether of ethinylestradiol which must be metabolized by the liver into the active ethinylestradiol 50 mg of mestranol is equivalent to only 35 mg of ethinylestradiol and should not be used when high dose 50 mg ethinylestradiol estrogen pills are needed mestranol was the estrogen used in the first oral contraceptive Enovid They are usually taken for 21 days with then a seven day gap during which a withdrawal bleed often but incorrectly referred to as a menstrual period occurs These differ in the amount of estrogen given and whether they are monophasic the same dose of estrogen and progestogen during each of the 21 days or multiphasic varying doses The introduction of extended cycle monophasic pills i e Seasonale has shown that the withdrawal bleeding intervals can be decreased Monophasic edit These are typically given as 21 tablets of estrogen and progestogen followed by seven tablets of placebo or an iron supplement 3 4 although some newer formulations contain more active tablets and fewer placebos Everyday regimens Microgynon 30 ED Femodene ED Logynon ED which include seven inactive placebo pills are rarely used in UK practice 5 Different formulations contain different amounts of estrogen and progestogen 15 mg ethinylestradiol 60 mg gestodene 24 days 4 days placebo Spain Melodene 15 Israel Minesse 6 20 mg ethinylestradiol 1000 mg norethisterone acetate UK Loestrin 20 Galen US Loestrin 1 20 Duramed Microgestin 1 20 Watson Pharmaceuticals Junel 1 20 Barr 1000 mg norethisterone acetate 24 days 4 days ferrous fumarate only US Loestrin 24 Fe Warner Chilcott 90 mg levonorgestrel continuous 365 days year no placebo US Amethyst Watson 100 mg levonorgestrel extended cycle 84 days 7 days 10 mg ethinylestradiol only US LoSeasonique Teva CamreseLo Teva 100 mg levonorgestrel US Alesse Wyeth Aviane Barr Lessina Barr Lutera Watson Sronyx Watson 150 mg desogestrel UK Mercilon Organon HU Novynette Richter Gedeon 75 mg gestodene UK Femodette Bayer RU Logest Bayer Brazil Femiane Bayer 7 3000 mg drospirenone 24 days 4 days placebo US EU RU Yaz Bayer Schering Pharma AG Cleonita 21 days 7 days placebo US EU Yasminelle Bayer 24 days 4 days placebo and levomefolate calcium US Beyaz Bayer 30 mg ethinylestradiol 1500 mg norethisterone acetate UK Loestrin 30 Galen US Loestrin 1 5 30 Duramed Microgestin 1 5 30 Watson Junel 1 5 30 Barr 300 mg norgestrel US Lo Ovral Wyeth Low Ogestrel Watson Cryselle Barr 150 mg levonorgestrel UK Ovranette Wyeth Microgynon 30 Microgynon 30 ED Bayer US Nordette Duramed Levora Watson Portia Barr 150 mg levonorgestrel 21 day cycle 7 days no pills Canada Min Ovral 21 EU Ovoplex 150 30 Sweden Neovletta Prionelle 150 mg levonorgestrel 21 day cycle 7 days placebo Canada Min Ovral 28 Sweden Prionelle 28 RU Rigevidon 21 7 Richter Gedeon 150 mg levonorgestrel extended cycle 84 days 7 days placebo US Seasonale Duramed Quasense Watson Jolessa Barr Introvale 150 mg levonorgestrel extended cycle 84 days 7 days 10 mg ethinylestradiol only US Seasonique Duramed Camrese Teva Amethia Watson 75 mg gestodene UK Femodene Femodene ED Bayer Minulet Wyeth RU Femoden Jenapharm 150 mg desogestrel AU EU RU UK Marvelon BR Microdiol US Desogen MSD US Ortho Cept Ortho McNeil RU Regulon Richter Gedeon 3000 mg drospirenone AU EU US Yasmin FR Jasmine RU Yarina Bayer Schering Pharma AG with levomefolate calcium US Safyral Bayer Schering Pharma AG 2000 mg chlormadinone acetate EU Belara Benelux Bellina Gedeon Richter 2000 mg dienogest AU EU Valette RU Jeanine Bayer Schering Pharma AG RU Siluet Gedeon Richter 35 mg ethinylestradiol 400 mg norethisterone chewable spearmint flavor US Femcon Fe Warner Chilcott 400 mg norethisterone US Ovcon 35 Warner Chilcott Balziva Barr 500 mg norethisterone UK Ovysmen Janssen Cilag Brevinor Pfizer US Modicon Ortho McNeil Brevicon Watson Nortrel 0 5 35 Barr 1000 mg norethisterone AU CAN Synphasic Pfizer UK Norimin Pfizer US Ortho Novum 1 35 Ortho McNeil Norinyl 1 35 Watson Necon Watson Nortrel 1 35 Barr 1000 mg etynodiol diacetate US Demulen 1 35 Pfizer Zovia 1 35 Watson Kelnor Barr 250 mg norgestimate UK Cilest Janssen Cilag US Ortho Cyclen Ortho McNeil MonoNessa Watson Sprintec Barr Sweden Amorest 8 2000 mg cyproterone acetate only approved for severe acne or severe hirsutism in the UK AU RU Diane 35 UK Dianette Bayer 50 mg mestranol equivalent to 35 mg ethinylestradiol 1000 mg norethisterone UK Norinyl 1 Pfizer US Ortho Novum 1 50 Ortho McNeil Norinyl 1 50 Watson Necon 1 50 Watson 50 mg ethinylestradiol 1000 mg norethisterone US Ovcon 50 Warner Chilcott 1000 mg etynodiol diacetate US Demulen 1 50 Pfizer Zovia 1 50 Watson 500 mg norgestrel US Ogestrel Watson 250 mg levonorgestrel US Nordiol Wyeth 1 5 mg estradiol as hemihydrate 2 5 mg nomegestrol acetate 24 day cycle 4 placebo pills AU EU RU Zoely MSD 15 mg estetrol monohydrate equivalent to 14 2 mg estetrol 3 mg drospirenone 24 day cycle 4 inactive pills US CAN Nexstellis Mayne EU Drovelis Gedeon Richter Plc EU Lydisilka Estetra SRL Multiphasic edit 25 mg ethinylestradiol triphasic ethinylestradiol norgestimate combination with 7 tablets 25 mg 180 mg 7 tablets 25 mg 215 mg 7 tablets 25 mg 250 mg followed by 7 placebos Ortho Tri Cyclen Lo from Ortho McNeil Tri Lo Sprintec back from Teva Tri Lo Marzia from Lupin and norgestimate ethinylestradiol from Mylan 9 ethinylestradiol desogestrel combination with 7 tablets 25 mg 100 mg 7 tablets 25 mg 125 mg 7 tablets 25 mg 150 mg followed by 7 tablets of ferric oxide US Cyclessa Organon Velivet Barr 20 30 35 mg ethinylestradiol estrophasic ethinylestradiol norethisterone acetate combination with 5 tablets 20 mg 1000 mg 7 tablets 30 mg 1000 mg 9 tablets 35 mg 1000 mg followed by 7 tablets of ferrous fumarate 75 mg US Estrostep Fe Warner Chilcott 35 30 30 mg ethinylestradiol triphasic ethinylestradiol desogestrel combination with 7 tablets 35 mg 50 mg 7 tablets 30 mg 100 mg 7 tablets 30 mg 150 mg RU Tri Merci Organon 30 40 30 mg ethinylestradiol triphasic ethinylestradiol levonorgestrel combination with 6 tablets 30 mg 50 mg 5 tablets 40 mg 75 mg 10 tablets 30 mg 125 mg UK Trinordiol Wyeth Logynon Logynon ED Bayer US Triphasil Wyeth Trivora Watson Enpresse Barr ethinylestradiol gestodene combination with 6 tablets 30 mg 50 mg 5 tablets 40 mg 70 mg 10 tablets 30 mg 100 mg UK Triadene Bayer Tri Minulet Wyeth 35 mg ethinylestradiol triphasic ethinylestradiol norethisterone combination with 7 tablets 35 mg 500 mg 9 tablets 35 mg 1000 mg 5 tablets 35 mg 500 mg UK Synphase Pfizer US Tri Norinyl Watson Leena Watson ethinylestradiol norethisterone combination with 7 tablets 35 mg 500 mg 7 tablets 35 mg 750 mg 7 tablets 35 mg 1000 mg UK TriNovum Janssen Cilag US Ortho Novum 7 7 7 Ortho McNeil Necon 7 7 7 Watson Nortrel 7 7 7 Barr ethinylestradiol norgestimate combination with 7 tablets 35 mg 180 mg 7 tablets 35 mg 215 mg 7 tablets 35 mg 250 mg followed by 7 placebos Ortho Tri Cyclen Ortho McNeil TriNessa Watson Tri Sprintec Barr 35 mg ethinylestradiol biphasic ethinylestradiol norethisterone combination with 10 tablets 35 mg 500 mg 11 tablets 35 mg 1000 mg followed by 7 placebos US Ortho Novum 10 11 Ortho McNeil Necon 10 11 Watson ethinylestradiol norethisterone combination with 7 tablets 35 mg 500 mg 14 tablets 35 mg 1000 mg UK BiNovum Janssen Cilag 3 2 1 mg estradiol valerate estrophasic estradiol valerate dienogest combination with 2 tablets 3 mg 0 mg followed by 5 tablets 2 mg 2 mg 17 tablets 2 mg 3 mg 2 tablets 1 mg 0 mg and 2 placebos AU EU RU Qlaira US Natazia Bayer 10 11 Progestogen only pills editProgestogen only pills POPs use a progestogen alone with doses taken continuously and no or a short gap between packs taken People who use them may experience irregular light bleeds and whilst irregular in the first few months of taking usually settles to a regular pattern in time The following progestogens are used 350 mg norethisterone norethindrone UK Micronor Janssen Cilag Noriday Pfizer US Micronor Ortho McNeil Nor QD Watson Nora BE Watson Jolivette Watson Camila Barr Errin Barr Heather Glenmark RU Primolut Nor Bayer Norkolut Richter Gedeon 4 mg drospirenone Slynd 75 mg desogestrel UK Cerazette Loestrin RU Cerazette Organon Lactinette Richter Gedeon SE Gestrina 30 mg levonorgestrel UK Norgeston Bayer AUS RU Microlut Bayer 500 mg etynodiol diacetate UK Femulen Pfizer 500 mg lynestrenol RU Exluton Organon Contraindications editGenerally oral contraceptives should not be used in people who currently have the following conditions Thrombophlebitis or thromboembolic disorders A history of deep vein thrombophlebitis or thromboembolic disorders Cerebrovascular or coronary artery disease current or history Valvular heart disease with thrombogenic complications Severe hypertension Diabetes with vascular involvement Headaches with focal neurological symptoms Major surgery with prolonged immobilization Known or suspected carcinoma of the breast or personal history of breast cancer Carcinoma of the endometrium or other known or suspected estrogen dependent neoplasia Undiagnosed abnormal genital bleeding Cholestatic jaundice of pregnancy or jaundice with prior pill use Hepatic adenomas or carcinomas or active liver disease Known or suspected pregnancy Hypersensitivity to any component of the productMore comprehensive guidelines that include analysis of risks and benefits can be found in the World Health Organization Medical Eligibility for Contraceptive Use Guidelines 12 which are reflected in the CDC Medical Eligibility for Contraceptive Use Guidelines 13 See also editMestranol noretynodrel Enovid the first oral contraceptive List of progestogens available in the United States List of estrogens available in the United StatesReferences edit Hatcher Robert A Nelson Anita 2004 Combined Hormonal Contraceptive Methods In Hatcher Robert A eds Contraceptive Technology 18th rev ed New York Ardent Media pp 391 460 ISBN 0 9664902 5 8 Speroff Leon Darney Philip D 2005 Oral Contraception A Clinical Guide for Contraception 4th ed Philadelphia Lippincott Williams amp Wilkins pp 21 138 ISBN 0 7817 6488 2 US Patent Oral contraceptive Patent 6451778 Issued on September 17 2002 Estimated Expiration Date July 2 2017 PatentStorm LLC Archived from the original on June 13 2011 Retrieved 2010 11 19 Serge Herceberg Paul Preziosi Pilar Galan Iron deficiency in Europe PDF Public Health Nutrition 4 2B pp 537 545 Archived from the original PDF on 2011 07 26 Retrieved 2010 11 19 FFPRHC 2007 Clinical Guidance First Prescription of Combined Oral Contraception PDF Archived from the original PDF on 2007 07 04 Retrieved 2007 07 07 Archived copy PDF Archived from the original PDF on 2011 07 22 Retrieved 2011 04 20 a href Template Cite web html title Template Cite web cite web a CS1 maint archived copy as title link Archived copy PDF Archived from the original PDF on 2015 05 03 Retrieved 2014 11 29 a href Template Cite web html title Template Cite web cite web a CS1 maint archived copy as title link Amorest 28 FASS se Retrieved 2019 08 08 GoodRx Error Retrieved 31 August 2016 Natazia Prescribing Information PDF Archived from the original PDF on 2011 10 05 Retrieved 2011 12 01 Summary of Product Characteristics for Qlaira Archived from the original on 2009 12 26 Retrieved 2009 12 29 Medical eligibility criteria for contraceptive use World Health Organization Retrieved 2016 03 11 United States Medical Eligibility Criteria USMEC for Contraceptive Use Unintended Pregnancy Reproductive Health CDC www cdc gov Retrieved 2016 03 11 Retrieved from https en wikipedia org w index php title Birth control pill formulations amp oldid 1178778004, wikipedia, wiki, book, books, library,
