| Progestin | Progestational Activity (relative to 1 mg of norethindrone) | Androgenic Activity (relative to 1 mg of norethindrone) |
|---|---|---|
| norethindrone 1 mg | 1.0 | 1.0 |
| norethrindrone acetate 1 mg | 1.2 | 1.6 |
| ethynodiol diacetate 1 mg | 1.4 | 0.6 |
| levonorgestrel 1 mg | 5.3 | 8.3 |
| dl-norgestrel 1 mg | 2.6 | 4.2 |
| norgestimate 1 mg | 1.3 | 1.9 |
| norelgestromin 1 mg** | 1.3 | 1.9 |
| desogestrel 1 mg | 9.0 | 3.4 |
| drospirenone 1 mg | 1.5 | 0.0 |
* - From Table 2 in Dickey RP: Individualizing oral contraceptive therapy. OBG Management Supplement October 2000, p 5.
** - Not yet tested but it is the major active metabolite of norgestimate
The birth control pills that are likely to cause worse acne and hair growth side effects are those pills high in androgenicity and low in estrogen content. Such pills might include:
- Loestrin® 1.5/30
- Loestrin® 1/20 Fe
- Estrostep® Fe
- Levlen®
- Alesse®
- Ovral®
- Norlestrin® 1/50
Keep in mind that MOST women on these above pills DO NOT have acne problems, just those that have a tendency toward androgenicity.
What pills would be better for...?
In order to classify an oral contraceptive as an estrogen dominant, progestin dominant or androgenic pill, you must multiply the actual dose of the components times the relative potency of that component.
Keep in mind that these are relative classification and do not always hold from one woman to another. For different oral contraceptive side effects, you might consider switching to the pills indicated in the table below to minimize those side effects.
Current Pill Problems and Choice of Pill to Switch To
| Side Effect/Problem | Principal | Pill Suggestions |
|---|---|---|
| Acne | higher estrogen, lower androgen potency | Yasmin®, Demulen® 1/50, Othro-Tri Cyclen®, Ortho-Cyclen®, Yasmin®, Brevicon®, Modicon®, Necon®, Ortho Evra®, Mircette® |
| Break-through bleeding | higher estrogen, higher progestin potency, lower androgen potency | Yasmin®, Demulen® 1/50, Zovia® 1/50E, Ovcon® 50, Desogen®, Ortho-Cept®, Estrostep® Fe, Loestrin® 1/20 |
| Absent or too light menstrual flow | higher estrogen, lower progestin potency | Ortho-Cyclen®, Ovcon® 35, Brevicon®, Modicon®, Necon® 1/50, Norinyl® 1/50, Ortho-Novum® 1/50, Necon® 1/35, Norinyl® 1/35, Ortho-Novum® 1/35, |
| Depression | lower progestin potency | Ortho Evra®, Ovcon® 35, Ortho-TriCyclen®, Othro-Cyclen®, Brevicon®, Modicon®, Necon® 1/35, Alesse®, Levlite®, Tri-Levlen®, Triphasil®, Trivora® |
| Moodiness or irritability | lower progestin potency | Ortho Evra®, Ovcon® 35, Ortho Tri-Cyclen®, Othro-Cyclen®, Brevicon®, Modicon®, Necon® 1/35, Alesse®, Levlite®, Tri-Levlen®, Triphasil®, Trivora® |
| Headaches (not menstrual migraines) | lower estrogen, lower progestin potency | Ortho Evra®, Alesse®, Levlite®, |
| Breast soreness | lower estrogen, lower progestin potency | Yasmin®*, Ortho Evra®, Alesse®, Levlite®, Loestrin® 1/20 Fe, any lower estrogen pill than currently on |
| Weight gain | lower estrogen, lower progestin potency | Yasmin®*, Ortho Evra®, Alesse®, Levlite®, Loestrin® 1/20 Fe, any lower estrogen pill than currently on |
| Severe menstrual cramps | higher progestin potency | Yasmin®, Desogen®, Ortho-Cept®, Mircette®, Loestrin® 1.5/30, Demulen® 1/35, Zovia® 1/35E, Demulen® 1/50, Zovia® 1/50E |
| Endometriosis or endometriosis prevention | lower estrogen, higher progestin potency, higher androgen potency | Loestrin® 1.5/30, Loestrin® 1/20 Fe, LoOvral®, Levlen®, Levora®, Nordette®, Demulen® 1/35, Zovia® 1/35, (used either continuously with zero days of placebo pills or with only 4 days of placebo pills for prevention) |
* - The progestin has anti-water retention properties
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