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  • Title: Clinical review of a monophasic oral contraceptive containing desogestrel and ethinyl estradiol.
    Author: Stone S.
    Journal: Int J Fertil Menopausal Stud; 1993; 38 Suppl 3():117-21. PubMed ID: 8260969.
    Abstract:
    A monophasic oral contraceptive (OC) containing 30 mcg ethinyl estradiol and 150 mcg desogestrel is the most commonly used OC in Europe. Desogestrel alone inhibits ovulation at 60 mcg/day. Breakthrough bleeding occurs in about 2.5% of all cycles. Intermenstrual bleeding occurs in about 8% of cycles. It is most common in cycle 1 and then decreases with subsequent cycles. Few women using this combined OC discontinue because of bleeding problems. Desogestrel's low androgenicity accounts for low incidences of acne and hirsutism. The combined OC causes few minor side effects. It appears to increase high density lipoprotein-cholesterol levels and to decrease low density lipoprotein-cholesterol levels. Even though various monophasic OCs significantly increase the area under the curve (AUC) for glucose, insulin, and C-peptide, the desogestrel-OC was the least active for glucose at 50% and one of the two lowest for insulin (20%) and C-peptide (16%). The increased AUCs signify a moderate slowed response to glucose loading and increased insulin resistance, rather than a diabetes-like situation. The trends in values for fibrinolytic activity and for fibrinogen suggest that the desogestrel-OC activates the clotting system, but European studies show that the clotting behavior activated by the desogestrel-OC is no different than that activated by a gestodene-monophasic OC. Desogestrel has a long half-life (23.8 hours) which prolongs the period during which women who miss 1-2 pills can be protected from pregnancy. In conclusion, the desogestrel-OC provides reliable contraception and good cycle control. It causes few side effects, a positive overall effect on lipid metabolism, and minimal effects on carbohydrate metabolism and hemostasis.
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