Progestins clinical effects

Clinical studies also have been carried out with nonbio degradable implants releasing the progestin desogestrel (8). Unlike levonorgestrel, desogestrel possesses lower androgenic activity and thus has less adverse effect on blood Hpids. 

Limit the use of estrogen, alone or in combination with a progestin, to the lowest effective dose available and for the shortest duration consistent with treatment goals and risks for the individual woman. Periodically re-evaluate patients as clinically appropriate (eg, 3- to 6-month intervals) to determine if treatment is still necessary. Prempro One 0.625 mg/2.5 mg tablet once daily can increase to 0.625 mg/5 mg once daily. 

Clinical trials of these orally active progestins showed that they were effective as contraceptives with a success rate that exceeded 99%. These compounds were then marketed as obtained from the reaction sequence after appropriate purification. As the analytical methodology improved it became apparent that a small amount of an impurity was present in all active samples. An examination of the reaction scheme allowed ready identification of that by-product. Any unreduced estradiol methyl ether (13-1) will go to estrone methyl ether on oxidation this will then afford the potent orally active estrogen mestranol (9-1) on ethynylation. Subsequent... 

Walden CE, Knopp RH, Johnson JL, Heiss G, Wahl PW, 183. Hoover JJ. Effect of estrogen/progestin potency on clinical chemistry measures. The Lipid Research Clinics Program 184. Prevalence Study. Am J Epidemiol 1986 123(3) 517—31. 

Oral contraceptives affect many different constituents measured in the clinical laboratory. Tests are affected by both the progestin and estrogen components. The overall effect depends on the proportion and amount of the two components. 

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