Progestins side effects

Mirena is a relatively new intrauterine contraceptive device that releases levonorgestrel into the uterine cavity for 5 years. Use of this contraceptive device is associated with fewer systemic progestin side effects and is at least as effective as Norplant. 

Jaundice with Less rheumatoid arthritis Progestin side effects (acne. ... 

Jadelle, Acute liver disease pounds Progestin side effects ... 

Irregular menstrual bleeding, headache, weight gain, acne Delayed return of fertility Possible increased risk of breast cancer in younger users Decreased HDL Progestin side effects Decreased bone density in long-term users... 

Office visit required monthly Progestin side effects Estrogen side effects... 

Side effects associated with the use of combined oral contraceptives may be minimized by appropriately adjusting either the total estrogen or progestin content. 

As with all medications, there are potential adverse effects with combined oral contraceptives (COCs). Many side effects can be minimized or avoided by adjusting the estrogen and/or progestin content of the oral contraceptive. It is also important to have proper patient selection for oral contraceptives because some women are at increased risk for potentially serious side effects. 

In addition, progestin-only pills can be used as EC (Ovrette [20 tablets/dose]). Common side effects of EC are nausea, vomiting, and irregular bleeding. 

Dosage adjustments Side effects noted during the initial cycles may be transient if they continue, dosage adjustments may be indicated. Many side effects are related to the potency of the estrogen or progestin in the products. The following table summarizes these dose-related side effects. 

Common side effects associated with estrogen use include nausea, weight gain, and edema. Progestin use is associated with weight gain and mild depression. Tolerance to these effects usually develops over several months. 

A low dosage of progestin ( mini-pill ) is used, in the form of medroxyprogesterone acetate, which is active at a very low dose. The mini-pill does not inhibit ovulation, but rather interferes with the endometrium and the cervical mucus. The use of this pill prevents most of the side effects of oral contraception, specifically nausea, water retention, and in some cases thrombophlebitis. However, a lower success rate and other frequent side effects have reduced the widespread acceptance of this preparation. Nevertheless, the mini-pill has a role to play in certain specific situations. For example, in an uncommon form of epilepsy called catamenial epilepsy, female patients will experience seizures at particular times during their menstrual cycle, reflecting the fact that seizure focus is stimulated by estrogens but inhibited by progestins. In such women, the mini-pill may afford not only birth control but also improved seizure control. 

Contraception with progestins is useful in patients with hepatic disease, hypertension, psychosis or mental retardation, or prior thromboembolism. The side effects include headache, dizziness, bloating and weight gain of 1-2 kg, and a reversible reduction of glucose tolerance. 

Loder EW, Buse DC, Golub JR. Headache as a side effect of combination estrogen-progestin oral contraceptives a systematic review. Am J Obstet Gynecol 2005 193 636-49. 

Most adverse effects are believed to be due to the estrogen component, but cardiovascular effects reflect the action of both estrogen and progestin. The incidence of side effects with oral contraceptives is relatively low and is determined by the specific compounds and combinations used. 

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