Desogestrel

Desogestrel : alone progestin

In certain conditions, the taking of a progestatif without ethinylestradiol can have a contraceptive effect, it is the case of the desogestrel. The 3rd generation progestin used as contracepif are desogestrel, gestodene, and norgestimate. According to the mode of administration we distinguish :

1. Continues contraception

In the continuous contraception by oral way, in weak dose, ovulation is not always removed, but the permanent impregnation by the progestatif makes the cervical mucus hardly conducive to the transport of sperm and unfit for endometrial implantation. The treatment involves taking one tablet a day without interruption, even during menstruation. The concomitant taking of medicine with enzymatic inductive effect can return this mode of ineffective contraception by accelerating the inactivation of the progestatif. When a pregnancy occurs, there is a possibility to be increased ectopic.

2. Discontinuous Contraception

In discontinuous contraception by oral way, the progestin is determined so much higher than previously, but only from the fifth to the twenty-fifth day. progestogens have an antiganotrope effect by inhibiting ovulation.

3. Injectable Contraception

In contraception through an injection, the progestin is given in the form of extended release preparation for 3 months. This method leads to a permanent impregnation by the progestin in high concentrations. The first injection should be made between the first and fifth day of the cycle. This method of contraception is reserved for women unable to take charge of their own contraception treatment.

Contraception oestro progestin

It represents the mode of contraception the most used in a developed country. It is the combination of an estrogen and norsteroide progestin as desogestrel. For many years, the composition of oestro progestin oral contraceptives undergone many modifications to limit side effects, particularly cardiovascular. The doses of EE have been gradually reduced from 150 ?g in the 60's to 15 ?g in recent years. The nosteroides progestin potentiate hyperglycaemic effect of estrogen. So, during the tests of provoked hyperglycaemia, the hyperinsulinemia is variable according to the type of progestatif (Maximum and dose-dependent with progestin of 3rd generation, and especially desogestrel).

Desogestrel : Progestin Contraception

The norsteroides can be used in small doses in the form of microprogestatives pills (desogestrel). At these doses, their mode of contraceptive action is peripheral (coagulation of the cervical mucus, tubal mobility decreased and astrometrial atrophy). They must be prescribed continuously at the same times. The first month of treatment is not fully effective and it is necessary to use in combination mechanical methods. Furthermore, this contraception can encourage the occurrence of ectopic pregnancy (due to the effect of slowing tubal) and may not be associated with an enzyme inducer treatment. The interest is that in these doses, they do not interfere with the clotting proteins and have no metabolic conferred effect. There is only few epidemiological data but it seems that the use of contraceptive microprogestatifs is not associated with an increased vascular risk. While their contraceptive effect is mainly peripheral and while they are supposed to respect the secretion of gonadotrophin and ovulation, they tend to interfere with the gonadotrope function and secrete the peak of LH in 50 % of the cases. The persistence of the secretion of FSH and a follicular maturation leads sometimes to functional cysts of the ovary and to a climate of hyperœstrogenie on enhancing masmopathies, endometrial hyperplasia and fibroids. Their gynecological tolerance is low, and the recent proposal of a progestin micropill (desogestrel) presented as "also inhibiting ovulation" should not improve this tolerance.

Implant desogestrel

Subcutaneous implants : This is an acetate stick of vinyl-éthylène inserted into the subcutaneous tissue of the arm, issuing the estonogestrel (active metabolite of desogestrel). The contraceptive efficiency of this active ingredient of desogestrel is based on the peripheral action of the progestin (coagulation of the cervical mucus, endometrial atrophy), which joins the abolition of the ovulatory peak of LH. The contraceptive efficiency of the désogestrel is excellent and continues for 3 years. The immediate inconveniences are the irregularities menstrual related to a continuation of the secretion of FSH associated with follicular maturation.At the women, there is no modification of the parameters of the haemostasis, nor fractions lipids were studied. However, we keep a moderated insulino-resistance without rise of the glycaemia consecutive to the distribution of the désogestrel.