Evaluation of a new generation of oral contraceptives. The Advisory Board for the New Progestins.
OBJECTIVE
To assess the differences and similarities in efficacy, safety, and metabolic effects of oral contraceptives (OCs) containing the new progestins desogestrel, gestodene, and norgestimate. All formulations reviewed contained no more than 35 micrograms ethinyl estradiol.


METHODS
Data were reported from approximately 100 published reports, dating from 1980, of comparative and noncomparative clinical studies on phasic and fixed-dose preparations culled from computer searches of several sources, including MEDLINE and Excerpta Medica.


METHODS
An attempt was made to select the most meaningful studies in terms of length, size, methodology, and quality of description. All clinical studies were considered; in general, review articles were not. Some preclinical studies were also included. No abstracts were used.


METHODS
The indices chosen for examination were contraceptive efficacy, cycle control, coagulation, carbohydrate and lipid metabolism, and androgenicity.


CONCLUSIONS
The new formulations were found to be comparable in efficacy to each other and to established agents. They also appeared to be less androgenic than current OCs and to have less impact on carbohydrate and lipoprotein metabolism. Cycle control was similar to that of older products. Changes in coagulation-promoting and antithrombotic factors were minor. Clinical relevance of the results could not be determined because of small sample size and methodologic differences between studies.
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Speroff
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DeCherney
D000728:Androgens / Q000378:metabolism; D001777:Blood Coagulation / Q000187:drug effects; D001786:Blood Glucose / Q000187:drug effects; D003276:Contraceptives, Oral; D017135:Desogestrel; D005260:Female; D006801:Humans; D007328:Insulin / Q000378:metabolism; D050356:Lipid Metabolism; D009644:Norgestrel / Q000031:analogs & derivatives*; D009652:Norpregnenes; D045167:Progesterone Congeners
D000728:Androgens; D001786:Blood Glucose; D003276:Contraceptives, Oral; D007328:Insulin; D009652:Norpregnenes; D045167:Progesterone Congeners; C033273:Gestodene; D009644:Norgestrel; D017135:Desogestrel; C017576:norgestimate