low vs. high progestin bcp?

iVillage Member
Registered: 06-07-2004
low vs. high progestin bcp?
3
Tue, 06-08-2004 - 10:37am
I was wondering what the main differences between low-progestin and high-progestin bcp are?

I know it depends on the person, but are there any indicators that you might be better suited to pills with higher or lower progestin? What does progestin do?

iVillage Member
Registered: 04-19-2004
Tue, 06-08-2004 - 11:31am
The whole progestin thing is actually really complex, and goes beyond dosage. Some progestins are more potent than others, some more androgenic, etc. There's a great webpage that details the different progestins, what their potency is like, and which ones are best for resolving which conditions. Of course, since every woman is different these aren't hard-and-fast rules, but they make for good guidelines in general.

http://www.wdxcyber.com/ncontr13.htm
iVillage Member
Registered: 03-19-2003
Tue, 06-08-2004 - 2:17pm
Just to add to what klannert already posted, progestins are a very complex issue. There are about seven or so progestins on the US market and they're all of different strengths. The progestin component in birth control pills is the primary factor in suppressing ovulation (estrogen helps) and it also thickens the cervical mucous to prevent sperm from passing into the uterus from the vagina. Progestin is also a big factor in how your monthly bleeding is when it's combined with the estrogen component of the pill. The estrogen component helps with ovulation suppression, but it mostly just keeps you more comfortable--progestin-only contraception can be hard on some women. When you're not ovulating regularly, your natural estrogen levels are nowhere near what they are when you're ovulating normally and that can bring on a host of unpleasant side effects (ask a perimenopausal woman if she'd like her estrogen back...).

With the pill, we have our variety of progestins of different strengths in different doses combined with differing amounts of estrogen--each different combination may affect a woman differently, which is why there are so many options. For me, I can't tolerate one of the progestins (levonorgestrel, it's found in Alesse, Nordette, Triphasil, etc. and derivatives of it are in Ortho Cyclen/Evra/Tri Cyclen, etc.), but I can use several of the other progestins without a problem.

Which progestin a woman may do better on is totally dependent on her body chemistry. Typically, though, low levels of progestin can allow for heavier crampier periods, breakthrough bleeding, breast tenderness (because the estrogen is too high for the level of progestin), depression, and any other too-much-estrogen side effects. If progestin is too high, that can cause depression, irritability, fatigue, absent periods, breast shrinkage, vaginal dryness, and other not-enough-estrogen side effects.

Which combination of progestin + estrogen is best may even vary during your reproductive years, it's common for a woman to take a pill for years and have to switch later on because she's starting to have side effects that are new to her. Chemistry in the human body is difficult, particularly where hormones are concerned, which is why the pill is so much trial-and-error to get the right fit.

Make sense? Too much information? Or more questions? Just holler...

Judie
Co-cl for Birth Control
Judie Cl for Birth Control 
iVillage Member
Registered: 06-07-2004
Wed, 06-09-2004 - 9:04am
That gives me the general idea. Thank you so much!