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Alesse

Oral contraceptives come in a variety of formulations. The main division is between combined oral contraceptive pills, containing both estrogen and progesterone, and progesterone only pills (mini-pills). Combined oral contraceptive pills also come in varying types, including varying doses of estrogen, and whether the dose of estrogen or progesterone changes from week to week. more...

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Combined oral contraceptive pills

All contain the estrogen ethinyl estradiol, although in varying amounts, and one of a number of different progesterones. They are taken for 21 days with then a 7 day gap during which a withdrawal bleed (often, but incorrectly, referred to as a menstrual period) occurs. These differ in the amount of estrogen given, and whether they are monophasic (only one dose of estrogen and progesterone during the 21 days) or multiphasic (varying doses).

Monophasic

These are given as 21 tablets of estrogen and progesterone, followed by 7 tablets of placebo. Different formulations contain different amounts of estrogen and progesterone:

  • 20 mcg estrogen
    • 0.1 mg levonorgestrel (Alesse®, Levline®)
    • 1 mg norethindrone acetate (Loestrin 1/20®Fe)
  • 30 mcg estrogen
    • 0.15 mg levonorgestrel (Levlen®, Levora®, Nordette®)
    • 0.3 mg norgestrel (Lo-Ovral®)
    • 0.15 mg desogestrel (Desogen®, Organon; Ortho-Cept®, Ortho-McNeil)
    • 1.5 mg norethindrone acetate (Loestrin® 1.5/30)
    • 3.0 mg drospirenone (Yasmin®)
  • 35 mcg estrogen
    • 0.25 mg norgestimate (Ortho-Cyclen®)
    • 0.4 mg norethindrone (Ovcon-35®, Warner Chilcott)
    • 0.5 mg norethindrone (Modicon®, Brevicon®)
    • 1 mg norethindrone (Ortho-Novum 1/35®, Necon®, Norethin®, Norinyl 1/35®)
    • 1 mg ethynodiol diacetate (Demulen 1/35®, Zovia 1/35E®)
  • 50 mcg estrogen
    • 0.4 mg norethindrone (Ovcon-50®, Warner Chilcott))
    • 1 mg norethindrone (Necon 1/50®, Norinyl 1/50®, Ortho-Novum 1/50®, Ovcon-50®)
    • 0.5 mg norgestrel (Ovral®)
    • 1 mg ethynodiol diacetate (Demulen 1/50®, Zovia 1/50E®)

Multiphasic

  • Desogestrel 0.15 mg and ethinyl estradiol 0.02 mg x 14 tablets, followed by ethynil estradiol 0.01 mg x 2 tablets, followed by 5 tablets of placebo (Kariva®, Barr Laboratories; Mircette®, Organon)
  • Desogestrel 0.1 mg ethynil estradiol 0.025 mg x 7 tablets, followed by desogestrel 0.125 mg and ethynil estradiol 0.025 mg x 7 tablets, followed by desogestrel 0.15 mg and ethynil estradiol 0.025 mg x 7 tablets, followed by 7 tablets of ferric oxide (Cyclessa®, Organon; Velivet®, Barr Laboratories)
  • Norethindrone 0.5 mg and ethinyl estradiol 0.035 mg x 7 tablets, followed by 0.75 mg of norethindrone and 0.035 mg of ethinyl estradiol x 7 tablets, followed by 1 mg of norethindrone and 0.035 of ethinyl estradiol, followed by 7 tablets of placebo (Ortho-Novum 7/7/7®)
  • Norethindrone 0.5 mg and 0.035 mg of ethinyl estradiol x 10 tablets, followed by 1 mg norethindrone and 0.035 ethinyl estradiol x 11 tablets, followed by 7 tablets of placebo (Ortho-Novum 10/11®)

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Low-dose OCs ease dysmenorrhea in teens
From OB/GYN News, 10/15/04

WASHINGTON -- Adolescents treated with a low dose oral contraceptive reported a significantly greater reduction in pain as sociated with dysmenorrhea than did their counter-parts who received a placebo in a small study. Dr. Anne Davis reported at the annual meeting of the Association of Reproductive Health Professionals.

The study is the first randomized, controlled trial of low-dose OCs to treat dysmenorrhea in a teen population, noted Dr. Davis, a consultant for Wyeth Pharmaccuticals Inc., which markets Alesse, the OC used in the study.

Low-dose OCs have proven effective in treating amenorrhea in adolescent girls, so the investigators hypothesized that these agents would be similarly successful in treating dysmenorrhea, according to Dr. Davis, who is an ob.gyn, in the division of prevention and ambulatory care at Columbia University Medical Center, New York.

A total of 76 girls, mean age 16 years, were randomized to receive either three cycles of treatment with a combination of 100 [micro]g levonorgestrel plus 20 [micro]g ethinyl estradiol (Alesse) or placebo.

Overall, 57% of the girls reported severe dysmenorrhea at baseline. Results were assessed based on phone interviews conducted after each cycle.

At the end of the 3 months, mean scores on the Moos Menstrual Distress Questionnaire (MMDQ) pain subscale dropped significantly more in the OC group compared with the placebo group. Both groups had significant decreases in pain from baseline, however, ranging from 11.1 to 2.8 in the OC group and from 11.8 to 5.5 in the placebo group.

In addition, 61% of the girls in the OC group reported using no analgesics by the third cycle of the study, compared with 36% in the placebo group. Dr. Davis reported.

The study was funded by a grant from the National Institute of Child Health and Human Development.

COPYRIGHT 2004 International Medical News Group
COPYRIGHT 2004 Gale Group

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