[New progestational hormones].
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This review surveys four new 19-norethisterone-derived progestogens (gestodene, desogestrel, norgestimate, dienogest) for oral contraceptives, finding they lack androgenic effects and demonstrate varying progestogenic potencies with favorable impacts on SHBG, free testosterone, and lipid metabolism.
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Abstract
The pharmacology and the application in oral hormonal contraceptives of four new progestogens--gestodene, desogestrel, norgestimate, and dienogest--are described in a survey. Although derived from 19-norethisterone these progestogens exhibit in clinical dosages no androgenic effects. Both in animal and in human tests gestodene possesses the highest progestogenic potency followed by levonorgestrel, desogestrel, norgestimate, and dienogest. The monophasic preparations with the new progestogens (femovan--gestodene, marvelon--desogestrel, cilest--norgestimate, certostat--dienogest) are safe contraceptives and the incidence of bleeding disturbancies amount to about 5%. After administration of these monophasic contraceptives the concentration of SHBG in serum increases and as a result of this the level of free testosterone decreases. Further a favourable effect on lipid metabolism is observed. In spite of a different progestogen content these combination pills are almost without influence on biochemical parameters and carbohydrate metabolism.
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