Desogestrel

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Desogestrel is a synthetic progestin used mainly in birth control. In the body it is converted into etonogestrel, which provides the hormonal effect. It can be used alone as a progestin-only pill or in combination with an estrogen in many birth control pills. It is taken by mouth.

What it does:
- It stops ovulation (prevents an egg from being released) and changes cervical mucus and the lining of the uterus to reduce the chance of pregnancy.
- It has very weak androgenic (masculinizing) effects and little other hormonal activity.

How it’s used:
- Contraception: available as a progestin-only pill or in combination pills with estrogen.
- Other uses: sometimes used in hormone therapy for menopausal symptoms or endometriosis in certain regimens.
- Research has explored its use in male contraception, but it is not approved for that purpose.

Who should avoid or use with caution:
- Not for use during pregnancy.
- Like other hormonal contraceptives, it carries a risk of serious side effects in some people (e.g., blood clots); talk with a clinician about personal risk factors.

Brand names and availability:
- Widely marketed around the world under many names. In the United States, desogestrel is only available in combination pills with ethinylestradiol. In the UK, some desogestrel products can be bought over the counter with a pharmacist check.

Dosage basics:
- Desogestrel is available in different pill formulations, commonly 75 micrograms alone or 150 micrograms in combination with a small amount of ethinylestradiol. The medication is a prodrug, becoming etonogestrel in the body.

How it behaves in the body:
- Bioavailability varies (about 40–100%, averaging around 76%).
- Desogestrel is rapidly converted to etonogestrel; the prodrug has a short initial half-life, while etonogestrel stays in the body longer.
- It binds mainly to albumin in the blood, with high protein binding overall.

Common side effects:
- Irregular or missed periods, headaches, nausea, breast tenderness, mood changes, acne, and changes in hair growth.
- Some people experience weight changes or lipid (cholesterol) changes.
- Serious side effects are rare but can include blood clots or other hormone-related issues. Overdose symptoms are not well-defined; seek medical advice if concerned.

Drug interactions:
- Enzyme-activating drugs (like certain anticonvulsants, rifampin, some HIV meds) can reduce desogestrel’s effectiveness.
- Some antifungal or antibiotic drugs can affect levels of the hormone.
- Other medicines may interact with hormonal contraception, so discuss all medications with a healthcare provider.

Key points:
- Desogestrel is a highly selective progestin with strong progestogenic effects and very weak androgenic activity.
- It works mainly by preventing ovulation and altering cervical mucus and the uterine lining.
- It’s one of the options in modern “third-generation” progestin birth control, available in various brands worldwide.