Allcombination birth control pillscontain estrogen (typically ethinyl estradiol) and aprogestin. Progestin is a synthetic version of progesterone; its chemical structure is related to but not necessarily identical to natural progesterone. In contrast to estrogen, there are many types of progestin found in various oral contraceptive brands. The older progestin types are usually referred to as first- and second-generation while the newer ones are called third- and fourth-generation.
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Progestin Amounts
Types of Progestin
There are manytypes of progestins, and each has a different profile in terms of progestational, estrogenic, and androgenic activity and/or effects. The result of these effects is dependent on the combination of the type and level of progestin and the level of estrogen.
Because the hormones found in each type of pill are different, and because every woman responds differently to the pill, these general guidelines may not apply to all pill users. To better understand how a progestin may be classified, it is helpful to clarify what effects a progestin may have on the body.
Classification of Progestins
Combination birth control pills include one estrogen and one progestin. Most synthetic progestins are chemical derivatives of testosterone (known as 19-nortestosterone derivatives).
The available birth control pills that are classified under 19-nortestosterone can be further divided into two families: estrane and gonane.
Typically the third- and fourth-generation progestins tend to be highly selective and possess minimal androgenic properties. These include norgestimate, desogestrel, and drospirenone. There has been some evidence to suggest that the third-generation progestins may carry a higherrisk of blood clots.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.UpToDate.Combined estrogen-progestin oral contraceptives: patient selection, counseling, and use.Sims ST, Heather AK.Myths and methodologies: reducing scientific design ambiguity in studies comparing sexes and/or menstrual cycle phases.Exp Physiol. 2018;103(10):1309-1317. doi:10.1113/EP086797Regidor PA.The clinical relevance of progestogens in hormonal contraception: present status and future developments.Oncotarget. 2018;9(77):34628-34638. doi:10.18632/oncotarget.26015Oedingen C, Scholz S, Razum O.Systematic review and meta-analysis of the association of combined oral contraceptives on the risk of venous thromboembolism: the role of the progestogen type and estrogen dose.Thromb Res. 2018;165:68-78. doi:10.1016/j.thromres.2018.03.005
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.UpToDate.Combined estrogen-progestin oral contraceptives: patient selection, counseling, and use.Sims ST, Heather AK.Myths and methodologies: reducing scientific design ambiguity in studies comparing sexes and/or menstrual cycle phases.Exp Physiol. 2018;103(10):1309-1317. doi:10.1113/EP086797Regidor PA.The clinical relevance of progestogens in hormonal contraception: present status and future developments.Oncotarget. 2018;9(77):34628-34638. doi:10.18632/oncotarget.26015Oedingen C, Scholz S, Razum O.Systematic review and meta-analysis of the association of combined oral contraceptives on the risk of venous thromboembolism: the role of the progestogen type and estrogen dose.Thromb Res. 2018;165:68-78. doi:10.1016/j.thromres.2018.03.005
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
UpToDate.Combined estrogen-progestin oral contraceptives: patient selection, counseling, and use.Sims ST, Heather AK.Myths and methodologies: reducing scientific design ambiguity in studies comparing sexes and/or menstrual cycle phases.Exp Physiol. 2018;103(10):1309-1317. doi:10.1113/EP086797Regidor PA.The clinical relevance of progestogens in hormonal contraception: present status and future developments.Oncotarget. 2018;9(77):34628-34638. doi:10.18632/oncotarget.26015Oedingen C, Scholz S, Razum O.Systematic review and meta-analysis of the association of combined oral contraceptives on the risk of venous thromboembolism: the role of the progestogen type and estrogen dose.Thromb Res. 2018;165:68-78. doi:10.1016/j.thromres.2018.03.005
UpToDate.Combined estrogen-progestin oral contraceptives: patient selection, counseling, and use.
Sims ST, Heather AK.Myths and methodologies: reducing scientific design ambiguity in studies comparing sexes and/or menstrual cycle phases.Exp Physiol. 2018;103(10):1309-1317. doi:10.1113/EP086797
Regidor PA.The clinical relevance of progestogens in hormonal contraception: present status and future developments.Oncotarget. 2018;9(77):34628-34638. doi:10.18632/oncotarget.26015
Oedingen C, Scholz S, Razum O.Systematic review and meta-analysis of the association of combined oral contraceptives on the risk of venous thromboembolism: the role of the progestogen type and estrogen dose.Thromb Res. 2018;165:68-78. doi:10.1016/j.thromres.2018.03.005
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