What is Desogestrel used for?

Introduction to Desogestrel

Desogestrel is a synthetic progestogen, also known as a progestin, that is often utilized in hormonal contraceptives. Marketed under various trade names including Cerazette, Cerelle, and Desogen, this hormone-altering medication plays a critical role in birth control formulations. Developed and researched by pharmaceutical companies such as Organon, desogestrel is widely accepted and prescribed globally for its efficacy in preventing pregnancy. The medication is typically found in combination with estrogen, but it is also available as a progestogen-only pill (POP), often referred to as the "mini-pill." Apart from its primary indication in contraception, desogestrel is under research for its potential applications in treating conditions like endometriosis and menstrual disorders.

Desogestrel Mechanism of Action

The mechanism of action of desogestrel primarily involves the inhibition of ovulation. It accomplishes this by maintaining a consistent level of progestogen in the bloodstream, which exerts its effects on the hypothalamic-pituitary-ovarian axis. By doing so, desogestrel suppresses the secretion of gonadotropins, particularly luteinizing hormone (LH), which is crucial for ovulation. Additionally, desogestrel increases the viscosity of cervical mucus, making it more difficult for sperm to travel through the cervix and fertilize an egg. It also induces changes in the endometrial lining, making it less receptive to a fertilized egg and thus preventing implantation. Together, these mechanisms work synergistically to provide effective contraception.

How to Use Desogestrel

Desogestrel is typically administered orally in the form of tablets, taken once daily at the same time each day to maintain a steady level of the hormone in the bloodstream. This consistent dosing is crucial for its effectiveness, especially for the progestogen-only pill, which has a narrower window for missed doses compared to combined oral contraceptives. The onset of desogestrel's contraceptive effects depends on when you start taking the pill. If you begin on the first day of your menstrual cycle, the contraceptive effect is immediate. However, if you start at any other point in your cycle, it's advised to use an additional method of contraception, such as condoms, for the first seven days. It's also important to follow specific guidelines regarding missed pills. If you miss a dose by more than 12 hours, the contraceptive efficacy may be reduced, and additional precautions should be taken.

What are Desogestrel Side Effects

Like all medications, desogestrel can cause side effects, although not everyone experiences them. Common side effects include menstrual irregularities, such as breakthrough bleeding or spotting, and changes in menstrual flow. Some women may experience headaches, breast tenderness, or mood changes. Less common but more severe side effects can include thromboembolic events like deep vein thrombosis (DVT) or pulmonary embolism, although these risks are significantly lower compared to combined oral contraceptives that contain estrogen. Weight gain, acne, and changes in libido are other reported side effects. Contraindications for using desogestrel include known or suspected pregnancy, active liver disease, and a history of hormone-sensitive cancers such as breast cancer. Women with unexplained vaginal bleeding should also avoid its use until a definitive diagnosis is made. It is crucial to consult a healthcare provider to discuss potential risks and benefits before starting desogestrel.

What Other Drugs Will Affect Desogestrel

Several medications can interact with desogestrel, potentially reducing its effectiveness or increasing the risk of side effects. Enzyme-inducing drugs, such as certain antiepileptics (e.g., carbamazepine, phenytoin), antituberculous medicines (e.g., rifampicin, rifabutin), and some antiretrovirals used in HIV treatment (e.g., ritonavir, efavirenz), can accelerate the metabolism of desogestrel, thereby reducing its contraceptive efficacy. St. John's Wort, an herbal supplement often used for depression, can also decrease the effectiveness of desogestrel by inducing liver enzymes that metabolize the drug. On the other hand, desogestrel can affect the metabolism of other drugs, such as increasing the effects of cyclosporine, potentially leading to toxicity. Therefore, it is vital to inform your healthcare provider about all medications and supplements you are taking to manage potential drug interactions effectively. In some cases, alternative contraceptive methods may be recommended to ensure effective pregnancy prevention.