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Low Dose Birth Control Pills

Q: Who manufactures ultra low dose birth control pills? More than one company?  I need specifics and can't find them.

Dr. Donnica:
In general, "low dose" birth control pills are those that have 35 micrograms (mcg) or less of an estrogen (usually ethinyl estradiol). "Ultra low dose" or "very low dose" pills are those that have the lowest amount of estrogen in a birth control pill or 20 mcg (0.02 milligrams or mg).  The 20 mcg estrogen dose is sufficient for contraception, but pills with this so-called ultra low estrogen dose of 20 mcg are associated with more spotting and breakthrough bleeding than pills containing 30 or 35 mcg of estrogen. There are no ultra low dose triphasic pills. There is also one birth control pill that contains NO estrogen (Micronor contains 0.35 mg norethindrone and is manufactured by Ortho-McNeil). This would be suitable for nursing mothers or for those who cannot take estrogen because of a contraindication.

Examples of the "ultra low dose" birth control pills on the market include:

  • Alesse (contains 20 mcg ethinyl estradiol and 0.1 mg levonorgestrel; manufactured by Wyeth)

  • Mircette (contains 20 mcg ethinyl estradiol and 0.15 mg desogestrel; manufactured by Organon)

Examples of the "low dose" birth control pills on the market include:

  • LoOvral (contains 0.03 mg ethinyl estradiol and and 0.3 mg nogestrel;  manufactured by Wyeth)

  • Nordette (contains 0.03 mg ethinyl estradiol and 0.15 mg levognorgestrel; manufactured by Wyeth)

  • Ortho-Cept (contains 30 mcg ethinyl estradiol and 0.15 mg desogestrel; manufactured by Ortho-McNeil)

  • Cyclessa is the first triphasic oral contraceptive with an estrogen dose as low as 25 mcg; the graduated progestin (desogestrel) doses are 0.1, 0.125, and 0.15 mg in weeks 1, 2, and 3, respectively. U.S. clinical trial results with Cyclessa were published in 2000 (Kaunitz. Contraception. 2000;61:295-302.). In two large studies of identical design, a total of 5,654 sexually active women of child-bearing potential between the ages of 18 and 50 (average age 28.5 years) were randomly assigned to use either the popular triphasic Ortho-Novum 7/7/7 or Cyclessa for six menstrual cycles. Both pills proved equally effective at preventing pregnancy, but women who used Cyclessa had significantly less breakthrough bleeding or spotting--11.0% vs 15.5%. The Cyclessa group also experienced an average weight loss of 0.2 kg (about -0.4 lbs) compared with an average weight gain in the Ortho-Novum 7/7/7 group of 0.1 kg (about +0.2 lbs).  This difference was small, but statistically significant.

  • Yasmin (manufactured by Berlex) is a relatively new oral contraceptive containing 30 mcg of estrogen and 3.0 mg of drospirenone, a novel progestin that is more similar to natural progesterone. Yasmin has been associated with improved acne and seborrhea (excessively oily skin) as well as an improved sense of well-being. Yasmin appears to offer better weight control by reducing water retention. Women with liver, kidney, or adrenal problems should not take Yasmin because there is a risk of potassium levels becoming dangerously high. Yasmin also may not be appropriate in the presence of several other drugs, including certain over-the-counter pain relievers, potassium sparing diuretics, potassium supplements, ACE inhibitors, and angiotensin-II receptor antagonists.

Click here for more information on contraception.

Created: 8/21/2002  -  Donnica Moore, M.D.

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