Desogestrel
progestogen · hormonal contraception
Our referenceBy the Layer Nutrition editorial team · How the atlas classifies the 664 molecules
What this medicine is for
Pharmacologically, Desogestrel relates to the category “progestogen (hormonal contraception)”. This hormone is part of hormonal contraception: taken each day, it prevents ovulation and makes the body unfavorable to a pregnancy, reversibly.
Specifically, for Desogestrel: Component of a hormonal contraceptive. It is most often a long-term treatment, taken at regular times over long periods; its benefit is judged over time, not by how you feel on a given day.
Under which brands it is found
In France, about 15 reimbursable presentations containing Desogestrel are recorded. It is found under several brand names and as generics.
- Antigone
- Cerazette
- Desobel
- Desogestrel Biogaran
- Desogestrel Cristers
- Desogestrel Sandoz
- Desogestrel/Ethinylestradiol Biogaran
- Desogestrel/Ethinylestradiol Biogarancontinu
- and other presentations
Generics and the original brand are equivalent for the active substance; only the appearance, the name or the excipients may differ.
Our product for this treatment
Desogestrel is one of the everyday treatments for which we have formulated a targeted supplement.
Layer Nutrition Contraception
Vitamin B6 helps you regulate your hormonal activity and reduce tiredness. Folate supports normal blood formation.
- Contributes to the regulation of hormonal activity (vitamin B6)
- Contributes to the reduction of tiredness (B6, folate, B12)
- Contributes to normal psychological function (B6, folate, B12)
B6 10 mg · Folate 250 µg · B2 4.2 mg · B12 50 µg
One bottle, one dose per day. Reduced price from the second box, free delivery from two boxes.
How desogestrel works
Desogestrel is a synthetic progestogen. It is a prodrug: the body converts it into its active metabolite, etonogestrel, also called 3-keto-desogestrel, which carries the entire contraceptive effect. This etonogestrel binds to the progesterone receptor, the key through which it drives its effects. Its terminal half-life is around 30 hours, and the blood concentration reaches steady state after four to five days of daily intake.
Its main action is to prevent ovulation. Like other progestogens, it curbs the secretion of GnRH by the hypothalamus and the release of LH and FSH by the pituitary gland, the hormonal signal that normally drives the maturation and then the release of the egg. Added to this central blockade are local effects: desogestrel thickens the cervical mucus, which hinders the passage of sperm, slows the motility of the tubes and thins the endometrium. In trials of the 75 microgram pill, the observed ovulation rate was only 1 percent, that is one user in 103.
A contraceptive taken continuously
This progestogen-only pill is taken without a break: one tablet each day, at roughly the same time, with no interruption between packs. No dietary restriction applies, and it is swallowed with or without a meal. Regularity matters, because protection rests on a stable hormone concentration and the half-life of etonogestrel is short. This contraceptive is not stopped on one's own initiative: any interruption is decided with the professional who prescribed it.
The margin in the event of a missed dose is narrow. If the delay stays under 12 hours, contraceptive protection is maintained: simply take the tablet as soon as possible, then continue at the usual time. Beyond 12 hours, efficacy is no longer guaranteed: take the last missed tablet, continue the pack and add a barrier method for the following seven days. This short window follows directly from the speed with which the body eliminates etonogestrel.
The bleeding pattern and the endometrium
The most expected change affects menstruation. A change in the bleeding pattern, irregular bleeding, spotting between cycles or a complete absence of periods, concerns up to half of users. Irregular periods and amenorrhoea are indeed among the common effects, reported in at least one user in a hundred. This pattern stems from the action of the progestogen on the endometrium, which it keeps thin.
This thinning of the uterine lining, endometrial atrophy, locally extends the contraceptive mechanism. It explains why bleeding becomes unpredictable, lighter, or stops altogether. Dysmenorrhoea, that is painful periods, appears uncommonly, in fewer than one user in a hundred. An ovarian cyst may occur within this same frequency range, between one user in a thousand and one in a hundred.
The other effects to be aware of
Several common effects, defined as affecting at least one user in a hundred and fewer than one in ten, are worth knowing. Reported are an altered mood, a depressed mood, a drop in libido, headaches, nausea, acne, breast pain and weight gain. Their intensity varies from one person to another and none of these effects occurs systematically. Spotting them early makes it possible to raise them at the right moment with the prescriber.
Uncommon effects, between one user in a thousand and one in a hundred, include vomiting and fatigue. Rarer still, below one in a thousand, are a skin rash, urticaria and erythema nodosum. Furthermore, desogestrel lowers estradiol at the level of the early follicular phase; it is not yet known whether this decrease has a clinically relevant effect on bone mineral density.
Interactions and monitoring
Certain combinations reduce the efficacy of desogestrel. Inducers of liver enzymes, in particular inducers of cytochrome P450 3A4, speed up its elimination and lower its blood concentrations. Concerned are rifampicin, carbamazepine, phenytoin and St John's wort, among others. During these treatments and for the 28 days that follow their discontinuation, a barrier method is recommended in addition to the pill.
Medical monitoring accompanies this contraceptive. It includes an annual examination with measurement of blood pressure, examination of the breasts, abdomen and pelvic organs, as well as cervical cytology. When desogestrel is combined with an oestrogen in a combined pill, other parameters shift: a decrease in glucose tolerance appears in a proportion of users, the carrier protein for sex hormones (SHBG) rises markedly, going from 150 to 230 nmol/L between the first and twenty-first day of the third treatment cycle, and HDL cholesterol may decrease. These elements guide the biological points of vigilance.
On the plate
Diet meets this treatment on one precise point: folate, that is vitamin B9. Oral contraception can lower the level of folate circulating in the blood. Yet this folate comes mainly from the plate: dark green leafy vegetables such as spinach and kale, legumes such as lentils and beans, and citrus fruit, foremost among them the orange. Building meals around these foods supports the baseline intake.
Vitamin B9 holds a particular place for a woman of childbearing age, because it acts very early in a pregnancy, sometimes even before it is known. A plate rich in green vegetables, legumes and fruit covers a good part of the daily need. When this intake stays on the low side, a targeted supplement makes sense, in addition to your treatment, never in its place.
Sources
Related molecules
To explore in the « Hormones and contraception » family and its neighbours.
See the whole « Hormones and contraception » family · Back to the atlas
Frequently asked questions
Does desogestrel cause weight gain?
The package leaflet lists weight gain among the reported side effects. The response varies from one person to another. For your own situation, refer to the leaflet and speak to your doctor or pharmacist.
What are the most common side effects of desogestrel?
Among the effects most often reported in the package leaflet are changes to the cycle, acne, mood changes, breast tenderness and nausea. This list is not exhaustive and the intensity varies. Read the full leaflet and ask your doctor or pharmacist for advice.
Does desogestrel cause bleeding or no periods?
Changes in bleeding are common with progestogen-only pills: light spotting between periods, less frequent periods or, in some people, no periods at all. This is described in the package leaflet. If any doubt remains or a pregnancy test is warranted, speak to your doctor or pharmacist.
What should I do if I miss a desogestrel pill?
Desogestrel has a 12-hour window: within it, the package leaflet says to take the missed pill and carry on as normal. After more than 12 hours, extra protection is generally advised for several days. Follow the leaflet precisely and contact your doctor or pharmacist if you have had unprotected sex.
When should I take desogestrel and how effective is it?
The package leaflet recommends taking it once a day at a regular time, with no break between packs, as consistency is what makes it effective. No contraception is 100% effective. For the exact instructions, refer to the leaflet and to your doctor or pharmacist.
Can desogestrel cause or worsen acne?
Acne is one of the effects mentioned in the package leaflet, and how it develops varies from person to person. If it bothers you or persists, speak to your doctor or pharmacist rather than changing how you take it on your own.
What drug interactions does desogestrel have?
Some medicines and products, including enzyme inducers and ulipristal-based emergency contraception, can reduce the effectiveness of desogestrel according to the package leaflet. Tell your doctor or pharmacist about any ongoing treatment, including herbal products such as St John's wort.
Can you take desogestrel during pregnancy or breastfeeding?
Desogestrel is not intended for use in pregnancy, and its use while breastfeeding is a matter for the package leaflet and medical advice. If you suspect you are pregnant or are planning to breastfeed, refer to the leaflet and to your doctor or pharmacist.
Can you drink alcohol while taking desogestrel?
The package leaflet does not describe any direct interaction between alcohol and desogestrel. However, vomiting or diarrhoea can affect how the pill is absorbed. For any question about your own situation, speak to your doctor or pharmacist.
What happens when you stop taking desogestrel?
After stopping, the cycle can take several weeks to settle back into its rhythm and periods may be delayed. If the absence of periods continues, medical advice is recommended to look into the cause. Refer to the package leaflet and to your doctor or pharmacist.
Does oral contraception affect certain nutrients?
A review by Palmery et al. (Eur Rev Med Pharmacol Sci, 2013) links oral contraception to lower folate, vitamin B6 and magnesium status in users. This is an association observed in the literature, not an established cause-and-effect relationship. A blood test, decided on with a healthcare professional, can help take stock.
Which form of folate, vitamin B6 and magnesium should you consider on contraception?
In line with the review by Palmery et al. (2013), the nutrients documented on this angle are folate, vitamin B6 and magnesium. The best-utilised forms are methylated folate (methylfolate), vitamin B6 as pyridoxal-5-phosphate and magnesium bisglycinate. This is the focus of our CO01 reference, to be considered after checking in with your doctor or pharmacist.
Ces réponses portent sur le volet nutritionnel. Pour toute question sur votre médicament, la notice et votre médecin ou pharmacien font foi.