Desogestrel is a new, potent progestogen with very low androgenic properties. When used as a contraceptive, it is a strong antiovulatory compound, even at low doses. The clinical efficacy is as good as that of the old progestogens. It has a low incidence of side effects and complications, similar to other progestogens. It may have a role as an anti-androgen in women with hyperandrogenic symptoms in need of adequate oral contraception.
PIP: A new generation of progestogens was developed in response to perceived drawbacks of the classic oral progestogens, especially their inherent androgenic effect and concern over the negative effect upon plasma lipids and the possible clinical consequences of the described changes. The new progestogens had to confer the high levels of contraceptive effectiveness achieved with the old oral contraceptives, while maintaining a low incidence of side effects. Desogestrel is one of these new, potent progestogens with very low androgenic properties. It has been used in some countries for more than a decade, but only recently in the US. The author describes desogestrel's chemical composition and metabolism, metabolic effects, biologic activity, availability, and clinical studies on cycle control, contraceptive effectiveness, side effects, anti-androgenic effects, and use in peri-menopause. When used as a contraceptive, desogestrel is a strong antiovulatory compound, even at low doses, with clinical efficacy as good as that of the old progestogens. There is a low incidence of side effects and complications with use of the compound. Moreover, desogestrel may have a role as an anti-androgen in women with hyperandrogenic symptoms in need of adequate oral contraception.