What are the brands of progestin-only (progestogen-only) contraception available?

Available Brands of Progestin-Only Contraception

Progestin-only contraceptive options include oral pills (mini-pills), injectable forms, implants, and intrauterine devices, each with specific brand names and effectiveness profiles. These methods are particularly valuable for women who cannot use estrogen-containing contraceptives.

Progestin-Only Pills (POPs)

Progestin-only pills work primarily by thickening cervical mucus to prevent sperm penetration 1. They require strict adherence to timing, with pills taken at the same time each day (within 3 hours) 2.

• Norethindrone-based pills:

  • Micronor
  • Ovrette 3
  • Generic norethindrone

• Drospirenone-based pills:

  • Fourth-generation progestin with anti-androgenic properties 1

Injectable Progestin Contraceptives

• Medroxyprogesterone acetate (DMPA):
  • Depo-Provera
  • Depo-subQ Provera 104 3
  • Administered every 3 months (13 weeks) 4
  • Highly effective with 0.3% failure rate with both perfect and typical use 4

Progestin-Containing Implants

• Etonogestrel implant:
  • Implanon 3
  • Nexplanon (newer version with radiopaque marker)
  • Lasts up to 3 years

Progestin-Containing Intrauterine Devices (IUDs)

• Levonorgestrel IUD:
  • Mirena 1, 3
  • Kyleena
  • Skyla
  • Liletta
  • Effectiveness rates comparable to sterilization 4

Progestin-Only Emergency Contraception

• Levonorgestrel emergency contraception:
  • Plan B One-Step 1, 3
  • Generic versions
  • More effective than combined emergency contraceptive pills with fewer reported side effects 5

Effectiveness Considerations

The effectiveness of progestin-only contraceptives varies by method:

• Progestin-only pills: 0.5% failure rate with perfect use, higher with typical use due to strict timing requirements 6
• Injectable DMPA: 0.3% failure rate with both perfect and typical use 4
• Implants: 0.05% failure rate 6
• Levonorgestrel IUD: 0.1-0.2% failure rate 6, 4

Clinical Considerations

1. Advantages of progestin-only methods:

   • Safe for women with contraindications to estrogen 2
   • Can be used during breastfeeding 2, 7
   • No increased risk of venous thromboembolism, stroke, or cardiovascular events 2
   • Fewer drug interactions than combined hormonal methods 2

2. Common side effects:

   • Irregular bleeding patterns are the most commonly reported complaint 8
   • Injectable forms may cause weight changes and delayed return to fertility
   • Potential impact on bone mineral density with long-term DMPA use 4

3. Special populations:

   • Ideal for women with hypertension, history of venous thromboembolism, or migraine with aura 2
   • Suitable for breastfeeding women, with no negative effects on milk production or infant development 7
   • May be appropriate for adolescents, though adherence to daily pill timing can be challenging 1

Important Considerations for Patient Selection

When selecting a progestin-only method, consider:

1. Patient's ability to adhere to regimen: Daily pills require strict timing compliance, while long-acting methods like implants and IUDs eliminate daily adherence concerns

2. Desired duration of contraception: Options range from daily pills to methods lasting 3-7 years

3. Bleeding pattern preferences: All methods may cause irregular bleeding, particularly in the first few months of use

4. Medical contraindications: While safer than estrogen-containing methods for many conditions, specific progestins may have individual contraindications

Remember that for sexually active individuals, condoms should be used concurrently with hormonal contraceptives to provide protection against sexually transmitted infections 1.