From the Guidelines
Cerazette (desogestrel) is generally preferred over norethisterone for contraception due to its higher effectiveness at preventing ovulation and more forgiving dosing schedule. The main difference between norethisterone and Cerazette (desogestrel) lies in their contraceptive effectiveness and mechanism of action.
- Cerazette is a single-ingredient progestin pill that contains 75mcg of desogestrel, which is a potent progestin that reliably inhibits ovulation, making it a more effective contraceptive compared to norethisterone 1.
- Norethisterone, on the other hand, is a less potent progestin that may not consistently inhibit ovulation, resulting in a lower contraceptive effectiveness. Some key points to consider when choosing between norethisterone and Cerazette include:
- Contraceptive effectiveness: Cerazette has a higher effectiveness rate (99%) compared to norethisterone (40-50%) due to its ability to reliably inhibit ovulation.
- Dosing schedule: Cerazette has a more forgiving dosing schedule, allowing for a 12-hour window for taking missed pills, whereas norethisterone has a stricter 3-hour window.
- Cycle control: Cerazette is associated with better cycle control, resulting in fewer women experiencing irregular bleeding patterns.
- Side effects: Both medications have similar side effects, including headaches, mood changes, breast tenderness, and acne, although individual responses may vary. It's worth noting that the risk of venous thromboembolism (VTE) is a concern with hormonal contraceptives, and some studies suggest that second-generation progestins like levonorgestrel may have a safer coagulation profile compared to third-generation progestins like desogestrel 1. However, the benefits of Cerazette's high contraceptive effectiveness and forgiving dosing schedule make it a preferred choice for many women, and the risk of VTE can be mitigated by careful patient selection and monitoring.
From the Research
Difference between Norethisterone and Cerazette (Desogestrel)
- Norethisterone is a second-generation progestin, whereas Cerazette (Desogestrel) is a third-generation progestin 2, 3.
- The main difference between the two is their impact on coagulation and venous thromboembolism (VTE) risk. Combined oral contraceptives (COCs) containing desogestrel, like Cerazette, are associated with a higher VTE risk compared to COCs with norethisterone or levonorgestrel 2, 4, 5, 6.
- Progestin-only contraceptives, such as those containing desogestrel, do not significantly increase the risk of VTE, except for depot medroxyprogesterone acetate 4.
- In patients with a history of VTE and/or a known thrombophilic defect, progestagen-only contraceptives like norethisterone can be safely used, whereas COCs are contraindicated 2, 4.
- The risk of thrombotic stroke and myocardial infarction is increased with the use of combined products, with little difference in risk between different progestins, including norethisterone and desogestrel 5.