Not All Progesterones Are Created Equally: Birth Control Pills Differ

There are literally dozens of birth control pills for us in the US to pick from, and we still don't have some that are the top world wide best birth control pill sellers. Most oral contraceptive pills have an estrogen hormone component and a progesterone hormone component. In other posts we have discussed the fact that the dosage of the estrogen may vary, but up until recently all have the identical estrogen (except for one of the combined pills). The progesterone provides most of the contraceptive protection in birth control. Progesterone suppresses ovulation and changes the mucus of the cervix so sperm can't swim through the cervix, nor be stored in the cervical mucus glands. Some of these cervical  mucus effects occur instantly within hours of taking your very first birth control pill, but for full effect, more like a day or two. That is why oral contraceptive pill prescriptions do work promptly! The official stance is that 7 days of consecutive pill use makes you pregnancy protected. But like all hormones, they just aren't created equally. Some are very potent, some are not; some are more androgenic (male like), and some are not. And potency has a lot to do with how much gets absorbed into the blood stream, and how much gets metabolized to less potent hormones after it is swallowed. Like the sounds of natural and bioidentical? And for bioidentical the estrogen would have to be a 17 beta estradiol, and there are not any of these pills currently available. Sadly, the bioidentical progesterones are not well absorbed, and bioidentical progesterone is only about 50% available unlike the progesterone in a pill like Seasonale which is about 99% bioavailable. If the progesterone in your pill is created to be potent, you may significant beneficial hormone effects. So that the progesterone in Seasonale and it's cousins, actually a molecule called levonorgestrel, is very potent for instance in controlling break through bleeding. Other factors control the way the progesterone in your birth control pill will act on your body. What you eat, how your liver functions, what medications you are on, what time you take your medication and the genetics of how your body naturally binds hormones all can also affect this factor of bioavailability. Again, potency may be a very good thing when your birth control pill can be affected by so many factors. So if you are having hormonal side effects from your contraception, it's time to gab with your gyno, maybe the hormone in your pill is not right and your gyno can pick a new pill for you!


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