Triphasic oral contraceptives: review and comparison of various regimens
Open accessAbstract
Objective To review and compare the risk-benefit profile of triphasic oral contraceptives with that of low-dose monophasic oral contraceptives.Design Literature on currently marketed triphasics and monophasics.Patient(s) Healthy women of reproductive age.Main outcome measure(s) Comparison of the rationale for development, composition, mechanism, efficacy, menstrual cycle control, side effects, health benefits, and risk-benefit profile.Result(s) All triphasics contain ethinyl estradiol (0.025-0.040 mg/d) and one of several progestins in doses (0.05-1.0 mg/d) related to their relative potencies, which are substantially lower overall (total dose) than those in monophasics. The triphasics are highly efficacious. In general, menstrual cycle control and side effects are similar in both types, but triphasics containing the newer progestins (desogestrel, gestodene, and norgestimate) have better cycle control and a reduced incidence of androgenic side effects compared with those with norethindrone or levonorgestrel. Both triphasics and monophasics have minimal effects on carbohydrate and lipid metabolism and hemostasis parameters, and therefore comparable low risks of coronary heart disease. The health benefits of triphasics and monophasics are similar and include decreased incidence of unwanted and ectopic pregnancies, ovarian cysts, endometrial and ovarian cancers, benign breast disease, and acute pelvic inflammatory disease; less menstrual blood loss and iron deficiency anemia; and lower frequency of irregular bleeding and menorrhagia.Conclusion(s) The risk-benefit profiles of both triphasics and monophasics are favorable and similar.
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Newer progestins have selectivity ratios for the progesterone receptor seven to eight times higher than those of older progestins.
“Progestins also differ in their selectivity for the progesterone receptor, with newer progestins having selectivity ratios seven to eight times higher than those of older progestins [54].”
From Temperature regulation in women: Effects of the menstrual cycle (2020) · cites this paper as [54]
New oral contraceptive formulations contain less than 20% of the earliest preparations.
“New oral contraceptive formulations have been developed to contain the minimum steroid doses necessary to inhibit ovulation, and current formulations contain less than 20% of the earliest preparations [54].”
From Temperature regulation in women: Effects of the menstrual cycle (2020) · cites this paper as [54]
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- Authors
- Cedars, M. I.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- Cedars, Marcelle I
- ORCID
- Cedars, Marcelle I
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2002-01
- Volume
- 77
- Issue
- 1
- Pages
- 1-14
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2071155073
- Cited by
- 34
- References
- 71
- Citations by year
- 2025: 2 · 2023: 1 · 2022: 1 · 2020: 2 · 2019: 1 · 2018: 3 · 2016: 1 · 2014: 1
- FWCI
- 3.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Social Sciences › Political Science and International Relations › International Human Rights and Reproductive Law
- Keywords
- triphasic oral contraceptives, monophasic oral contraceptives, ethinyl estradiol, progestins, desogestrel, gestodene, norgestimate, norethisterone, levonorgestrel, menstrual cycle regulation, androgenic side effects, coronary heart disease risk, contraceptive efficacy, ovarian cancer prevention, endometrial cancer prevention, benign breast disease, pelvic inflammatory disease, iron deficiency anemia, risk-benefit profile
- MeSH terms
- Contraceptives, Oral, Combined, Drug Administration Schedule, Female, Humans, Menstrual Cycle, Reproduction
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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