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Green Gables

Member Since 06 Jun 2011
Offline Last Active Dec 25 2013 10:32 AM

Topics I've Started

Can I Have Acne From Low Progesterone / Estrogen Dominance?

20 December 2013 - 03:07 PM

Now, I'm going to preface this by saying that I have dabbled in progesterone myself (not for acne specifically, but for other health issues), and some of the literature out there for "low progesterone / estrogen dominance" makes sense to me, even though estrogen dominance is not recognized by mainstream medicine.

 

HOWEVER, there is very little scientific evidence out there showing that low progesterone = acne or that high estrogen = acne. Yes, some books and a lot of naturopaths say that it does. Yes, some people have anecdotally experienced clearance of acne from estrogen dominance protocols (and I applaud their success).

 

I've been bamboozled by it all a little myself, until you realize that most of these naturopaths basically claim that progesterone fixes every possible symptom of any health problem you could have.

 

So I'm writing this post to explore what literature is (or isn't) out there that actually supports "low progesterone / estrogen dominance = acne."

 

Basically...what is progesterone? 

 

Progesterone is a precursor in the steroid hormone cascade. It can be converted to testosterone and estrogen as needed, among other things. 

 

 

 

Image171.gif

 

 

 

So, as progesterone is also a precursor to testosterone/estrogen, if your progesterone is too high, progesterone itself can potentially cause testosterone/estrogen hormonal imbalances down the steroid hormone path. 

 

Similarly, though, if progesterone is too low, it can cause a number of deficiency problems because progesterone is needed to complete various pathways. Could possibly a deficiency of progesterone lead to a hormonal imbalance that causes acne? Yes, I suppose it could. However I couldn't find any studies showing that particular outcome.

 

What does progesterone do for the skin?

 

Let's first go through what all the hormones do for the skin. 

 

Estrogen:

  • Thins sebum secretions
  • Reduces size and activity of sebaceous glands 
  • Increases activity of hyaluronidase (related to hyaluronic acid, related to skin moisture content)

 

As far as acne production goes, thinning sebum and reducing sebaceous activity is a HUGE positive.

 

Testosterone:

  • Increase sizes and activity of sebaceous glands
  • Increases rate of cell turnover in the basal layer which thickens the skin around the sebaceous duct

Increasing sebum production is bad when it comes to acne, and so is thickening the skin around the sebaceous duct because it makes a sebum plug -> acne more likely. If you've forgotten how that links together, see this image:

 

 

Acne-pimples.jpg

 

Progesterone

 

Okay, but what does progesterone do? The short answer is that the direct relationship between progesterone and the skin has not been studied much. The skin has progesterone receptors. Their action is mostly unknown.

 

It does seem to have some anti-inflammatory effects on the skin. Not necessarily directly related to acne, but conceivably could have an effect since acne involves inflammation:

 

- Progesterone regulates lipid peroxidation (free radical cell damage) 

- Progesterone regulates lysosomal activity (sort of like garbage disposal for your cells)

 

Again, is that directly related to the sebum plug -> acne chain in the picture? No, but some anti-inflammatory action on the skin could still help.

 

- May temporarily reduce sebum secretion in females

 

There is evidence that anti-androgens may help in the treatment of acne vulgaris. We therefore performed a double-blind trial to assess the effect of topically applied progesterone on sebum excretion rate. Thirty-eight patients took part in the trial which was for 3 months. The preparation had no etfect in males. However, a signiticant reduction in sebum excretion rate was found in females, the etfect being maximal at the end of the second month. There was a significant loss of effect at the end of the third month and this was not related to deterioration of the progesterone preparation.

 

I got bad side effects on anti-androgens like spironolactone or saw palmetto. Does progesterone have anti-androgenic effects?

 

Natural progesterone (and SOME types of synthetic progestins) has a high affinity for 5 alpha reductase, which means that it competes for 5 alpha reductase with testosterone. Why is this a good thing? Because testosterone uses 5 alpha reductase to convert to dihydrotestosterone (DHT) which has been implicated as a potent factor in acne. 

 

I really want to stress this point, because some who use progesterone claim that "reducing androgenic activity doesn't help my acne." BY USING PROGESTERONE you are exerting an anti-androgenic influence on your body!

 

Perhaps progesterone's particular mechanism worked well for you and spironolactone's didn't. But please realize that we are still attacking the same thing here, which is an ANDROGENIC problem -> acne. 

 

Can HIGH progesterone cause acne?

 

We are talking about natural progesterone here. (Many synthetic progestins, have been shown over and over again to have androgenic activity.)

 

- Progesterone can increase sebaceous hyperplasia (at least in rats -- see Haskin's study)

- Progesterone as effective as testosterone in stimulating sebaceous glands (at least in the elderly -- see Smith's study)

- Progesterone CREATED acne in females

 

However, these studies have been countered by other studies (Strauss and Kligman) that say that natural progesterone is largely "sebaceous gland neutral." So the jury is still out on this one.

 

How does progesterone reduce estrogen?

 

PROGESTERONE has long been considered an antagonist of oestrogen action1. The delicate balance and interactions between these ovarian hormones are essential for many reproductive functions. Early studies in chick oviducts and uteri of rats and mice have shown that the simultaneous administration of progesterone and oestrogen resulted in inhibition or modification of oestrogen-induced growth of these target organs2–5. One possible mechanism by which progesterone could be antagonistic to oestrogen is by suppressing the quantity of cytoplasmic oestrogen receptor. It is generally held that the mechanism by which oestrogen, O, stimulates uterine growth depends on the binding of O to cytoplasmic receptors, Rc, to form RCO complexes6. These RCO complexes are translocated to nuclear sites where they probably stimulate nuclear events that cause the uterus to grow7. Translocation and nuclear accumulation of receptor–oestrogen complexes, RnO, are accompanied by a concomitant decrease in the quantity of Rc (ref. 8). During the period when Rc is reduced, the uterus is insensitive to additional exogenous oestrogen9. Gradually Rc is replenished by processes which may involve reutilisation and/or resynthesis8. Work from our laboratory indicates that the mechanism of action of non-steroidal oestrogen antagonists resides in their inability to stimulate the replenishment of the cytoplasmic oestrogen receptor, Rc, thereby rendering oestrogen responsive tissues less sensitive to oestrogen10,11. The possibility that progesterone might also act as an oestrogen antagonist by reducing the amount of oestrogen Rc has been suggested12,13. In this report, we demonstrate that progesterone does decrease the quantity of oestrogen receptors by interfering with the replenishment of Rc and that this decrease results in a reduced sensitivity of uterine tissue to oestrogen.

 

Does high estrogen cause acne?

 

I could not find any studies linking high estrogen levels to acne. If anything, most research indicates that while excessively high estrogen has other side effects (such as weight gain), estrogen overall is extremely beneficial for acne. 

 

 

Does lowering androgenic activity or raising estrogenic activity change the menstrual cycle, via spironolactone? 

 

The reason spironolactone is indicated for messing with the menstrual cycle is, as far as research has shown, because of its PROGESTOGENIC effect. Not to get huffy on this, but people keep stating that "lowering androgenic activity" or "raising estrogen" changes the menstrual cycle, and then point to spironolactone as proof. It is the progestogenic activity that is most likely to blame (citation). Also think: you can have a progestin-only birth control pill. Why? Because progesterone is ultimately what controls the cycle. 

 

Another point here, is that Finasteride, which has been often compared to spiro, is very powerful anti-androgen but does not have progestogenic effects. As such, Finasteride does not interfere with the menstrual cycle (citation). So again, it is not the testosterone or the estrogen that really messes with your periods, it is progesterone. This is also why some doctors recommend cycling spironolactone for patients who are very sensitive to the weak progestogenic effect. 

 

Conclusion

 

So from my (admittedly limited) study...

 

High estrogen does not cause acne.

Low progesterone does not cause acne (at least not directly).

High progesterone can potentially cause acne. 

Progestogenic effects are responsible for major menstrual cycle changes. 

Androgens can cause acne.

Progesterone's anti-acne mechanism is primarily its anti-androgenic action. 

If one is progesterone deficient, progesterone may potentially solve health problems (possibly including acne) via its general ability to create and regulate other hormones. 


"estrogen Dominance" May Be A Histamine Problem

10 December 2013 - 04:18 PM

Histamine and Hormones

Histamine-intolerant women often suffer from the symptoms listed above, especially headaches and menstrual pain, during certain phases of their menstrual cycle. Histamine levels tend to fluctuate with the level of hormones, especially oestrogen, at ovulation and just prior to the onset of menstruation. In contrast, many women with both allergies and histamine intolerance find significant relief of their symptoms during pregnancy; this is because the placenta makes a great deal of DAO, the enzyme that breaks down histamine. The result is that the level of histamine no longer exceeds the woman’s tolerance threshold, and she remains blissfully free from her symptoms throughout her pregnancy. Unfortunately, the symptoms tend to recur once the DAO from the placenta is no longer available after the birth of her child.

 

Pain and Inflammation. A low progesterone to estrogen ratio is associated with increased levels of molecules that cause inflammation. These molecules are called kinins. Estrogen increases kinin levels, and giving progesterone can decrease them. Kinins occur naturally in the body but promote the release of histamines. In conditions of allergic inflammation, kinins are elevated. High levels of kinins are linked to asthma, rheumatoid arthritis, psoriatic arthritis, and a number of bowel diseases.

 

Histamine stimulated a dose-related increase in estradiol secretion with a maximal stimulatory effect at 10(-3) mol/l.

 

To summarize:

- Progesterone promotes myelination, which is one of the pathways the body uses to break down histamine (primary pathways are DAO in the gut and HMT on the cellular level).

- Unopposed estrogen increases histamine overall, which is why some women feel better on progesterone, even if their progesterone is not actually low. 

- Histamine stimulated estrogen secretion. Catch-22? Estrogen increases histamine, increased histamine also increases estrogen...

- Estrogen increases kinins and progesterone decreases them. Kinins promote inflammation. If you have a histamine issue, progesterone may help by decreasing the kinins. 

 

 

I'm not making any blanket statements here. So no one get their panties in a twist if progesterone was your miracle cure. But it's an interesting discussion to get going.

 

Read the full article here. 

 

Other reading:

 

Histamine and histamine intolerance


To Jjjmmmhhh12345

26 November 2013 - 09:43 PM

Green Gables, 

 

I always had clear skin (none of the knocking on wood has helped me apparently). Even as a teenager I only had mild breakouts. I've been taking birth control for about 8 years and now trying to stop. I know, I know, has anyone heard that one before? Anyways, tried last year, succeeded for 6 months, had an emotional breakdown about my acne (" I am the ONLY person in the world with acne at this age" heard that one?) and went back on the pill. Now I am trying again, but this time I decided to do it right. Treat my skin before I went off get it completely clear (on retinoids)  and then stop. Now I stopped and acne is starting its little feast. I spoke to my derm and she prescribed spiro. But I went online and found lots of anecdotal evidence of severe problem when withdrawing from it, in fact, much worse than coming of birth control. People reported having problems not only with acne coming back with a vengeance but also severe hair loss. 

 

Now I have read your other posts and know you are really smart and informed. So I am sincerely wanting to know about your take on it. 

 

Also, I am deciding to stick to more natural methods for as long as I can hang in there (I'm on month three of post BC and last time I made it to month 6). What are your experiences? I had never heard of Saw Palmetto before. I saw you posted that it's for men. Are you familiar with anything of the sort that would be beneficial for women?

 

If you don't mind me asking, are you a man or a women? In all other respects it would not matter, but as we are speaking hormones, I would obviously base myself more closely on your experience if you are woman. smile.png makes sense no?

 

Thanks for the informative post. As you know if you check your msgs I am you huge fan!

 

Retinoids 

 

I actually don't recommend retinoids unless you are already completely clear and are using them for anti-aging effects.

 

Why? Retinoids increase cell turnover and also increase collagen.

 

EXACTLY two of the things that androgens do!

 

When you increase cell turnover and increase collagen at the same time, you basically put thicker skin near follicles. This makes it easier for sebum plugs to form.

 

Retinoids also are an irritant to the skin, a fact that has been documented over and over again, but is glossed over by well-meaning dermatologists. 

 

I have experimented with retinoids when I was clear of acne, but still had some tiny little clogged pores. Guess what happened? Those tiny little clogged pores, barely visible, would become a full-blown zit after a few days on retinoids. I could reproduce this effect over and over again. So if you have ANY clogged pores or tendencies to clogged pores, all you are going to do with retinoids is give yourself worse acne.

 

Spiro

 

Okay, let's just talk about side effects for a minute. There are no guarantees with any treatment, natural or prescription, that you won't get side effects. A treatment that works wonderfully for you may give horrible side effects to your neighbor. There just are no guarantees here.

 

Compared to other medications (like Accutane), spironolactone is relatively mild. You may experience some side effects initially. For MOST people, these side effects completely disappear.

 

These side effects are:

- Spotting during periods

- Shift in your menstrual

- Temporary light hair shedding

- Some lightheadedness (make sure you stay hydrated)

- Increased urination

 

Yes, as with any hormonal treatment that clears your skin, once you stop the treatment the acne will come back. Some people swear the acne is worse when they stop spiro, or stop birth control pills, or whatnot. Sometimes it's true. Sometimes though, we just forget how bad it really was.

 

For someone who never had acne, yeah, sometimes the big change in hormones after BCP is a shock, and you will get worse acne than you did before. Dramatic hormonal fluctuations are generally a bad idea. 

 

Whether or not you want to take spiro is a personal choice. It has worked wonderfully for me and many other women. Really all you can do is weigh your options and make a decision for yourself.

 

Saw Palmetto

 

Saw Palmetto can be used for women as well. For women, I would start out at 620mg a day. Use capsules of extract standardized to 85%+ fatty acids. 

 

I recommend it for men, simply because men can't get a prescription for spiro. But many women have used it to clear acne. 


Topicals For Hormonal Acne

05 November 2013 - 04:31 PM

Alright, I'd just like to put the word out there about topicals that can actually help with hormonal acne.

 

The standard acne topicals, like your Duacs and Epiduos and Benzaclins and ProActives, do not help hormonal acne because they simply don't communicate with hormones. Acne is a long chain of events, and topicals typically attack the END of the chain, which is bacteria and inflammation.

 

Hormones are at the beginning of the chain, and the typical way to address hormones is with a pill or herbal supplement of some sort. 

 

But I want to address this: there are actually topicals that can communicate with hormones. If you get bad side effects from birth control pills or anti-androgen herbs, or if these methods aren't clearing you 100%, there ARE topical options that can help you control your acne.

 

Topical spironolactone cream. This works as an anti-androgen directly on the follicles you apply it to. There is currently no evidence that it is absorbed significantly systemically, so it is safe for males or those who don't respond well to spironolactone pills.

Butyl Avocodate / Avocutine / 5-alpha Avocuta. A 2% cream was able to reduce sebum production by 30% after 3 weeks. Butyl Avocdate is an inhibitor of 5-alpha reductase type 1. It is a patented ingredient and is NOT the same thing as avocado oil. It is OBTAINED from avocado oil through a specific process, but if you just slather avocado oil on your face you won't be getting the active ingredient. 

Lichochalcone. Inhibits 5-alpha reductase.

L-Carnitine. Encourages uptake of fatty acids in the mitochondria, converting them into energy instead of sebum. Topical application can reduce the amount of sebum.

Saw Palmetto. Saw Palmetto capsules are the go-to ingredient for men with hormonal acne. It is also available in some creams.

Vitamin B5. There was a study done showing that vitamin B5, because of its role in CoA metabolism, can keep excess lipids from accumulating in sebaceous glands. Also when your level of vitamin B5 is too low, CoA increases androgen production.

Relatively untested ingredients: The following ingredients were shown in one small study to have beneficial effects, but so far the reliability is very low compared to the ingredients above.

 

Peppermint. Inhibits 5 alpha reductase.

Arnica. Inhibits androgen receptor binding.

  • Look for arnica creams in the pain relief section of any drugstore.

Levels Of Estrogen / Progestin In Birth Control Pills

26 October 2013 - 04:06 PM

Just a for your information post. Also includes what type of progestin is in each pill.

 

If you see a "Phase 1" "Phase 2" in the description, it means that the hormones fluctuate, in biphasic (2 phase) or triphasic (3 phase) cycles.

 

Any description without a phase is a monophasic pill that keeps hormone levels steady throughout the month. 

 

Altavera
-  ethinyl estradiol 30 mcg/levonorgestrel 0.15 mg

Alyacen 1/35
-  ethinyl estradiol 35 mcg/norethindrone 1 mg

Alyacen 7/7/7
-  Phase 1: ethinyl estradiol 35 mcg/norethindrone 0.5 mg. Phase 2: ethinyl estradiol 35 mcg/norethindrone 0.75 mg. Phase 3: ethinyl estradiol 35 mcg/norethindrone 1 mg.

Amethia
-  Phase 1: levonorgestrel 0.15 mg/ethinyl estradiol 30 mcg. Phase 2: ethinyl estradiol 10 mcg

Apri
-  ethinyl estradiol 30 mcg/desogestrel 0.15 mg

Aranelle
-  Phase 1: ethinyl estradiol 35 mcg/norethindrone 0.5 mg. Phase 2: ethinyl estradiol 35 mcg/norethindrone 1 mg. Phase 3: ethinyl estradiol 35 mcg/norethindrone 0.5 mg

Aviane
-  ethinyl estradiol 20 mcg/levonorgestrel 0.1 mg

Azurette
-  Phase 1: desogestrel 0.15 mg/ethinyl estradiol 20 mcg. Phase 2: ethinyl estradiol 10 mcg

Balziva
-  ethinyl estradiol 35 mcg/norethindrone 0.4 mg

Beyaz
-  ethinyl estradiol 20 mcg/drospirenone 3 mg

Brevicon
-  ethinyl estradiol 35 mcg/norethindrone 0.5 mg

Camrese
-  Phase 1: levonorgestrel 0.15 mg/ethinyl estradiol 30 mcg. Phase 2: ethinyl estradiol 10 mcg

Caziant
-  Phase 1: desogestrel 0.1 mg/ethinyl estradiol 25 mcg. Phase 2: desogestrel 0.125 mg/ethinyl estradiol 25 mcg. Phase 3: desogestrel 0.15 mg/ethinyl estradiol 25 mcg

Cesia
-  Phase 1: desogestrel 0.1 mg/ethinyl estradiol 25 mcg. Phase 2: desogestrel 0.125 mg/ethinyl estradiol 25 mcg. Phase 3: desogestrel 0.15 mg/ethinyl estradiol 25 mcg

Cryselle
-  ethinyl estradiol 30 mcg/norgestrel 0.3 mg

Cyclessa
-  Phase 1: desogestrel 0.1 mg/ethinyl estradiol 25 mcg. Phase 2: desogestrel 0.125 mg/ethinyl estradiol 25 mcg. Phase 3: desogestrel 0.15 mg/ethinyl estradiol 25 mcg

Desogen
-  ethinyl estradiol 30 mcg/desogestrel 0.15 mg

Enpresse-28
-  Phase 1: levonorgestrel 0.05 mg/ethinyl estradiol 30 mcg. Phase 2: levonorgestrel 0.075 mg/ethinyl estradiol 40 mcg. Phase 3: levonorgestrel 0.125 mg/ethinyl estradiol 30 mcg

Estrostep Fe
-  Phase 1: norethindrone acetate 1 mg/ethinyl estradiol 20 mcg. Phase 2: norethindrone acetate 1 mg/ethinyl estradiol 30 mcg. Phase 3: norethindrone acetate 1 mg/ethinyl estradiol 35 mcg

Femcon Fe
-  ethinyl estradiol 35 mcg/norethindrone acetate 0.4 mg

Gianvi
-  ethinyl estradiol 20 mcg/drospirenone 3 mg

Jolessa
-  ethinyl estradiol 30 mcg/levonorgestrel 0.15 mg

Junel 1/20
-  ethinyl estradiol 20 mcg/norethindrone acetate 1 mg

Junel 1.5/30
-  ethinyl estradiol 30 mcg/norethindrone acetate 1.5 mg

Junel Fe 1/20
-  ethinyl estradiol 20 mcg/norethindrone acetate 1 mg

Junel Fe 1.5/30
-  ethinyl estradiol 30 mcg/norethindrone acetate 1.5 mg

Kariva
-  Phase 1: ethinyl estradiol 20 mcg/desogestrel 0.15 mg. Phase 2: ethinyl estradiol 10 mcg

Kelnor
-  ethinyl estradiol 35 mcg/ethynodiol diacetate 1 mg

Leena
-  Phase 1: ethinyl estradiol 35 mcg/norethindrone 0.5 mg. Phase 2: ethinyl estradiol 35 mcg/norethindrone 1 mg. Phase 3: ethinyl estradiol 35 mcg/norethindrone 0.5 mg

Lessina
-  ethinyl estradiol 20 mcg/levonorgestrel 0.1 mg

Levora 0.15/30
-  ethinyl estradiol 30 mcg/levonorgestrel 0.15 mg

Lo Loestrin Fe
-  Phase 1: ethinyl estradiol 10 mcg/norethindrone 1 mg. Phase 2: ethinyl estradiol 10 mcg

Loestrin 21 1/20
-  ethinyl estradiol 20 mcg/norethindrone acetate 1 mg

Loestrin 21 1.5/30
-  ethinyl estradiol 30 mcg/norethindrone acetate 1.5 mg

Loestrin 24 Fe
-  ethinyl estradiol 20 mcg/norethindrone acetate 1 mg

Loestrin Fe 1/20
-  ethinyl estradiol 20 mcg/norethindrone acetate 1 mg

Loestrin Fe 1.5/30
-  ethinyl estradiol 30 mcg/norethindrone acetate 1.5 mg

Lo/Ovral
-  ethinyl estradiol 30 mcg/norgestrel 0.3 mg

Loryna
-  ethinyl estradiol 20 mcg/drospirenone 3 mg

LoSeasonique
-  Phase 1: levonorgestrel 0.1 mg/ethinyl estradiol 20 mcg. Phase 2: ethinyl estradiol 10 mcg

Low-Ogestrel
-  ethinyl estradiol 30 mcg/norgestrel 0.3 mg

Lutera
-  ethinyl estradiol 20 mcg/levonorgestrel 0.1 mg

Lybrel
-  ethinyl estradiol 20 mcg/levonorgestrel 90 mcg

Marlissa
-  ethinyl estradiol 30 mcg/levonorgestrel 0.15 mg

Microgestin 1.5/30
-  ethinyl estradiol 30 mcg/norethindrone acetate 1.5 mg

Microgestin 1/20
-  ethinyl estradiol 20 mcg/norethindrone acetate 1 mg

Microgestin Fe 1/20
-  ethinyl estradiol 20 mcg/norethindrone acetate 1 mg

Microgestin Fe 1.5/30
-  ethinyl estradiol 30 mcg/norethindrone acetate 1.5 mg

Mircette
-  Phase 1: desogestrel 0.15 mg/ethinyl estradiol 20 mcg. Phase 2: ethinyl estradiol 10 mcg.

Modicon
-  ethinyl estradiol 35 mcg/norethindrone 0.5 mg

MonoNessa
-  ethinyl estradiol 35 mcg/norgestimate 0.25 mg

Natazia
-  Phase 1: estradiol valerate 3 mg. Phase 2: dienogest 3 mg/estradiol valerate 2 mg. Phase 3: dienogest 3 mg/estradiol valerate 2 mg. Phase 4: estradiol valerate 1 mg

Necon 0.5/35
-  ethinyl estradiol 35 mcg/norethindrone 0.5 mg

Necon 1/35
-  ethinyl estradiol 35 mcg/norethindrone 1 mg

Necon 1/50
-  mestranol 50 mcg/norethindrone 1 mg

Necon 7/7/7
-  Phase 1: ethinyl estradiol 35 mcg/norethindrone 0.5 mg. Phase 2: ethinyl estradiol 35 mcg/norethindrone 0.75 mg. Phase 3: ethinyl estradiol 35 mcg/norethindrone 1 mg

Necon 10/11
-  Phase 1: norethindrone 0.5 mg/ethinyl estradiol 35 mcg. Phase 2: norethindrone 1 mg/ethinyl estradiol 35 mcg.

Nordette-28
-  ethinyl estradiol 30 mcg/levonorgestrel 0.15 mg

Norinyl 1 + 35
-  ethinyl estradiol 35 mcg/norethindrone 1 mg

Norinyl 1 + 50
-  mestranol 50 mcg/norethindrone 1 mg

Nortrel 0.5/35
-  ethinyl estradiol 35 mcg/norethindrone 0.5 mg

Nortrel 1/35
-  ethinyl estradiol 35 mcg/norethindrone 1 mg

Nortrel 7/7/7
-  Phase 1: norethindrone 0.5 mg/ethinyl estradiol 35 mcg. Phase 2: norethindrone 0.75 mg/ethinyl estradiol 35 mcg. Phase 3: norethindrone 1 mg/ethinyl estradiol 35 mcg

Ocella
-  ethinyl estradiol 30 mcg/drospirenone 3 mg

Ogestrel 0.5/50
-  ethinyl estradiol 50 mcg/norgestrel 0.5 mg

Ortho-Cept
-  ethinyl estradiol 30 mcg/desogestrel 0.15 mg

Ortho-Cyclen
-  ethinyl estradiol 35 mcg/norgestimate 0.25 mg

Ortho-Novum 1/35
-  ethinyl estradiol 35 mcg/norethindrone 1 mg

Ortho-Novum 7/7/7
-  Phase 1: norethindrone 0.5 mg/ethinyl estradiol 35 mcg. Phase 2: norethindrone 0.75 mg/ethinyl estradiol 35 mcg. Phase 3: norethindrone 1 mg/ethinyl estradiol 35 mcg.

Ortho Tri-Cyclen
-  Phase 1: norgestimate 0.18 mg/ethinyl estradiol 35 mcg. Phase 2: norgestimate 0.215 mg/ethinyl estradiol 35 mcg. Phase 3: norgestimate 0.25 mg/ethinyl estradiol 35 mcg.

Ortho Tri-Cyclen Lo
-  Phase 1: norgestimate 0.18 mg/ethinyl estradiol 25 mcg. Phase 2: norgestimate 0.215 mg/ethinyl estradiol 25 mcg. Phase 3: norgestimate 0.25 mg/ethinyl estradiol 25 mcg.

Ovcon-35
-  ethinyl estradiol 35 mcg/norethindrone 0.4 mg

Ovcon-50
-  ethinyl estradiol 50 mcg/norethindrone 1 mg

Portia-28
-  ethinyl estradiol 30 mcg/levonorgestrel 0.15 mg

Previfem
-  ethinyl estradiol 35 mcg/norgestimate 0.25 mg

Quasense
-  ethinyl estradiol 30 mcg/levonorgestrel 0.15 mg

Reclipsen
-  ethinyl estradiol 30 mcg/desogestrel 0.15 mg

Safyral
-  ethinyl estradiol 30 mcg/drospirenone 3 mg

Seasonale
-  ethinyl estradiol 30 mcg/levonorgestrel 0.15 mg

Seasonique
-  Phase 1: ethinyl estradiol 30 mcg/levonorgestrel 0.15 mg. Phase 2: ethinyl estradiol 10 mcg

Solia
-  ethinyl estradiol 30 mcg/desogestrel 0.15 mg

Sprintec
-  ethinyl estradiol 35 mcg/norgestimate 0.25 mg

Sronyx
-  ethinyl estradiol 20 mcg/levonorgestrel 0.1 mg

Syeda
-  ethinyl estradiol 30 mcg/drospirenone 3 mg

Tilia Fe
-  Phase 1: norethindrone acetate 1 mg/ethinyl estradiol 20 mcg. Phase 2: norethindrone acetate 1 mg/ethinyl estradiol 30 mcg. Phase 3: norethindrone acetate 1 mg/ethinyl estradiol 35 mcg

Tri-Legest 21
-  Phase 1: norethindrone acetate 1 mg/ethinyl estradiol 20 mcg. Phase 2: norethindrone acetate 1 mg/ethinyl estradiol 30 mcg. Phase 3: norethindrone acetate 1 mg/ethinyl estradiol 35 mcg

Tri-Legest Fe
-  Phase 1: norethindrone acetate 1 mg/ethinyl estradiol 20 mcg. Phase 2: norethindrone acetate 1 mg/ethinyl estradiol 30 mcg. Phase 3: norethindrone acetate 1 mg/ethinyl estradiol 35 mcg

Tri-Norinyl
-  Phase 1: norethindrone 0.5 mg/ethinyl estradiol 35 mcg. Phase 2: norethindrone 1 mg/ethinyl estradiol 35 mcg. Phase 3: norethindrone 0.5 mg/ethinyl estradiol 35 mcg

Tri-Previfem
-  Phase 1: norgestimate 0.18 mg/ethinyl estradiol 35 mcg. Phase 2: norgestimate 0.215 mg/ethinyl estradiol 35 mcg. Phase 3: norgestimate 0.25 mg/ethinyl estradiol 35 mcg

Tri-Sprintec
-  Phase 1: norgestimate 0.18 mg/ethinyl estradiol 35 mcg. Phase 2: norgestimate 0.215 mg/ethinyl estradiol 35 mcg. Phase 3: norgestimate 0.25 mg/ethinyl estradiol 35 mcg

TriNessa
-  Phase 1: norgestimate 0.18 mg/ethinyl estradiol 35 mcg. Phase 2: norgestimate 0.215 mg/ethinyl estradiol 35 mcg. Phase 3: norgestimate 0.25 mg/ethinyl estradiol 35 mcg

Trivora-28
-  Phase 1: levonorgestrel 0.05 mg/ethinyl estradiol 30 mcg. Phase 2: levonorgestrel 0.075 mg/ethinyl estradiol 40 mcg. Phase 3: levonorgestrel 0.125 mg/ethinyl estradiol 30 mcg.

Velivet
-  Phase 1: desogestrel 0.1 mg/ethinyl estradiol 25 mcg. Phase 2: desogestrel 0.125 mg/ethinyl estradiol 25 mcg. Phase 3: desogestrel 0.15 mg/ethinyl estradiol 25 mcg.

Yasmin
-  ethinyl estradiol 30 mcg/drospirenone 3 mg

Yaz
-  ethinyl estradiol 20 mcg/drospirenone 3 mg

Zarah
-  ethinyl estradiol 30 mcg/drospirenone 3 mg

Zenchent
-  ethinyl estradiol 35 mcg/norethindrone 0.4 mg.

Zenchent Fe
-  ethinyl estradiol 35 mcg/norethindrone 0.4 mg

Zeosa
-  ethinyl estradiol 35 mcg/norethindrone 0.4 mg

Zovia 1/35E
-  ethinyl estradiol 35 mcg/ethynodiol diacetate 1 mg

Zovia 1/50E

-  ethinyl estradiol 50 mcg/ethynodiol diacetate 1 mg