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What is a 4th generation Oral Contraceptive?

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Drospirenone is what is known as a 4th generation progestin, which is an essential component in the newer and most popular oral contraceptives Yaz and Yasmin. Oral contraceptives that contain 4th generation progestins are accordingly referred to as 4th generation as well. That sounds simple enough, but the question is why the distinction?

First of all, progestins are synthetic (man-made) forms of progesterone, the presence of which inhibits ovulation among other physiological effects, which makes it the active ingredient for contraception. Naturally occurring progesterone is poorly absorbed by the body and rapidly degrades. Progestins, on the other hand, are more stable. The first generation of progestins was developed in 1951 and was first approved for use in the US as an oral contraceptive in 1960. These were estranes (steroids) derived from testosterone.

As the science improved, so did progestins. The aim for use in oral contraception is for high progestational selectivity and low androgenic effects. By the 4th generation, progestins not only prevented ovulation, but actually improved skin health and regulated menstrual cycles. As a result of these improvements, oral contraceptives using 4th generation progestins such as drospirenone seemed to be a godsend to all women of childbearing age.

However, with the good came the bad. Some time after Yasmin (2001) and Yaz (2006) were introduced into the market, concerns started to crop up regarding the apparent link between some cases of abnormal rates of blood clotting and drospirenone. Although the number of cases was relatively small, it still prompted the Food and Drug Administration to conduct studies regarding the high risk of blood clotting being attributed to drospirenone. The results of these studies were not conclusive but indicative of a serious problem with the products containing drospirenone.

Today, despite the big numbers being used in personal injury lawsuit against Bayer for using drospirenone in their products, 4th generation oral contraceptives are still widely prescribed and used. And because Bayer refuses to acknowledge that the company knew or should have known about the risks associated with using drospirenone and withheld the information from the public, or to confirm that the health risks are present, anyone who is adversely affected by using Yaz and Yasmin may still be able to sue for compensation.

  1. Good writing as always

  2. You did this piece justice

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