Medical Q&As

Progestogen - second versus third generation?

What is the difference between second generation progestogens and third generation progestogens with regards to the pill?

All “combined oral contraceptive” pills contain two types of hormone, namely oestrogen and progestogen. Combined pills are sub classified on the basis of which type of progestogen they contain hence the terms first, second and third generation progestogens. Second generation pills contain a progestogen called levonorgestrel and third generation pills contain either desogestrel or gestodene. There is no significant difference between second and third generation pills with regard to their effectiveness as contraceptives. The side effect profile of third generation progestogens is marginally better than second generation progestogens and cycle control is also better. However, third generation pills carry a marginally higher risk of blood clots but this marginal increase in risk is balanced by the increased cardioprotective effect of third generation pills.