Gestodene

Gestodene

Gestodene is a synthetic progestogen used in hormonal contraception. It is a third-generation progestin, which is often combined with estrogens in combined oral contraceptive pills. Gestodene is known for its high progestational activity and low androgenic activity, making it a popular choice in contraceptive formulations.

Chemical Properties

Gestodene is a derivative of 19-nortestosterone, which is a common structural basis for many synthetic progestins. It has the chemical formula C21H26O2 and a molecular weight of 310.43 g/mol. The compound is characterized by its high affinity for the progesterone receptor, which contributes to its effectiveness in preventing ovulation.

Mechanism of Action

Gestodene works primarily by inhibiting ovulation. It achieves this by suppressing the secretion of gonadotropins from the pituitary gland, specifically luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This suppression prevents the mid-cycle surge of LH, which is necessary for ovulation. Additionally, gestodene induces changes in the endometrium that make it less suitable for implantation and thickens the cervical mucus, hindering sperm penetration.

Clinical Use

Gestodene is used in various formulations of combined oral contraceptives. It is often combined with ethinylestradiol, a synthetic estrogen, to enhance contraceptive efficacy. The typical dosage in contraceptive pills ranges from 60 to 75 micrograms of gestodene, combined with 20 to 30 micrograms of ethinylestradiol.

Side Effects

Like other hormonal contraceptives, gestodene-containing pills may cause side effects. Common side effects include nausea, headache, breast tenderness, and mood changes. Rare but serious side effects include an increased risk of venous thromboembolism and myocardial infarction, particularly in smokers and women over 35 years of age.

Advantages

Gestodene is favored for its minimal androgenic effects, which reduces the risk of side effects such as acne and hirsutism. Its high progestational activity allows for lower doses, which can reduce the incidence of side effects associated with higher hormone levels.

Pharmacokinetics

Gestodene is rapidly absorbed after oral administration, with peak plasma concentrations occurring within 1 to 2 hours. It is extensively metabolized in the liver and excreted primarily in the urine. The elimination half-life of gestodene is approximately 12 to 14 hours.

Images

File:Gestodene structure.png

Chemical structure of gestodene

Related Pages

• Progestogen
• Combined oral contraceptive pill
• Ethinylestradiol
• Hormonal contraception