COC third generation with gestodene
Updated · Methodology
First line
Regular contraception. Per SEGO 2023, preferred in patients prone to edema and weight gain on 2nd-gen COCs (gestodene's antimineralocorticoid activity reduces fluid retention). 2019 and MHRA still recommend levonorgestrel first-line due to lower VTE risk. Dose 20–30 µg ethinylestradiol + 75 µg gestodene.
Sources
ICD-10: Z30.0 · ICD-11: QA21
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Gestodene COCs during breastfeeding. MEC 2015 category 4 first 6 weeks, then 2. Gestodene transfers to milk in small amounts, RID about 0.6%. Main issue – estrogen reduces milk supply. Progestin-only preferred while breastfeeding.
Sources
ICD-10: Z30.0 · ICD-11: QA21
Ethinylestradiol + gestodene – a third-generation progestin with antimineralocorticoid and mild antiandrogenic activity. Suppresses ovulation, thickens cervical mucus, thins endometrium. Gestodene shares the elevated VTE risk of desogestrel (9–12 per 10,000 woman-years per MHRA 2014 and MEGA).
Discontinue if pregnant.
Estrogen reduces milk supply. WHO MEC first 6 weeks – category 4. Gestodene RID about 0.6%, Hale L3.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
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Ethinylestradiol + Gestodene is evaluated for the following indications with varying evidence strength: Contraception (evidence tier A), Contraception during breastfeeding (evidence tier D). See the full indication matrix with dosing and citations above on this page.
Common side effects of Ethinylestradiol + Gestodene (≥ 1 in 100): Nausea, Breast tenderness, Spotting, Headache. See the Safety section for uncommon and serious reactions.
Discontinue if pregnant.
Estrogen reduces milk supply. WHO MEC first 6 weeks – category 4. Gestodene RID about 0.6%, Hale L3.
Ethinylestradiol + Gestodene is contraindicated in: History VTE; Thrombophilia; Smoking after 35; Migraine with aura; Uncontrolled HTN. Full list in the Safety section.
Ethinylestradiol + Levonorgestrel, Ethinylestradiol + Norgestimate, Etonogestrel (implant), Follitropin alfa, Levonorgestrel, Progesterone, micronized, Cyproterone acetate, Estradiol