ORAL CONTRACEPTIVES and ANDROGENICITY ---------------------------------------------------------------------------- Does anyone have an updated table or chart comparing the relative androgenicity of the progestins in various oral contraceptives? I am looking for a table that includes the newer oral contraceptives, so I can be authoritative when comparing Orthocept to Demulen, for example. Walter H. Wood, M.D. -------------------- Barbara Reed did an excellent review in Fitzpatrick's Journal Sept/Oct 94 on "The Pill". She listed them in order of less androgenicity to more androgenicity as: Desogen, Ortho-Cept, Ortho-Cyclen, Ortho Tri-Cyclen, Micronor, Nor-Q D, Ovcon-35, Brevicon/Modicon, Ortho Norvum 7/7/7, Ortho Novum 10-11, Tri-Norinyl, Norinyl and Ortho 1/35, Demulen 1/35, Triphasil/Tri-Levien, Nordette, Lo/Ovral, Ovrette, Ovral, Loestrin1/20, Loestrin 1.5/30. She listed these as the best BCP for Acne, Alopecia, and Hirsuitism: Desogen, Ortho-Cept, Ortho-Cyclen, Ortho-Tri-Cyclen, Brevicon, Modicon, Ovcon-35, and Demulen-35. John L. Jennings, Jr., M.D. --------------------------- On this same subject, I have a number of european patients who had been on a BCP called "Diana". This was very effective in controlling their acne and is not available in the US. When they are switched to a US brand, including Demulen, they begin to breakout. Does anyone know the composition of "Diana" and if there is a US equivelent? From: Reviva@aol.com -------------------- According to my New Zealand Schering contact, "Diane 35" is an antiacne oral contraceptive containing the anti-androgen cyprotereone acetate. It's not available in the USA but is in New Zealand, Australia (I suspect) and Europe. I don't know more than that, but I recall reading papers published in BJD, etc about it years ago. Marilynne McKay, MD Professor of Derm & Gyn/Ob Director of Continuing Medical Education Emory University School of Medicine Atlanta GA USA -------------- There was a great table comparing the androgenocity of BC pills in Fitzpatrick's Journal of Clinacal Dermatology Sept/Oct 1994, page 43. It lists the least androgenic as Desogen and Ortho-cept, followed by Ortho-cyclen and Ortho-tri-cyclen. My own opinion (it was omitted from the chart) is that Demulen 1/50 may be the least androgenic. Philip Hughes, M.D. ------------------- In Australia "Diana" is marketed as Diane-ED 35 . This contraceptive contains Cyproterone acetate 2000micrograms and ethinyloestradiol 35mcg. Its indication is contraception in women with refractory acne and or hirsutism. Philip Bekhor MB BS FACD Director Laser Unit Dept. Dermatology Royal Childrens hospital Melbourne Australia ------------------- Diane 35 ED is available in Australia. Composition is cyproterone acetate 2000 mcg, ethinyloestradiol 50 mcg. The main drawbacks are cost ($22 per month cf other BCP's which are subsidised by the govt), relatively slow onset of effect compared to antibiotics, and that is is not available to half of the population! It is useful in females who want a BCP anyway or who have other signs of androgen excess. The effect can be improved by adding cyproterone acetate (10mg to 100mg) for the first 10 to 15 days of the cycle depending on the daily dose. This greatly increases the cost of treatment. Chris Clay ----------- Diane contains cyproterone acetate in combination with ethinyl estradiol I believe. In canada one would use a combination of Androcur 50 mg and Estinyl 0.5 micrograms taken together for 21 days of the cycle with 7 days off. Jason Rivers ------------- To all: An excellent article on the above is "The Pill" by Barbara R. Reed in Fitzpatrick's Journal of Clinical Dermatology Sept/Oct 1994 pages 41-44 Thomas F. Downham II, MD Henry Ford Medical Center Taylor, MI USA -------------- From: KSmithDerm@aol.com Just got back from Mexico yesterday - noticed they were selling Diane BCP at the news stand in my hotel - no Rx. If you live close to the Mexico border I suppose you could tell patients to go over to Mexico to get Diane, but you'd probably have all the liability that would be associated with prescribing BCP [maybe more, because if a pregnant woman took Diane a male fitus could be feminized]. KC Smith MD FRCPC ----------------- It would seem that by combining aldactone with one of the low progestin BCPs containing Desogestrel, an effect comprable to Diane- 35 could be acheived. Has anyone had experience using these combinations? Are there any known contraindications to such therapy? H. Blumenthal, M.D. ------------------- I use Marvelon BCP together with Aldactone 100 - 200 mg QAM with good results for acne and in particular for hirsutism. Lots of pleased ladies. KC Smith MD FRCPC Niagara Falls ON ----------------- ------- 4.17.96