The pill is the main method of contraception for French women. Combined oral contraceptives (COCs) called estrogen-progestogen pills or combined pills are the most commonly used. They contain both estrogen and progestin. The most commonly used estrogen is ethinyl estradiol (a derivative of estradiol). It is the type of progestin that determines the generation of the pill. 66 million platelets of combined oral contraceptives (COC), all generations combined, were sold in France in 2011. Note: all 2nd generation pills are reimbursed in 2012, while less than half of those for 3rd generation and none 4th generation is not covered by Health Insurance.
The 1st generation pill
The 1st generation pills, marketed in the 60s, contained a high dosage of estrogen. This hormone was at the origin of many side effects: swelling of the breasts, nausea, migraines, vascular disorders. Only one pill of this type is marketed today in France.. This is the Triella.
2nd generation pills
They have been marketed since 1973. These pills contain levonorgestrel or norgestrel as a progestogen. The use of these hormones made it possible to lower the levels of ethinyl estradiol and thus decrease the side effects of which the women complained. Almost one in two women take a 2nd generation pill among those using combined oral contraceptives (COCs).
3rd and 4th generation pills
New pills appeared in 1984. 3rd generation contraceptives contain different types of progestins: desogestrel, gestodene or norgestimate. The peculiarity of these pills is that they have a lower dosage of estradiol, so as to further limit the inconveniences, such as acne, weight gain, cholesterol. In addition, the researchers had observed that too high a concentration of this hormone could promote the occurrence of venous thrombosis. In 2001, the 4th generation pills were introduced to the market. They contain new progestins (drospirenone, chlormadinone, dienogest, nomégestrol). Studies have recently shown that 3rd and 4th generation pills have twice the risk of thromboembolism as compared to 2nd generation pills.. This time, it is the progestins which are in question. To date, 14 complaints have been filed against laboratories manufacturing 3rd and 4th generation contraceptive pills. Since 2013, 3rd generation contraceptive pills are no longer reimbursed.
Diane’s case 35 The National Agency for the Safety of Health Products (ANSM) has announced the suspension of the marketing authorization (AMM) for Diane 35 and its generics. This hormonal acne treatment was prescribed as a contraceptive. Four deaths “attributable to venous thrombosis” are linked to Diane 35. “ |
Source: Medicines Agency (ANSM)