1, 2, 3, 4 … Different generations of pills are marketed in France depending on the nature of the progestin (s) they contain. Their indications, side effects or risks are not the same.
There contraceptive pill is a way of female contraception intended to avoid pregnancy. It contains hormones, so it is said that it is a hormonal contraception. There are two main categories:
► The pills which contain both an estrogen and a progestogy are called oral contraceptives combined. These are classic pills, the most commonly prescribed. They are classified by “generation” according to their seniority. Also the 3rd generation pills are more recent than those of 2nd generation. What distinguishes them is the nature of the progestin that they contain.
► microdosed pills or also called “microprogestatives” Who contain much (or not at all) estrogens. They are advised to women who have a risk of thrombosis: the smokers, those who make hypertension or diabetes or during the breastfeeding period.
What are the 1st generation pills?
The 1st generation pills appeared in the 1960s, they were strongly dosed in estrogens. Among their side effects include, for example, swelling of breasts, nausea, migraines, vascular disorders. Today, Triella® is the only first generation pill marketed in France.
What are the 2nd generation pills?
2nd generation pills were marketed in the 1970s and 80s. “These pills contain progestins (Norgestrel, Lévonorgestrel). The change in composition has reduced some of the side effects linked to 1st generation pills“Explains Dr. Philippe Mironneau, gynecologist and obstetrician in Dijon. 2nd generation pills (today Minidril®, Adepal®, Trinordiol®) Nevertheless present a risk of venous thrombosis among their side effects.
What are the 3rd generation pills?
The 3rd generation pills appeared in the 1990s, they associated three new synthetic derivatives of progesterone, deogestrel, gestodene and norgestimate. They are supposed Limit side effects Pills from previous generations such as acne, breast pain or nausea for example. But these pills are associated with risks of thromboembolic accident (formation of a clot (thrombus) in a vein, most often at the level of the legs) higher than the second generation pills. The risk of venous thrombosis is detected according to the personal and family history of the patient. It increases when there are family history of venous thrombosis or pulmonary embolism (especially in the first degree related, that is to say parent, brother, sister or child).
What are the 4th generation pills?
The most recent 4th generation pills contain a new progestogen, Drospirenone. Their side effects are close to those of the 3rd generation pills.
Table of pills according to generations
| Pill names |
|---|
| 1st: Triella |
| 2nd: ADEPAL, AMANANCE GE, DAILY GE, EVANECIA GE, Evepar, Leeloo GE, LOVAPHARM, LUDEAL GE, Microval, Minidril, OPTIDRIL, OPTILOVA, PACILIA GE, SEASRIE, STEDIRIL, TRINORDIOL, ZIKIALE GeKIALE |
| 3rd: Antigone, Carlin, Cerazette, Cilet, Clareal GE, Cycleane, Desobel GE, Desopop, Diamilla, Efezial, Effiprev, Felixita, Harmonet, Holgyeme, Meliane, Melodia, Mercilion, Minerva, Minesse, Minulet, Moneva, Optinese, Phaeva, Sylviane, Tiafemi TRIMINOLET, VARNOLINE, |
| 4th: Belanette, Belara, Convuline, Drospibel, Jasmine, Jasmineur, Qlaira, Rimandia, Yaz, Zoely |
Official recommendations
The high health authorized (HAS) has updated its recommendations concerning the contraceptive pill. HAS explains that “The cripprogestatives can be used in adolescent girls with no contraindications (mainly venous or arterial, hepatic, carcinological thromboembolic, etc.) and taking into account the risk factors for thrombosis (in particular personal or family history of venous or arterial thrombosis, known biological thrombophilia, prolonged immobilization, obesity, obesity, obesity, obesity, obesity HTA, diabetes, dyslipidemia, smoking, migraine, etc.)“.
Regarding 3rd generation pills containing deogestrel or gestodene, and 4th generation containing the Drospirenone, the HAS recalls that they “expose to an increased risk of thromboembolic accidents compared to pills containing levonorgestrel; They should not be used as a first intention“. And to conclude:”The other cripprogestatives (including rings and patches) should only be reserved for cases of intolerance for 1st or 2nd generation pills and women for which another type of contraception is not possible“.
Thank you to Dr. Philippe Mironneau, gynecologist and obstetrician in Dijon.
