Dienogest as contraceptive as an alternative to other progesterone along with oestrogen-Brand names, When What benefits ?

Part I: In minimal endometriosis particular in peri pubertal period dienogest is usually combined with natural oestrogens(not EE) as a contraceptives The idea of prescribing Dienogest containing along with natural oestrogens stems from the fact such drugs will ensure monthly bleeds & possibly assure the adolescent girl or young women with minimal endometriosis , She, therefore will feel that all is well as because she is having monthly bleeds and part alleviation of endometriosis too.. I understand many gynaecologists will purposefully intend to avoid EE (synthetic agent) which is very potent and will exert more harmful effect on the existing pathology (endometriosis.)evonorgestrel is not an very safe component ij COC , IN some cases we like to avoid LNG and seek for some other progesterone as a component of COC. Lets see “How safe is LNG containg COC” -- amongst Indian where most men & women has Liver dysfunction?? WHO medical Eligibility criteria put use of LNG as category 2 risk (not that dangerous) in cases with 1) Non vascular DM 2) DM with nephropathy 3) P/H/O preg Cholestasis (cat 1 risk-no risk)/ past COC related Cholestasis(Cat 2 risk 4) Acute viral hepatitis ! (Not to speak of Chr carriers) -believe me I am quoting from original WHO BOOK, Ed. 2010, ISBN 978 92 4 15388 8) p. 53 5) Valvular heart disease ) Multiple risk factors for arterial CVS disease (!) 7) Controlled HTN with drugs. ) no age bar. 9) Smokers of all ages (!). 10) Obese women 110, kg , DVT on oral anticoagulants (!) & Myomas. Such views have also been expressed by other academic bodies like Clinical Guidance. Contraception for women aged over 40 yrs by UK, Australia and USA separately.

IN these clinical settings I am not very sure whether LNG will be safe or lNG will be a better choice. . Another issue- The compulsion of use of a drug for treating disuse as using dienogest cannot be equated to contraceptive prophylaxis where other options are available .so WE HAVE TO KEEP OUR MIND OPEN. members OPINION as a choice of dienogest as contraceptive