Desogestrel+ethinylestradiol versus levonorgestrel +ethinylestradiol: Which one has better affect on acne, hirsutism, and weight change

To compare complications of third and second generation oral contraceptive pills (OCPs). In a randomized clinical trial from October 2007 to October 2008, 100 healthy women of reproductive age referred to Amir Hospital Family Planning Clinic and some heath centers in Semnan, Iran were randomized in 2 equal groups. They received either a third generation OCP (150 microgram desogestrel [DSG] + 30 microgram ethinylestradiol [EE]) or a second generation type (150 microgram levonorgestrel [LNG] + 30 microgram EE). Six months later, changes of weight, acne, and hirsutism severity, as well as serum titers of sex hormone-binding globulin (SHBG) and free testosterone were compared between the 2 groups. Forty-five women were evaluated in the DSG+EE OCP group, and 46 women in the LNG+EE OCP group. The BMI was significantly higher in the second group (p=0.000) after 6 months duration. Likewise, the decrement of acne and hirsutism severity was significantly higher in the DSG+EE users (p=0.000). Mean changes of serum free testosterone (p=0.967) and SHBG (p=0.916) were comparable between the 2 groups. In comparison with the LNG+EE OCP, the DSG+EE OCP is a contraceptive pill that significantly decreases the severity of acne and hirsutism, without any significant change in weight.