Drug safety evaluation of desogestrel

Introduction: Desogestrel (DSG) is a third-generation progestin. It is commonly used in various formulations for hormonal contraception including combinations with ethinyl estradiol (EE), progestin-only pill and subdermal implants. DSG is also used in menopausal patients for hormone replacement therapy (HRT). Areas covered: The current manuscript aims to review the available data on safety and tolerability of DSG in oral contraception and HRT. The material included in the manuscript was searched and obtained via Medline, PubMed and EMBASE up to September 2012 using the search terms 'adverse events, side effects, tolerability' in combination with 'desogestrel and progestins'. Expert opinion: DSG is frequently used as contraceptive and it shows good contraceptive efficacy as demonstrated by the Pearl indexes reported in the studies reviewed in this manuscript. It is a versatile compound; in fact, it can be used either as progestin-only contraceptive or in combination with EE, and different formulations are available (such as the subdermal implant). In contraception, DSG is generally well tolerated but its use is associated with doubled risk of venous thromboembolism compared to second-generation progestins. Although DSG is efficacious in HRT, it may not represent the best choice due to the potential higher risk of breast cancer compared with progesterone or dydrogesterone.