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Progesterone (P4), sold under the brand name Prometrium among others, is a medication and naturally occurring steroid hormone. [20] It is a progestogen and is used in combination with estrogens mainly in hormone therapy for menopausal symptoms and low sex hormone levels in women.
The FDA first approved the oral contraceptive in 1960. The first oral contraceptive contained 100 to 175 μg of estrogen and 10 mg of progesterone. However, at these levels significant adverse effects were seen and modern preparations contain lower levels of 30 to 50 μg of estrogen and 0.3 to 1 mg of progesterone. [49]
Excess estrogen, such as from birth control pills, appears to increase cholesterol levels in bile and decrease gallbladder movement, which can lead to gallstones. [152] Progestins found in certain formulations of oral contraceptive pills can limit the effectiveness of weight training to increase muscle mass. [ 153 ]
[84] [85] [86] The preceding side effects of synthetic estrogens do not appear to occur in pregnant women, who already have very high estrogen levels. [84] This suggests that these effects are due to estrogenic activity. [84] Synthetic estrogens have markedly stronger effects on the liver and hepatic protein synthesis than natural estrogens.
[1] [81] Contraceptive vaginal rings and contraceptive patches likewise have been found to increase SHBG levels by 2.5-fold and 3.5-fold, respectively. [125] [81] Birth control pills containing high doses of ethinylestradiol (>50 μg) can increase SHBG levels by 5- to 10-fold, which is similar to the increase that occurs during pregnancy. [128]
With bi- and tri-phasic pills, skipping the placebo week results in a sudden change in hormone levels, which may cause irregular spotting or flow. (Monophasic pills offer the same dose of estrogen and progestogen whereas multiphasic pills have varying doses from day to day; see formulations for details.) [citation needed]