[Clinical experience with Mercilon and Marvelon with special reference to ovarian function]

Area of Science:

• Endocrinology
• Pharmacology
• Reproductive Health

Background:

• Oral contraceptives (OCs) are widely used for pregnancy prevention and managing gynecological conditions.
• Ethinylestradiol (EE) and desogestrel are common components in combined OCs.
• Different dosages of EE may influence hormonal profiles and cycle control.

Purpose of the Study:

• To compare the effects of two oral contraceptive combinations: Mercilon (0.020 mg EE + 0.150 mg desogestrel) and Marvelon (0.030 mg EE + 0.150 mg desogestrel).
• To assess hormonal profiles (LH, FSH, prolactin, progesterone, estradiol, SHBG) and clinical outcomes (efficacy, cycle control, tolerability).

Main Methods:

• Two independent trials were conducted.
• Trial 1: 71 women, serum hormone levels measured before, during (3rd and 6th cycle), and after treatment.
• Trial 2: 781 women (5193 cycles), assessed efficacy, cycle control, and tolerability at 1st, 3rd, and 12th cycles.

Main Results:

• Mercilon (lower EE dose) resulted in significantly less suppressed FSH compared to Marvelon.
• Estradiol and progesterone levels were suppressed with Mercilon; some users showed extremely high levels.
• Sex hormone-binding globulin (SHBG) increased significantly with both OCs; prolactin and testosterone levels were unaffected. Mercilon had more breakthrough bleedings (7.7%) and body weight changes than Marvelon (3.6%). Marvelon was associated with slightly more breast tenderness.

Conclusions:

• Both Mercilon and Marvelon demonstrate comparable efficacy and tolerability, with minor differences in hormonal suppression and cycle control.
• The lower ethinylestradiol dose in Mercilon leads to less FSH suppression but a higher incidence of breakthrough bleeding and body weight changes.
• Higher ethinylestradiol dose in Marvelon is associated with slightly more breast tenderness but fewer breakthrough bleedings.