Dr. Mary Claire Haver

So the issue with the progestins though is remember how I told you that progesterone can be metabolized into the mineralocorticoids and glucocorticoids?

Well, progesterone naturally will not target anything but a progesterone receptor, but the progestins will.

Where are they binding?

They're binding the androgen receptor as well, and they're affecting the androgen receptor.

And the androgen receptor is what testosterone binds to.

That's why you get different side effects, because they target the receptors differently.

This is why this is the best topic.

All right, what does disperinone do?

So drosperinone looks very different from most of the common ones.

Remember, it is the one that is approved to prevent acne.

Well, that's because it blocks the androgen receptor very, very well.

And so that's a really specific type.

And so if that's your goal, it's great.

Well, as a sexual medicine expert, it has the worst sexual side effects because it blocks the androgen receptors.

Anything good for your skin is bad for your sex life.

The other ones we talk about a lot are norethindrone and norethindrone acetate.

So the brand name is Agestin for norethindrone acetate.

Norethindrone is actually the mini pill when we talk about the very low-dose progestin-only birth control.

Well, norethindrone metabolizes into ethanol estradiol.

This is a little-known fact.