Maturitas, 12 (1990) 171-197
"Norgestimate, which is also a pro-drug, is rapidly and extensively metabolized
after oral intake. Only negligible NGM concentrations of maximally 100 pg/ml
can be measured in serum during the first 4 h after intake [67]. Accordingly, the
metabolites of NGM, in particular levonorgestrel-170-acetate, levonorgestrel-3-
oxime and levonorgestrel, which show different binding affinities to the progesterone
receptor (Fig. 9), must be responsible for the biological effects."
Hum Reprod Update. 1995 May;1(3):231-63.
"Of particular relevance here may be the recent finding that approximately 20% of administered norgestimate is metabolized into levonorgestrel."
Levonorgestrel is a somewhat androgenic progestin. It is derived from testosterone.
Maturitas 46S1 (2003) S7–S16
"Levonorgestrel causes a decrease of SHBG of 50%"
Androgenic substances do this. Less SHBG, higher levels of free T.
BMJ 2011; 342
"Androgenic progestogens like levonorgestrel which has quite powerful
androgenic activity but no oestrogenic activity may cause or exacerbate
acne.5"
Experimental and Clinical Psychopharmacology
2007, Vol. 15, No. 5, 427–444
"The LNG derivatives, such as desoestrel (DSG),
etonogestrel (DSG derivative in Implanon and NuvaRing),
gestodene, norgestimate, and norelgestromine (norgestimate
derivative in Evra), are classified as the third generation of
progestins. The majority of progestins in all three generations
are testosterone-derived and therefore exhibit undesirable
androgenic effects because, despite modification, they
still bind to the androgen receptor (AR)."
Contraception. 1998 Sep;58(3 Suppl):23S-27S; quiz 67S.
"classification of oral contraceptives according to their level of androgenicity. Under such a system, norgestimate, desogestrel, and norethindrone would fall into the low category. (...)while norgestrel, norethindrone acetate, and levonorgestrel would fall into the high androgenicity category."
Overall, this progestin appears to have weak/minimal androgenic activity but I would still be on the lookout for any signs. Why was this prescribed when there are other progestogens with no androgenic activity at all, like progesterone, dydrogesterone and hydroxyprogesterone caproate?
