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In the last few decades contraceptives have become well established in Western societies. Especially women benefit from birth control since the ability to plan pregnancies has high implications on a woman’s way of life. In that way it is no wonder that many contraceptive methods are focused on females by (roughly) either killing sperm on their way to the ovum, preventing ovulation or preventing nidation after conception.

According to a recent study hormonal contraceptives are among the most popular contraceptive methods in the USA with the contraceptive pill being the most important contraceptive method (Jones, Mosher, & Daniels, 2012). The important active components of combination oral contraceptive pills are estrogens and progestins whereby estrogens primarily regulate menstruation and prevent ovulation to some degree (Graefe, Lutz, & Bönisch, 2011, p. 397). Progestins (which are synthetic analogs of progestogens like progesterone) are the most important components of the pill because they prevent nidation by altering the viscosity of the endometrium (Graefe et al., 2011, p. 397). Drospirenone, levonorgestrel, norethindrone, medroxyprogesterone and megestrol are progestins that are frequently used for medical purposes (Vulliet, Wiest, Baudot, & Grenier-Loustalot). Usually, combination pills contain up to 0.1 mg of progestin (http://www.gpnotebook.co.uk/simplepage.cfm?ID=275447832&linkID=25044&cook=no).

After the progestin has made its way through the female body it is excreted and is piped (together with the sewage water) to a sewage treatment plant (STW). Unfortunately, due to their chemical properties (like hydrophobicity) and overloading the capacity of STWs progestins are still present in the treated effluent of the STWs i.e. in the purified water that enters the water cycle again (Kolodziej, Gray, & Sedlak, 2003). The progestin concentrations in the water of receiving rivers can vary immensly between different rivers of course. For example, Kuster et al. (2008) found a maximum of 1.39 ng/L progesterone in a river near Barcelona, Spain. Kolodziej et al. (2003) have measured up to14.9 ng/L medroxyprogesterone in STW effluent with median values at 0.3 ng/L somewhere in the USA. In a river near Budapest, Hungary, Tölgyesi, Verebey, Sharma, Kovacsics, and Fekete (2010) found up to 0.37 ng/L progesterone. Vulliet et al. (2008) tested samples from rivers in the area of Rhône-Alpes, France, and measured up to 2.8 ng/L norethindrone, a maximum of 7.0 ng/L levonorgestrel and up to 3.5 ng/L progesterone in surface waters. Kolpin et al. (2002) surveyed surface waters at 139 locations across 30 states in the USA and measured a maximum progesterone concentration of 199 ng/L. Progestins seem to be stable for up to one week once they are discharged to surface waters (Kolodziej et al., 2003).
We do not have any surface water progestin concentrations for Asia, Africa, South America or Australia but we can conclude that progestin is present in surface waters all across Europe and North America.

References

GRAEFE, K.-H., LUTZ, W. & BÖNISCH, H. 2011. Duale Reihe Pharmakologie und Toxikologie, Stuttgart, Georg Thieme Verlag.

JONES, J., MOSHER, W. & DANIELS, K. 2012. Current Contraceptive Use in the United States, 2006-2010, and Changes in Patterns of Use Since 1995. National Health Statistics Report, 60