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Oestrogen-free oral contraception with a 4 mg drospirenone-only pill: new data and a review of the literature

S. Palacios, PA. Regidor, E. Colli, SO. Skouby, D. Apter, T. Roemer, C. Egarter, RE. Nappi, A. Skřivánek, AJ. Jakimiuk, S. Weyers, N. Ács, D. Elia, K. Gemzell Danielsson, J. Bitzer

. 2020 ; 25 (3) : 221-227. [pub] 20200421

Language English Country Great Britain

Document type Journal Article, Review

Persistent link   https://www.medvik.cz/link/bmc21012518

Purpose: The contraceptive pill is an effective and safe method of preventing pregnancy. The progestins used for contraception either are components of a combined hormonal contraceptive (tablets, patches or vaginal rings) or are used alone in progestin-only formulations. Progestin-only contraceptives are available as daily oral preparations, subcutaneous or intramuscular injectables (every 1-3 months), subdermal implants (every 3-5 years) and intrauterine systems (every 3-5 years). Long-acting progestins are highly effective in typical use and have a very low risk profile and few contraindications.Material and Methods: A new progestin-only, oestrogen-free contraceptive, drospirenone, in a dosage of 4 mg/day in a 24/4 regimen, has received regulatory approval in the USA and the EU. The molecule has antigonadotropic, antimineralocorticoid, antiestrogenic and antiandrogenic properties.Results: The regimen was chosen to improve the bleeding profile; maintain plasma oestradiol levels at those of the early follicular phase, to avoid hypoestrogenism; and preserve efficacy even with a missed pill, as drospirenone has a half-life of 30-34 h.Conclusions: Clinical studies have shown good efficacy, very low cardiovascular side effects and a favourable bleeding pattern, as well as maintenance of ovulation inhibition after scheduled 24 h delays in pill intake.

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