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

Santiago Palacios, Pedro-Antonio Regidor, Enrico Colli, Sven Olaf Skouby, Dan Apter, Thomas Roemer, Christian Egarter, Rossella E Nappi, Aleš Skřivánek, Artur J Jakimiuk, Steven Weyers, Nándor Ács, David Elia, Kristina Gemzell Danielsson, Johannes Bitzer


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.

Original languageEnglish
JournalThe European journal of contraception & reproductive health care : the official journal of the European Society of Contraception
Issue number3
Pages (from-to)221-227
Number of pages7
Publication statusPublished - Jun 2020


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