A novel estetrol-containing combined oral contraceptive: European expert panel review

Kristina Gemzell-Danielsson, Angelo Cagnacci, Nathalie Chabbert-Buffet, Jonathan Douxfils, Jean-Michel Foidart, Ali Kubba, Luis Ignacio Lete Lasa, Diana Mansour, Joseph Neulen, Jaoquim Neves, Fátima Palma, Thomas Römer, Robert Spaczy Ski, Vera Tóth

Research output: Contribution to journalReview articlepeer-review


PURPOSE: Despite considerable advances in recently developed combined oral contraceptives (COCs), resulting in lower rates of adverse events while maintaining contraceptive efficacy, there is interest in further innovation.

MATERIALS AND METHODS: Estetrol (E4), a native oestrogen, and progestin drospirenone (DRSP) were combined in a new COC. A European expert panel reviewed the pharmacology, efficacy, and safety and tolerability of this combination. Their findings are presented as a narrative review.

RESULTS: E4 15mg/DRSP 3 mg in a 24/4 regimen provided effective contraception with good cycle control, characterised by a predictable regular bleeding pattern and minimal unscheduled bleeding, together with a good safety profile. The combination was associated with high user satisfaction, wellbeing, and minimal changes in body weight. The effects on endocrine and metabolic parameters were limited, and the combination was found to have a limited impact on liver function and lipid and carbohydrate metabolism. Moreover, its effect on several haemostatic parameters was lower than that of comparators containing ethinyl oestradiol (EE) 20mg/DRSP 3 mg and EE 30mg/levonorgestrel 150mg.

CONCLUSION: E4 15 mg/DRSP 3 mg provides safe and effective contraception, with high user satisfaction and predictable bleeding. Further research will evaluate the long-term safety of the COC.

Original languageEnglish
Pages (from-to)440-452
Number of pages13
JournalCeska gynekologie
Issue number6
Early online date21 Jul 2022
Publication statusPublished - 2022


  • Female
  • Humans
  • Contraception/methods
  • Contraceptives, Oral, Combined/adverse effects
  • Estetrol
  • Ethinyl Estradiol/adverse effects


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